Vein treatments

What is the Best Vein Treatment for Spider and Varicose Veins?

A guide from expert vein doctors

Vein Treatment technology has evolved rapidly. We break down the pros and cons of the best vein treatment for each type of vein problem and explain how to find a top vein clinic for your vein treatment.

In this article we compare advantages and disadvantages of every available treatment for Spider and Varicose Veins to help you decide which treatment is best for you if you are considering vein treatment.

Are you considering getting Vein Treatment done? If so, below is a must read article. With so many spider and varicose vein treatment options out there, with so many different types of doctor for vein disease, it’s hard to navigate what the best option is for you. We hope that the below article will help empower you to make the right decision on which type of treatment to have and in choosing which vein doctor is best for you.

Progress in the field of vein treatment has outpaced almost any other medical technology over the past three decades. With the development of minimally invasive spider and varicose vein treatment options, addressing your vein problems has gone from awful and unreliable to safe and effective awesome. But the number of different treatment options can almost seem overwhelming, and selecting the best type of vein treatment, vein specialist, and vein clinic can be tricky. In this article, we’ll break down the best treatments depending on the issue you want to address, and provide a step-by-step guide to finding a great vein doctor near you that will carry out these vein treatments effectively and safely.

Before we address treatment options, it’s important to understand a few basics about veins: most spider and varicose veins are due to an underlying condition called “venous insufficiency,” or “vein disease.” In venous insufficiency, veins slightly below the surface of the skin aren’t functioning efficiently. Instead of bringing blood back to the heart, the blood pools in the legs. This results in increased pressure, which can cause your body to form spider and varicose veins. A good vein doctor will always check for venous insufficiency before addressing any spider or varicose veins. Most of the time, venous insufficiency can be easily addressed. Without addressing this underlying cause, it may make it every difficult to treat the spider and varicose veins on the surface.

Also known as

Ablation, Radiofrequency Ablation, Laser Ablation

Best For

Large varicose veins, vein symptoms including discomfort, heaviness, leg fatigue, restless legs, cramps, treating venous insufficiency (the underlying cause of spider veins and varicose veins)

How long does it take?

The entire procedure takes less than an hour

Effectiveness

Likelihood of Insurance Coverage

Recovery Time

Overall Safety

Is Endovenous Ablation A Good Option For You?

The vast majority of patients are good candidates for endovenous ablation and this procedure is covered by most insurance providers. We specifically recommend endovenous radiofrequency ablation over laser ablation, as RF ablation has been shown to cause less discomfort after the procedure. In short, endovenous ablation may be an excellent option for you.

Endovenous Ablation (EVLT)

What is Endovenous Ablation?

Endovenous ablation is a procedure that uses heat energy to eliminate unhealthy veins. The unhealthy veins that cause vein disease typically are a few centimeters deep within your legs. Their function is to move blood in one direction, from your feet towards your heart. When the valves within these veins break, blood goes back down in the wrong direction. This causes a build up of venous pressure, which can cause Spider and Varicose Veins to appear on the surface of your skin.

What is Endovenous Ablation?

Endovenous ablation is a safe and effective treatment option that has replaced procedures such as vein stripping. When performing an ablation, your vein specialist will gently numb the surface of your skin and place a tiny device inside your unhealthy vein. The device is capable of generating heat by producing high intensity sound waves (a technology known as radiofrequency). Your vein doctor then surrounds the vein with a protective numbing fluid, and activates the device, delivering heat to the walls of the vein. The unhealthy vein is sealed closed, and over time is reabsorbed completely by the body. Blood flow is re-routed to healthier veins, so your circulation becomes more efficient.

Laser uses light to create energy and heat, radiofrequency uses sound waves as described above. A good vein doctor will have reasons to choose one device over the other and will be willing to explain his or her reasons to you in detail. Ablation technology has been around for over ten years, and is an absolute requirement for a good vein clinic. Our doctors have performed hundreds of ablations procedures, and are very comfortable with this top treatment option.

Patients respond well to:

Radiofrequency ablation is an effective and safe treatment for underlying vein disease.
It is significantly safer and more convenient than vein surgery (vein stripping).
Most insurance carriers will cover this procedure.
There is no down time, with most patients able to return to work the same day. This is one of the most commonly used modalities and has a proven track record of safety and efficacy.

What to know before your Endovenous Ablation:

There are multiple different machines and delivery devices on the market which may effect your overall results. Make sure you choose a reputable vein center. Many different vein doctors will have variable levels of experience.
Make sure you choose a provider who has done many of these procedures to ensure that your procedure will be as successful and comfortable as possible.
Note that endovenous ablation requires surrounding the vein with tumescent anesthesia, in an inexperienced provider’s hands, this part of the procedure may be more painful due to the extra number of injections you may require.

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Also known as

Vein Glue

Best For

Vein symptoms including discomfort, heaviness, leg fatigue, restless legs, cramps, treating venous insufficiency (the underlying cause of spider veins and varicose veins)

How long does it take?

The entire procedure takes less than an hour

Effectiveness

Likelihood of Insurance Coverage

Recovery Time

Overall Safety

Is Venaseal a good option for you?

Venaseal is a good option for you if you have a history of vein disease and received treatment in the past. Prior to deciding if Venaseal is right for you, you should have your doctor carefully check your allergies and make sure venaseal will be covered by your insurance provider.

VenaSeal

What is VenaSeal?

Venaseal is one of the newer technologies on the market, made by a reputable scientific company (Medtronic). Instead of using heat energy to close a vein, this procedure uses a substance called cyanoacrylate glue to close off diseased veins. Cyanoacrylate glue has been used for a long time in the medical industry for a variety of vascular procedures. It has a well-established safety record.

How Does VenaSeal Work?

VenaSeal, or Vein Glue, is one of the newest technologies used to treat veins. Your vein doctor will identify the unhealthy vein using an ultrasound machine. Her or she will then gently numb an entry point to gain access into the vein. Once the vein is accessed, a delivery device called a catheter is inserted into the vein. This catheter contains the cyanoacrylate glue.

Your vein doctor will then use an ultrasound machine to identify the tip of the catheter and then slowly inject the cyanoacrylate solution into the vein, causing the vein to shut down and essentially “glue” to itself. The solution seals the vein closed, re-routing blood flow to other healthier veins.

Why patients respond well to VenaSeal:

Venaseal does not require tumescent anesthesia so you will not experience any swelling after the procedure.
This procedure may have a significant advantage over endovenous ablation: in veins that have multiple branches the glue will travel into those branches and may close them as well.

What to know before getting VenaSeal:

Venaseal is only a few years old, so long term treatment effects are unclear. Some patients may develop an allergic reaction to the solution.
The solution becomes a permanent “implant” as it hardens – which may bother some patients psychologically. insurance coverage for this procedure is not widespread Your insurance may not cover this procedure.

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Also known as

Saline Injections, Salt Solution Injections, STS, vein injections, cosmetic sclerotherapy

Best For

Spider veins, small varicose veins

How long does it take?

The entire procedure takes less than an hour

Effectiveness

Likelihood of Insurance Coverage

Recovery Time

Overall Safety

Is sclerotherapy a good option for you?

If you have recurrent vein disease and your vein doctor cannot use radiofrequency ablation or venaseal, sclerotherapy may be an excellent option. Sclerotherapy is also the best choice if you have cosmetic issues only and no underlying vein disease.

Sclerotherapy

What is Sclerotherapy?

A medication is injected into the unhealthy vein. The medication, called a sclerosant, irritates the walls of the vein and causes the vein to collapse and close. Visible veins become smaller and lighter.

How Does Sclerotherapy work?

First, your vein doctor will identify the target vein visually on the surface of the skin or under ultrasound guidance. Your vein doctor will either use a small needle to enter surface spider veins and inject them with a sclerotherapy solution or use the ultrasound to inject veins slightly below the surface of your skin. The solution irritates the inside lining of the vein causing it to collapse.

There are several different medications that can be injected into veins to use as sclerotherapy. The oldest is hypertonic saline (very concentrated salt water). While hypertonic saline is effective, it can be extremely uncomfortable, even painful. Newer medications as used by our vein doctors cause much less discomfort.

Why patients respond well to Sclerotherapy:

Sclerotherapy is a liquid medication so it is able to travel into tortuous veins which cannot be treated with a device like the catheter required in vein ablation. Sclerotherapy is a quick, convenient, and effective way to treat spider veins on the surface of the skin. In the right hands, this procedure is generally safer and more effective than laser treatment for spider veins.
Most effective treatment for spider veins, no down-time.

What to know before receiving Sclerotherapy:

There are many different types of sclerotherapy available on the market. These solutions each have their own advantages and disadvantages, as well as pricing. Different clinics use different medications, so results may vary.
In addition, many of the medications need to be diluted (mixed with sterile water) to reach the proper dose. If this is not done properly in a certified vein center, the medication dosage may be incorrect.
Use of an inferior medication or incorrect dose can lead to discomfort as well as discoloration of your skin. If sclerotherapy is injected into the wrong location (like an artery) it can cause necrosis of the skin. It’s important to choose a Board Certified Vein Doctor to perform sclerotherapy.

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Also known as

Vein Injections, Foam Sclerotherapy

Best For

Large varicose veins, small varicose veins

How long does it take?

The entire procedure takes less than an hour

Effectiveness

Likelihood of Insurance Coverage

Recovery Time

Overall Safety

Is Foam Sclerotherapy a good option for you?

If you have visible varicose veins or reticular veins (unhealthy veins that are larger than smaller veins but smaller than varicose veins) that require cosmetic treatment, foam sclerotherapy may be an excellent option. Foam sclerotherapy is also effective and safe for recurrent vein disease, so if you’ve been treated in the past it may be an excellent option for you.

Foam Sclerotherapy

What is Foam Sclerotherapy?

Similar to liquid sclerotherapy, foam sclerotherapy is a technique in which a vein specialist uses medication to close a vein. The medication coats the walls of the vein, causing it to seal closed. Most liquid sclerotherapy is a “detergent,” meaning (just like dishwasher detergent) you can agitate it (mix the liquid with air) and create a bubbly foam. Using this technique allows your vein expert to fill a larger vein while using the same amount of medication. So a good physician can safely treat a larger vein. In addition to keeping the medication dose as low and safe as possible, foam sclerotherapy is easily visualized on ultrasound, so your vein doctor can easily see which veins he/she is closing.

The procedure

Similar to liquid sclerotherapy, your vein doctor will identify the vein visually on the surface of the skin or with the help of ultrasound technology. Once identified, your vein doctor will enter the vein and prepare to inject the sclerotherapy solution. To make sure the foam is fresh, the vein doctor will prepare the solution immediately before injecting it by mixing air and medication rapidly between two syringes.
Then, once injected, your physician will monitor the foam under ultrasound guidance as it travels through your veins.

Why patients respond well to Foam Sclerotherapy:

Foam sclerotherapy is effective in treating veins that are tortuous or more difficult to access with conventional therapy.
Foam sclerotherapy is an excellent choice for recurrent vein disease.

What to know before booking Foam Sclerotherapy treatment:

Foam sclerotherapy is an excellent choice for recurrent vein disease.
Varicose veins can have connections to deeper veins within your legs called perforating veins, and it is critical that no medication enters these perforating veins and travels to the deep veins.
An experienced physician will carefully assess for the presence of these connecting veins prior to injecting foam sclerotherapy.

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Also known as

Foam Sclerotherapy

Best For

Large Varicose veins, vein symptoms including discomfort, heaviness, leg fatigue, restless legs, cramps, treating venous insufficiency (the underlying cause of spider veins and varicose veins)

How long does it take?

The entire procedure takes less than an hour

Effectiveness

Likelihood of Insurance Coverage

Recovery Time

Overall Safety

Is Pre-mixed foam sclerotherapy a good option for you?

If you have appropriate insurance coverage, pre-mixed foam is a safe and effective alternative to standard foam sclerotherapy and even surgery in select cases.

Pre-mixed Foam Sclerotherapy

What is Pre-mixed Foam Sclerotherapy?

Pre-mixed foam is a newer and extremely effective type of foam sclerotherapy that comes in a premixed canister. Over time, there have been several cases of air embolism in patients treated with regular foam therapy where sclerosant is mixed with room air. An air embolism is a phenomenon in which the air travels through the bloodstream to the lungs, preventing proper travel of blood cells and oxygenation of the blood. In pre-mixed foam, rather than mixing the medication with room air, the sclerotherapy is mixed with a higher concentration of carbon dioxide and nitrogen. This composition causes the medication to travel more quickly through the bloodstream and deactivate faster, so it is hypothetically both more effective and safer than traditional foam sclerotherapy.

How is Pre-mixed foam sclerotherpy performed?

Similar to regular foam sclerotherapy, your vein doctor will identify the vein visually on the surface of the skin or with the help of ultrasound technology. Once identified, your vein doctor will either use a small needle to enter surface veins and inject them with a sclerotherapy solution or use ultrasound guidances to inject those veins slightly below the surface of your skin.

The difference between this procedure and regular foam sclerotherapy however, is that instead of agitating the solution with air, the sclerotherapy solution comes “pre-made” in a canister as described above.

Why patients respond well to Pre-mixed foam sclerotherapy:

Pre-mixed foam is safe and extremely effective. It’s an excellent option for recurrent vein disease.
Pre-mixed foam can be used instead of surgery to treat large varicose veins when performed by an experienced provider

What to know before booking Pre-mixed foam sclerotherapy vein treatment:

Pre-mixed foam is powerful, so should always be performed by an extremely experienced provider.
In addition, pre-mixed foam is not covered by all insurance and is very expensive without insurance coverage.

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Also known as

Mechanochemical Ablation

Best For

Vein symptoms including discomfort, heaviness, leg fatigue, restless legs, cramps, treating venous insufficiency (the underlying cause of spider veins and varicose veins)

How long does it take?

The entire procedure takes less than an hour

Effectiveness

Likelihood of Insurance Coverage

Recovery Time

Overall Safety

Is ClariVein right for me?

If you have an allergy to lidocaine and therefore would do poorly with tumescent anesthesia, but also don’t like the idea of having an implant such as Venaseal inside you, clarivein might be a good option for you. Bear in mind that results may vary and take care to make sure your insurance covers clarivein.

ClariVein

What is ClariVein?

This is a technology that uses both mechanical trauma and medication to close an unhealthy vein. The clarivein uses a special rotating device (a type of catheter) to damage the inner lining of your venous wall. After the inducing mechanical damage, the device secretes medication (sclerotherapy) to induce chemical damage to the vein wall as well, closing the diseased vein.

How is Clarivein Performed?

Your vein doctor will prep the area with a cleaning solution. The unhealthy vein is then identified using an ultrasound. The vein doctor will then gently numb an entry point to gain access to the vein. Once the vein is accessed, a delivery device called a catheter is inserted into the vein.

This catheter is a specially made catheter that is able to rotate and deliberately cause mechanical damage while delivering a sclerotherapy solution. The catheter is deployed along the entire length of the vein to ensure complete treatment.

Why patients respond well to ClariVein:

Clarivein does not leave a permanent implant like venaseal, and does not require tumescent anesthesia like endovenous ablation.
The catheter is relatively small and can be used to treat tortuous veins.

What to know before booking ClariVein treatment:

Clarivein is not covered by the majority of insurance providers.
In addition, there have been some reports of complications with clarivein, including difficulty travelling past a venous valve and causing patient discomfort in the process.

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Also known as

Phlebectomy, vein stripping, vein removal

Best For

Very large varicose veins

How long does it take?

The entire procedure takes less than an hour

Effectiveness

Likelihood of Insurance Coverage

Recovery Time

Overall Safety

Is vein surgery right for me?

In general, surgery is a good option for you only if every other option has failed or if your vein is extremely tortuous. If you currently have a blood clot, surgery may also be the best option.

Traditional Vein Surgery

What is Vein Stripping?

In a traditional vein surgery, the vein is accessed with an open incision. Once the vein is exposed, there are many different types of techniques using surgical equipment to remove the diseased vein.

How is vein stripping performed?

After the unhealthy vein is identified under ultrasound, the patient is taken to the operating room under anesthesia. The vein doctor will then perform a cut down, or cutting into the skin overlying the diseased vein.

Once the diseased vein is identified visually, the surgeon then uses various surgical instruments to enter and remove the vein. The most common method involves using a hook to forcibly pull the vein out of the body.

Why patients respond well to Vein Stripping:

For very tortuous or large veins, surgery may be the best option
Remains the best option in limited scenarios

What to stay aware before receiving Vein Stripping:

There are many non-invasive or minimally-invasive procedures that are safer and more efficacious than surgery with a lower rate of complications.
Surgery is no longer considered first-line treatment.

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So How Do You Know Which Vein Treatment Option is Best for You?

A qualified vein doctor at a reputable vein center can help you decide which treatment is best for you, or come up with a customized treatment plan that uses several technologies. Here are five things to look for at a top vein clinic:

The vein doctor actually listens to you! It seems obvious, but in today’s busy world your physician might run in and out the door before you finish explaining your symptoms. At our vein centers, we make sure we understand your goals and expectations before we even start to formulate a treatment plan. You should be provided with a thorough explanation and all your questions should be answered.

The vein center performs an ultrasound to take a look at what is going on under your skin. Even if you come in for cosmetic issues (spider veins only), a top vein dr evaluates the veins within the leg to find out what is causing the spider veins. Treating veins on the surface without addressing an underlying issue can be like repainting a wall without fixing a leaky pipe inside the wall – wasted effort!

The vein specialist knows how to use an ultrasound: In order to perform newer vein procedures with minimally invasive technology, your vein doctor should know how to use an ultrasound. Many doctors rely on assistants to help them; our physicians are all fully trained experts at ultrasound-guided technology.

The Vein Center is Accredited: The IAC, or intersocietal accreditation commission, recognizes top performing vein centers that meet the highest quality standards. All of our vein clinics are IAC certified with fully trained doctors, technicians and the best equipment.

Your Vein Treatment Plan is customized for you: Vein Treatment isn’t one-size-fits-all. You should feel like your vein specialist took time to come up with a plan that matches your legs. Our physicians come up with tailored treatment plans that use one, two, or even three of the top technologies available, and we explain each treatment plan to every patient so you know exactly what to expect.

Find your most convenient Vein Treatment location

If you need spider vein treatment or varicose vein treatment, or if you are experiencing chronic leg discomfort and wondering if your circulation is the problem, we are here to help. Our gold-standard accredited vein centers, staffed by Ivy League trained vein specialists, are located in New York, New Jersey, California and Maryland. Our vein doctors will help you choose the best vein treatment for your unique individual needs.

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Visit one of our vein centers