Lasers are also used to send bursts of concentrated light into the vein, collapsing it. When the laser hits the skin, there is a tinge of discomfort, but the doctor quickly cools the skin off. Another, even newer technique is called foam sclerotherapy, Weiss explains. An agent, such as a detergent or emulsifier, is agitated with air, forming foam the consistency of watery shaving cream (a little air in veins is acceptable, unlike Hollywood would have you believe). The foam is then injected into the problematic vein, gradually causing the walls to swell and stick together, blocking off the vein. The deeper venous systems take over the blood flow.
Tsao, however, says she would prefer use of foam sclerotherapy for spider veins. Varicose veins she said are larger bore vessels and require more aggressive therapy.
Another, older, but still often used technique, is called ambulatory phlebectomy, in which the vein is extracted with a crochet-hook-like device. And it's quick. Once it's out, there's no waiting for the vein to re-absorb. "Some people still prefer this to waiting," Weiss says.
As for the varicose veins returning, yes, there is a chance. "If you have the genetic susceptibility, smaller ones could form," Weiss says. "You should be relatively disease-free, though." And you can always do another procedure.
Can Holistic Remedies Help?
Where grandmother probably took a trip to the doctor and mother a trip to the medicine cabinet, younger sufferers now want to hit the health food store. Molly Kimball, RD, sports nutritionist at the Ochsner Clinic's Elmwood Center in New Orleans, recommends a diet low in carbs and rich in fiber to keep weight down and all circulatory systems going strong.
A 100 mg coenzyme Q10 helps with circulation and tissue oxygenation, she says. Omega-3 oils (1,000 mg daily) help with elasticity of blood vessels. Also much touted for varicose veins are ginkgo biloba and vitamin K. "You can start at 60 mg twice daily and go to 120 mg twice daily on ginkgo," Kimball says. Tsao and Weiss are both doubtful about ginkgo, however. "There have been no formal studies of the effects on varicose veins," Tsao says. And if you have normal levels of vitamin K, you don't need more, she adds.