Is laser vein ablation necessary if you have no symptoms? (Photo)

I had a few vericose and spider veins that prompted me to see a vein doctor. I had sclerotherapy two days ago and a mapping. That showed I had reflux and needed the safferus vein in each leg treated. I'm a healthy active 32 year old with no pain or issues with my legs. My doctor is pressuring me telling me this can't be put off. Is it really necessary to do it asap? Or can I wait till I have pain later down the road? I don't want to cause myself pain when I'm currently fine. Thank you!!

Doctor Answers 5

Laser vein ablation: is it necessary

Reflux of veins with symptoms should be treated. Veins that have no symptoms--pain, swelling, ulceration, may not need to be treated surgically. Many patients choose to manage minor reflux with support hose and exercise.

Hope this helps!
Dr. Bader

Boca Raton Dermatologic Surgeon
5.0 out of 5 stars 3 reviews

See a vein specialist.

Many people have some types of veins in their legs and many people have reflux that is asymptomatic.  Not all veins or all reflux needs to be treated.  Symptomatic veins with reflux should be treated.  There are also medical ways to manage minor veins such as support hose and exercise.  See a vein specialist for a full venous evaluation.

John Landi, MD
Naples General Surgeon
5.0 out of 5 stars 5 reviews

Venous Insufficiency procedures not recommended if you have no symptoms

Thank you for your question.

Venous insufficiency procedures should be done for symptoms.

If you don't have symptoms, don't have ablations done - VNUS Closure, EVLT laser ablation, ClariVein, VenaSeal or Varithena .... 

Symptoms for venous insufficiency should be for 1 or more of these 11 listed - aching and pain in the legs, heaviness of the legs, tired legs, itching or burning near clusters of veins, cramping and throbbing legs, restless legs and finally swelling (ankles, legs). 

Most patients have symptoms and varicose veins, reticular veins and spider veins.

I would wait to have endovenous ablation procedures until you have symptpms. 

There is a small risk of getting a blood clot and if you were to be that unlucky person, you may have to remain on blood thinners for life. It would imply that a person with NO symptoms now has to be on blood thinners. 

You wouldn't sign up for coronary artery bypass surgery or coronary artery stenting if you had minimal coronary artery disease, would you ?

You wouldn't have a breast biopsy if the mammogram showed a completely benign lesion, would you ?

Read my books about venous insufficiency.

I have done over 25,000 ablation procedures and I recommend for you not to have ablations and for the doctor to follow you once a year and to perform the laser procedures IF and WHEN symptoms develop. 

My ebooks are free access on the link below. 

Hratch Karamanoukian, MD, FACS
Buffalo Phlebologist
4.8 out of 5 stars 41 reviews

Annual venous ultrasounds are recommended

If a patient is completely asymptomatic and not having any swelling, skin changes or impending ulcers, it is safe to just watch the patient with annual ultrasounds.  In my experience though, many patients are not aware of the symptoms of venous reflux disease.  They may not realize that they actually do have some symptoms (ex: restless legs, night cramps)  which they don't attribute to vein disease.

Lisa Perez, MD
Atlanta Physician
5.0 out of 5 stars 2 reviews

Wait for Treatment

Asymptomatic veins should not be treated. You will also find that your insurance company will not cover the treatment of venous reflux unless you have symptoms. Over time, you may develop symptoms that begin to affect your life and then insurance will cover treatment. You should make sure to maintain a good weight and exercise. walking is one of the best exercises for your vein health.

Lornell E. Hansen II, MD
Sioux Falls Phlebologist
5.0 out of 5 stars 1 review

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.