Varicose veins occur in varying degrees in their appearance and severity of symptoms, largely dependent, on the size of the vein affected. Different levels of treatment are available to meet the individual needs of each patient.
The first line of attack against any type of varicose vein disease is to make lifestyle changes: maintain a healthy weight, exercise (especially walking or running), elevate legs while resting, and wear elastic support stockings.
Spider veins are the smallest and least symptomatic type of varicose vein, so called because of the thin, web-like appearance of the veins.
Spider veins may occur on the face as well as on the legs but are not raised or bumpy as are larger varicose veins. Spider veins can be treated with sclerotherapy or laser treatment.
Sclerotherapy is a simple procedure-a solution is injected into the vein and causes the vein walls to swell and stick together, eventually closing shut. In a short time, the vein turns to scar tissue and is no longer visible. Sclerotherapy requires no anesthesia, is performed in a doctor's office, and has few adverse effects. However, recurrence is common-some veins may require several treatments to eliminate them, and the procedure cannot prevent spider veins from cropping up in new places.
Laser treatment for spider veins is also relatively painless and easy, performed in the office without anesthesia. Laser light is directed at the surface of the skin, along the course of the vein.
However, like sclerotherapy, laser treatments may need to be repeated to be 100 percent effective, and laser treatment does not prevent new spider veins from forming.
For medium-sized varicose veins, a procedure called ambulatory phlebectomy may be effective. These veins are frequently very unsightly and may cause painful symptoms.
Ambulatory phlebectomy can be done under local or general anesthesia, and most patients can return to normal activity the next day.
To remove the vein, the physician makes several incisions in the skin, pulls the vein until it breaks, and removes it in pieces. Like vein stripping, this procedure may cause pain, bruising, and scarring (although to a lesser degree than the stripping procedure).
Large, deep varicose veins can be treated with surgical vein stripping or the less invasive laser surgery.
Large varicose veins are most likely to cause painful and irritating symptoms, in addition to being unsightly. Surgical treatment must be done under general anesthesia and may keep patients from their normal routine for up to three weeks; laser treatment requires only a local anesthetic, has few adverse effects and lower recurrence, and has a recovery period of about 24 hours.