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Most Efficient Procedure Available to Treat Varicose Veins?

I'm 18 and i have varicose veins on my legs (both lower legs and thighs). They are noticeble and green. I'm not overweight and i exercise daily so i think this is genetic. I know i have to have a consultation with a specialized surgeon for this problem but i'd like to know which are the most efficient treatments available and their advantages and disadvantages.

Doctor Answers (9)

Closure procedure.

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Varicose veins are due to leaking(refluxing) valves usually of the saphenous vein system.  The gold standard of varicose vein treatment is first doing a venous reflux ultrasound exam to both establish the diagnosis and to  help to formulate the treatment plan.  Once this is done the leaking valves can be sealed(closed) with either a laser or radiofrequency catheter. This is done under local anesthesia.  The term is called tumescent anesthesia.  Following closure of the valves, the varicose veins can then be removed with either sclerotherapy or small micro incisions. There are very few disadvantages to closure procedures since it is an office procedure done under local anesthesia.  The advantages are minimal down time and quick return to normal activities and cosmetically very acceptable.


Naples General Surgeon
5.0 out of 5 stars 2 reviews

Most Efficient Procedures Treatments for Leg Varicose Veins

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Yes, you should have a consultation with a vein specialist, and I would recommend a board-certified vascular surgeons as they have the appropriate training to provide you with the most advanced treatment options.  Not all vein clinics and vein doctors are created equal, so do your homework when selecting a vein doctor.

In terms of the "most efficient" treatment, most likely this will involve more than one procedure.  Usually the underlying causative vein (the source vein) is treated with laser (EVLT or endovenous laser therapy) or radiofrequency energy (VNUS Closure or Venefit Procedure).  If you are not a candidate for this particular procedure (about 20% of patients are not due to anatomical factors) then likely the underlying vein would be treated with ultrasound-guided foam sclerotherapy or phlebectomy (surgical vein removal).  In terms of the branch veins at the surface that have grown off of the source vein / trunk vein, they are usually treated with either sclerotherapy or micro-phlebectomy.

The advantages of the laser or radiofrequency procedure over surgery (phlebectomy or stripping) is that is is minimally invasive, does not require incisions,  is associated with very little discomfort and little down time, and has a very low complication rate.  There are not many downsides to the EVLT or VNUS procedure. 

The advantages of sclerotherapy is that it does not require any incisions, it is minimally invasive, and is associated with little discomfort and little downtime.  The disadvantage is that is may take some time (weeks to months) for the veins to disappear / fade away after the treatments.  There is also a small risk of reactions to the injected drug.

Surgery (phlebectomy or stripping) has the advantage of getting rid of the veins immediately, but has the disadvantage of being a more invasive procedure that requires incisions (i.e. will lead to some scars), often requires anesthesia, has risk of nerve injury that can lead to numbness or chronic pain, and has more associated pain with longer recovery times.

Ther are many different factors to consider when deciding on a treatment plan.  The best recommendation that I can give you is to seek out the opinion of a local board-certified vascular surgeons that specializes in vein treatments.  Just because a clinic advertises that they do vein treatments does not mean that they have the appropriate training and experience to provide you with the best possible vein care . . . Do Your Homework on the doctors available in your area before choosing one.

Joel Gotvald, MD, FACS
Austin General Surgeon
5.0 out of 5 stars 1 review

Vein Treatment

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All the advantages and disadvantages will vary with each person and their unique problems.  Sclerotherapy7, laser, and endovenous therapy can all be effective given a specific condition and patient.  See a Vascular Surgeon (board certified) first.

Vivek Bansal, MD
Danville Plastic Surgeon
5.0 out of 5 stars 9 reviews

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Treatment of leg veins

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If they are large--see a vascular surgeon. Do not go to one of these "vein clinics" on the side of the road. For superficial veins, I love sclerotherapy MUCH better than laser. It takes longer and less money on physician part, but I believe this works much better! You also have to play an active part in the process. I am very good at doing what I do, but I HIGHLY recommend patients invest in GOOD support hose to wear 3-4 weeks after the procedure.

Tracy Kuykendall, MD
Tulsa Dermatologist
5.0 out of 5 stars 1 review

Efficient treatments include laser and radiofrequency, and correct diagnosis

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Varicose veins are almost never formed in isolation; there is most often, a deeper, larger, vein that is "incompetent" that connects to the superficial, visible varicose vein.  This incompetent vein is usually the greater or lesser saphenous vein with valves that are not functioning normally.   These root cause veins typically give rise to the varicose veins seen on the surface, and thus, to treat the varicose most effectively, the incompetent saphenous vein needs to be diagnosed first with a duplex ultrasound.  Once identified, the vein can be treated with laser or radiofrequency (EVLT or VNUS), and the microphlebectomies performed at the same time to remove the varicose veins.  This can most often be performed under local anesthesia under 1 hr with the patient able to walk right away.    

These treatments are highly efficient and effective and far less problematic than the old "vein stripping" techniques of the past.

Charles K. Lee, MD
San Francisco Plastic Surgeon
5.0 out of 5 stars 4 reviews

Treatment options for large vessels

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Greetings to you in Belgium~

As you already know, the best decisions can be made and the best advice given once you have been seen in person.  There are many options available ranging from surgery (removing the vein), to closing the vein with laser, radio-frequency or a sclerosing solution. There are always the risks of bruising, swelling, scarring, blistering or ulceration, discoloration of the skin, or dvt.   Often, especially in young patients, sclerotherapy and laser treatments to close down the vessel work well.

Hope this helps.

Take care,

Dr. Grant Stevens      

Grant Stevens, MD
Los Angeles Plastic Surgeon
4.5 out of 5 stars 65 reviews

Treating Varicose Veins

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Based on your description, I would recommend a consultation with a vascular surgeon as your first step. Superficial veins like spider veins over the legs may be treated with either vein injections or laser. The best ttreatment for you would have to be decided by having an in-person consultation with someone who can see the appearance of your skin and take other pertinent factors into consideration. I would recommend at least two opinions of your condition and best treatment options.

Deason Dunagan, MD
Huntsville Plastic Surgeon
5.0 out of 5 stars 4 reviews

Varicose vein treatment

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Most efficient with least downtime are vnus and evlt. Types of laser and rfa therapy to veins. All vein procedures can cause dvts or skin discolration but this is rare. Check out vein-cure.com for further info.

Timothy Mountcastle, MD
Ashburn General Surgeon
4.5 out of 5 stars 19 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.