What is the most effective way to get rid of varicose veins?

For varicose veins, we typically recommend a safe, minimally invasive procedure called Sclerotherapy. A salt solution is injected directly into each vein, causing them to collapse and ultimately disappear. For long-term improvement, we often complement Sclerotherapy with IPL (Intense Pulsed Light) photofacial and the Excel V laser, which treats both superficial and deep vascular conditions on all skin types. I suggest seeing an expert for a formal evaluation to determine if this is the best solution for you. Best, Dr. Emer

Varicose vein treatments must begin with a careful vein mapping and sometimes an ultrasound to determine the source of the problem. I perform EVLT, VNUS, sclerotherapy, injections, and microphlebectomy for varicose veins and tailor to each patient in my LA office. 

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.   To simply treat the varicose veins with sclero/laser without treating the root cause will lead to multiple recurrences and failed treatments.   Make sure your physician is using the most cutting edge technologies to effectively treat your veins; the state of the art has moved beyond "vein stripping" and "sclerotherapy."

There are many treatments for varicose veins. Go to a dermatologic surgeon who has the ability to treat the unwanted vein with sclerotherapy, ambulatory phlebectomy or intravascular lasers. A surgeon who has the ability to perform all of these treatments is best able to choose the treatment that works best for your veins.

The most effective procedure to treat varicose veins is endovenous laser ablation this can be performed with either EVLT or the cool touch laser. This non-invasive technique is used to stop any blood from entering the vein. The is performed through the small incision just below the knee. Tumescence fluid which is a local anesthetic solution is injected around the vein to compress the vein and keep it away form the skin. The laser is then used to close the vein.

The most effective procedure to treat varicose veins is endovenous laser ablation EVLT. This non-invasive technique is used to close a vein with laser catheter, therefore stopping any blood from entering the vein. Laser ablation is an ultrasound guided procedure. The vein is accessed just below the knee through the small incision and the catheter is threaded up the vein to the groin region. Once the laser catheter is in place, the tumescence--a local anesthetic solution is injected around the vein. Once injected, the laser is activated applying heat to the wall of the vein sealing it shut. The role of the tumescence is to compress the vein and keep it away form the skin. Once the vein has been closed, the procedure called microphlebectomy can take place.
Microphlebectomy is a technique to remove the visible large varicose veins. It requires making small incisions along the vein and removing small segments of it. Some pain and discomfort is expected right after the procedure, but the recovery time is quick and results long-lasting.

Thank you for the question! In my practice, I offer sclerotherapy, endovenous laser ablation, Clariven treatment, and microphlebectomy to treat varicose and spider veins. It's not a matter of one treatment being better than the other. Rather, the choice of treatment will depend on a size and location of your veins.  
In recent years, endovenous laser ablation (EVLA) has replaced traditional surgical method of treating varicose veins. This procedure uses laser to heat the veins instead of surgically removing them. The heat produces a steam bubble inside the vein, which destroys the vein walls, causing the affected vein to collapse. The body, in turn, naturally absorbs the dead tissue. 
Sclerotherapy tends to be one of the most popular and widely-used treatments these days. It uses a sclerosing solution that causes the vein to shrink. Usually, sclerotherapy takes only 1 to 2 sessions to achieve fading of the undesirable veins.  
Microphlebectomy is ideally suited to treat superficial bulging veins that are too large for sclerotherapy.  In the course of this treatment, I will make tiny incisions as small as 1mm to remove an undesirable vein.  He will then insert a small phlebectomy hook to extract the vein through the puncture.  Only a small section of the vein needs to be eliminated because the remaining portion of the vein will clot off and gradually fade from view. 
Clarivein is a minimally-invasive procedure that utilizes a thin infusion catheter clinically proven to deliver faster results and guarantee up to 74% less pain than most other peripheral vascular treatments. 
An in-person exam with a board-certified plastic surgeon would the best way to assess your needs and decide on the appropriate treatment option. Best of luck!

We can treat these veins with one, or a mix, of these treatments—based on what’s right for your particular veins:Sclerotherapy: inject a liquid solution directly into the vein. The solution irritates the lining of the veins, causing them to seal shut. This stops the flow of blood, forcing blood to be rerouted to healthier veins. The result: the vein is reabsorbed into the body and fades within several weeks.Typically 10 to 40 veins can be treated in one session and sometimes the same vein needs to be treated more than once to get long-term results. Follow-up sessions are required to treat additional veins.Laser treatment: A laser beam is targeted at the blood vessel and the heat from the laser coagulates the blood inside, causing it to collapse and seal up—without damaging nearby skin, vessels, or tissue. Over several weeks, the vein will shrink and disappear. One to five sessions, spaced four weeks apart, is typically required.

Varicose veins are  large rope-like veins that are commonly seen in legs.  These are usually the result of malfunctioning valves (reflux) present in the saphenous system.  Think of your veins like a tree with the saphenous vein being the trunk and the varicose veins the branches.  The best treatment for varicose veins are tiny 2mm microincisions called microphlebectomy done under local anesthesia.  However, before removing these veins it would be wise to obtain a venous reflux exam to look at the valves in the saphenous system.  If  these valves are leaking then they should be corrected first usually with a laser or radio frequency catheter.  If the valves are not treated, then there is a high recurrence rate of the varicose veins.

Varicose veins of the legs are best treated by a board certified vascular surgeon, who is the recognized expert in treatment of blood vessel diseases of the veins.  There are many treatments for varicose veins, and the most appropriate or "best" treatment will depend on the anatomy of your leg veins.  Almost everyone with varicose veins has a defective "feeder" or "trunk" vein beneath the visible varicose veins that can be seen at the surface.  Imaging the veins in your legs like trees . . . they have trunks and branches.  Varicose veins that you see at the surface are the branches.  But there is also a defective "trunk" beneath the surface that also needs to be treated in order to get a good result and cure your problem. 

In the past, surgical stripping and phlebectomy (vein removal through incisions in the skin) were the main treatments offered.  With new technology, such as laser fibers and radiofrequency fibers, now most patients with varicose veins can be treated and cured with these less invasive options that do not require surgical incisions.  The most common procedures used to treat varicose vein problems are listed below:

1) EVLT, which stands for EndoVenous Laser Ablation.  This is a laser procedure that utilizes ultrasound guidance . . . no incisions are required.

2)VNUS, which is also known as the Venefit Procedure.  This is a procedure that utilizes a special radiofrequency cather to close the abnormal veins, and it is done under ultrasound guidance.  No incisions are required.

3)Ultrasound-guided foam sclerotherapy, which utilizes a chemical foam (shaving cream consistency) that is injected into the abnormal veins under ultrasound guidance, destroying the varicose veins from the inside

4)Ambulatory phlebectomy.  This is a outpatient surgical procedure in which small incisions are made on the skin overlying the veins, and the veins are removed through the incisions.  This is a more invasive procedure that is reserved for larger varicose veins

5)Vein stripping.  This is an old-school procedure that is rarely done anymore, as there are bettter less invasive options for most patients.  There are certain unusual circumstances, such as unusual venous anatomy or extremely large veins, where this procedure is still the best option.

 

It is not unusual to need a combination of the above treatments  in order to get rid of all the abnormal varicose veins.

 

Since many doctors, such as most dermatologists and plastic surgeons, do not have formal university training to do many of the above procedures, the most qualified physician to do varicose vein treatment is a board-certified vascular / vein surgeon.  Vascular surgeons are trained to perform all of these procedures and are best qualified to offer you appropriate workup and treatment.  Remember, you never want to just treat the surface veins that you see . . . you always want to treat the underlying causative vein as well or else you will get poor results and quick recurrence of your vein disease.