You’ve probably heard about varicose veins before, those bulging, twisted veins that can develop in the legs. Did you know that more than 40 million people in the United States suffer from varicose veins? Almost 50% of people with varicose veins have a family history of the condition. And the risk increases to 90% if both parents have varicose veins. Fortunately, there are good treatments to get rid of varicose veins.

The first step is to consult a certified vein specialist. A thorough evaluation should include an ultrasound examination of the legs, as well as a physical examination and medical history. A good vein specialist will create a treatment plan for you. Some simple, conservative remedies you can do on your own are:

  • Elevate your legs
    Lay down horizontal, or elevate your legs slightly above the level of you heart for 20 minutes a few times a day. Gravity will pull blood and swelling out of your leg and back toward your heart.
  • Wear compression stockings
    Compression stockings are helpful in the treatment of pain and swelling from varicose veins. The increased pressure of the stockings counteracts the increased pressure in your veins. The usual recommended pressure is 20 – 30 mmHg. Put them on in the morning and wear them all day. Take them off before bed, unless you have leg symptoms at night, then you might want to continue to wear them in bed as well as in the day.
  • Stay active
    The more you walk and move around, and the less sedentary you are, the more the muscles in the calf and foot pump blood out of your legs. Simple walking is fine. Exercise is great for your cardiovascular health. Exercise does not cause nor prevent varicose veins.

Oftentimes, lifestyle changes are not enough to ease the discomfort associated with varicose veins nor will they correct the unsightly visual appearance. Definitive vein treatment options include these minimally invasive procedures:

Radiofrequency Ablation

In this office based procedure done under local anesthesia, a small catheter uses heat energy to close down the abnormal vein. This treatment is done in a doctor’s office and normal walking and driving can be resumed immediately. Endovenous laser ablation is an identical procedure, except laser energy is used instead of radiofrequency energy.


Phlebectomy often times is the best therapy for bulging varicose veins. Done under local anesthesia in an office setting, the vein is removed in small sections through small (2-3mm) incisions. Routine activity can be resumed immediately and there is usually minimal discomfort. This is not a vein stripping, which is now an obsolete procedure.


VenaSeal™ is a procedure that uses a special glue to seal off damaged veins. It is a new way of treating venous insufficiency (venous reflux), which causes bulging varicose veins. This treatment is performed in the office and requires only one small needle prick. You will be able to return to your normal daily activities immediately, with minimal pain or bruising. At this point many insurance companies do not cover the VenaSeal procedure.


Varithena, a type of ultrasound guided foam sclerotherapy, is a procedure where abnormal veins are injected with a medical foam that closes down the veins. Over time the body absorbs the veins. It is a useful tool in treating venous disease and is often used to supplement other vein treatments.

At the VEINatlanta clinics in Atlanta GA, varicose vein treatments are done under local anesthesia in an office setting. Normal daily activity, such as walking, driving and office work can be resumed immediately. VEINatlanta has been voted the “best vein clinic” in Atlanta by Best Self readers six years in a row!

Written by Louis Prevosti, MD, FACS, RPhS