27 doctors weighed in:

Which treatment is best for varicose veins besides surgery?

27 doctors weighed in
Dr. David Rosen
Phlebology
12 doctors agree

In brief: It depends on...

Etiology, location and anatomy.
I agree with dr. Pak's answer, but the mainstay of definitive treatment of lower extremity varicosities is currently endovenous ablation to treat an underlying source of reflux when identified. This can be followed by ambulatory phlebectomy/sclerotherapy to treat remaining varicosities. Ultrasound evaluation needs to be performed early: dont wait for skin changes!

In brief: It depends on...

Etiology, location and anatomy.
I agree with dr. Pak's answer, but the mainstay of definitive treatment of lower extremity varicosities is currently endovenous ablation to treat an underlying source of reflux when identified. This can be followed by ambulatory phlebectomy/sclerotherapy to treat remaining varicosities. Ultrasound evaluation needs to be performed early: dont wait for skin changes!
Dr. David Rosen
Dr. David Rosen
Thank
2 comments
Dr. Gabriel Goren
As someone who is the field of Phlebology since 1984 and who has close to 20 publications in the field I will permit myself to have an opposing opinion regarding thermal ablation as the definite treatment of superficial vein reflux/incompetence associated with truncal varicose veins. The method performed by me in over 3500 limbs does rid of the axial reflux (by invaginated trunk saphenectomy) well as the varicose tributaries (by stab hook phlebextraction) in a mandatory single session. It is done in an office setting using only 0.25 % xylocaine (femoral block or simple infiltrative anesthesia). The method has eliminated down time and loss of income and is really an ambulatory procedure as patients, without exception, drive themselves from my office. Never was one single DVT observed, no thermal saphenous nerve injuries could certainly be encountered, no pigmentation was left behind, etc. all these being complications quite frequently observed after thermal ablation. Practitioners, if interested, are advised to look up three of my articles on the subject. 1. J Vasc Surg 1994; 20:970-77 (Goren, G., Yellin, A.E. Invaginated axial saphenectomy by a semirigid stripper: PIN stripping. 2. Ann Vasc Surg 1995; 9:401-14 (Goren, G., Yellin, A.E. Minimally invasive surgery for primary varicose veins: limited Invaginated axial stripping and tributary (hook) stab avulsion. A third article is advised to all 3. Derm Surg 1996; 22: 557-60 Goren.G., Yellin, A.E. Hemodynamic principles of varicose vein therapy There is no doubt in my mind that the over enthusiastically received thermal ablation (basically heat sclerotherapy) is embraced nowadays because of much better insurance reimbursement and because surgeons never interested in this non glamorous condition permitted the passing of the subject over every interested members of all existing medical specialty anxious to increase their income. Sir William Osler comes into my mind: “It is astonishing with how little reading a doctor can practice medicine, but it is not astonishing how badly he may do it”.
Dr. Scott Welker
Venous ablation is an excellent option, as is Dr. Goren's invention. It's up to each patient to make an informed choice.
Dr. Laura Pak
Surgery - Vascular
6 doctors agree

In brief: Depends

Mainstays of treatment are exercise, periodic leg elevation, compression stockings, skin moisturizer, and attaining ideal body weight.
Surgery these days is minimally invasive; an outpatient procedure called vein ablation has replaced vein stripping. Usually, if the veins are painful or if you have leg swelling or skin damage or have had clots, it makes sense to have an ultrasound evaluation.

In brief: Depends

Mainstays of treatment are exercise, periodic leg elevation, compression stockings, skin moisturizer, and attaining ideal body weight.
Surgery these days is minimally invasive; an outpatient procedure called vein ablation has replaced vein stripping. Usually, if the veins are painful or if you have leg swelling or skin damage or have had clots, it makes sense to have an ultrasound evaluation.
Dr. Laura Pak
Dr. Laura Pak
Thank
Dr. Michael Korona
Radiology - Interventional
3 doctors agree

In brief: Laser ablation

Works well for venous insufficiency and varicose veins.

In brief: Laser ablation

Works well for venous insufficiency and varicose veins.
Dr. Michael Korona
Dr. Michael Korona
Thank
Dr. Craig Schwartz
Phlebology
3 doctors agree

In brief: Varicose Veins

Surgery is considered old-fashioned and is no longer the best treatment for varicose veins.
We now have excellent minimally invasive, in-office procedures, performed under local anesthesia, with minimal downtime or discomfort. These are known as laser closure or laser ablation. Look for an experienced vein specialist or vein treatment center who can walk you through the process from start to end.

In brief: Varicose Veins

Surgery is considered old-fashioned and is no longer the best treatment for varicose veins.
We now have excellent minimally invasive, in-office procedures, performed under local anesthesia, with minimal downtime or discomfort. These are known as laser closure or laser ablation. Look for an experienced vein specialist or vein treatment center who can walk you through the process from start to end.
Dr. Craig Schwartz
Dr. Craig Schwartz
Thank
Dr. Norman Chideckel
Surgery - Vascular
1 doctor agrees

In brief: Varicose veins

Treatment is dependent on the cause Larger varicose veins if the result of valve reflux can be treated with thermal ablation Small spider veins by sclerotherapy

In brief: Varicose veins

Treatment is dependent on the cause Larger varicose veins if the result of valve reflux can be treated with thermal ablation Small spider veins by sclerotherapy
Dr. Norman Chideckel
Dr. Norman Chideckel
Thank
Dr. John Landi
Phlebology
1 doctor agrees

In brief: See a vein doctor.

Varicose veins are usually due to malfunctioning valves is the saphenous veins.
This can be diagnosed by a venous reflux ultrasound. You should see a vascular surgeon or a vein specialist. The gold standard for varicose vein treatment is to seal the leaking valves with a laser or radio frequency catheter.

In brief: See a vein doctor.

Varicose veins are usually due to malfunctioning valves is the saphenous veins.
This can be diagnosed by a venous reflux ultrasound. You should see a vascular surgeon or a vein specialist. The gold standard for varicose vein treatment is to seal the leaking valves with a laser or radio frequency catheter.
Dr. John Landi
Dr. John Landi
Thank
1 comment
Dr. Georgia Latham
Compression with ace bandages can be helpful.
Dr. Ted King
Phlebology
1 doctor agrees

In brief: A number of choices

As was mentioned, start with a vein specialist.
A venous ultrasound of your leg veins should be done to find the cause of your varicose veins and make a treatment recommendation. A treatment option that helps symptoms but doesn't make the veins go away is compression stockings. Other more definitive options include laser or radiofrequency ablation, ambulatory phlebectomy, and/or sclerotherapy.

In brief: A number of choices

As was mentioned, start with a vein specialist.
A venous ultrasound of your leg veins should be done to find the cause of your varicose veins and make a treatment recommendation. A treatment option that helps symptoms but doesn't make the veins go away is compression stockings. Other more definitive options include laser or radiofrequency ablation, ambulatory phlebectomy, and/or sclerotherapy.
Dr. Ted King
Dr. Ted King
Thank
Dr. Joel Gotvald
Surgery - Vascular

In brief: Varicose Veins

There is not really a single "best" treatment, as treatments are tailored to your specific anatomy.
Ultrasound is needed. The most common "non-surgery" treatments are compression stockings, endovenous thermal ablation, or sclerotherapy. Often a combination of therapies is needed. Vascular surgeons are considered the "vein experts" as they can offer all possible treatment options.

In brief: Varicose Veins

There is not really a single "best" treatment, as treatments are tailored to your specific anatomy.
Ultrasound is needed. The most common "non-surgery" treatments are compression stockings, endovenous thermal ablation, or sclerotherapy. Often a combination of therapies is needed. Vascular surgeons are considered the "vein experts" as they can offer all possible treatment options.
Dr. Joel Gotvald
Dr. Joel Gotvald
Thank
Get help from a real doctor now
Dr. Buck Parker
Board Certified, Surgery
13 years in practice
467K people helped
Continue
108,000 doctors available
Read more answers from doctors