What Is the Safest Treatment for Varicose Veins?

Varicose vein treatment has changed tremendously in recent decades. Vein stripping surgery was once a common solution. It’s now been largely replaced by minimally invasive procedures that don’t require large incisions, general anesthesia, stitches, or hospitalization. These gentler methods are completed in 30 minutes or less, and they don’t require downtime to recover. Book an appointment with Harvard-trained vein specialists to learn which method is safest for you.

Simply choosing a non-surgical option makes vein treatment safer for most patients. It minimizes the risks of bleeding, infection, scar tissue, pain, and anesthesia complications. But there’s no single treatment that’s safest for everyone. What is the safest varicose vein treatment for you? The right choice depends on your unique venous pathways, symptoms, and medical history. Our vein experts will conduct a thorough exam to select your optimal procedure. Here are some minimally invasive vein treatments our vein doctors recommend.

  • Sclerotherapy– An injection of a detergent-like solution that seals the vein shut. It’s considered one of the safest ways to treat veins since there’s no heat or local anesthesia involved.
  • Radiofrequency Ablation– An injection of a local anesthetic followed by an administration of thermal energy to heat and close the vein. It has an excellent safety record.
  • Endovenous Laser Ablation– Similar to radiofrequency ablation, but it uses laser energy instead of radiofrequency to ablate the vein.
  • Vein Adhesive– An injection of cyanoacrylate glue that closes the vein. It requires no thermal energy or local anesthesia.
  • Mechanochemical Ablation– A combination of sclerotherapy and mechanical agitation of the vein’s walls. This dual approach doesn’t use heat.

What is the safest varicose vein treatment? Minimally invasive vein treatments are low-risk. The safest one depends on your unique vasculature and medical history.

Is a Minimally Invasive Procedure Safer Than Surgery?

Minimally invasive procedures are safer than surgery for most patients. However, if you have blood clots, injectable medicines might not be safe for you since the clot could travel through the vein. And if your veins have severe tortuosity or complicated veins, treatment devices may not be able to navigate them. In these instances, surgery might be the safest choice. Read on to learn about ambulatory phlebectomy, a gentler alternative to traditional vein stripping surgery.

Is Radiofrequency Energy Safer Than Laser Energy?

Radiofrequency ablation (RFA) and endovenous laser treatment (EVLT) are both safe ways to treat veins. But some patients find radiofrequency energy to be more comfortable. Sound waves heat the vein at a lower temperature than laser energy. So, while neither treatment is painful, we often recommend RFA over EVLT.

Are Lasers on the Surface of the Skin Safer Than Injections?

There are multiple ways to use lasers to treat veins. Some methods beam lasers through the surface of the skin. These include Intense Pulsed Light (IPL) therapy, and Pulsed Dye Laser treatments. These surface applications are best for small blood vessels right at the surface, like facial spider veins. The amount of heat required to treat large veins through the skin would damage the skin. So, surface laser treatment is not recommended for varicose veins and spider veins in the legs. In addition, patients with sensitive skin or skin conditions should use caution with surface lasers even on superficial facial veins. They may be better suited to sclerotherapy.

So, how do lasers treat larger varicose veins in the legs? These bulging blood vessels are often caused by valve failure in a deeper vein, which must be addressed to prevent a recurrence. This issue is called Chronic Venous Insufficiency (CVI), and it causes symptoms like pain, swelling, itching, cramping, heaviness, and restlessness in the legs. Surface lasers can’t treat CVI. Instead, vein doctors can insert a tiny, hollow needle into the vein and surround the blood vessel with tumescent anesthesia. This acts as a buffer against heat for the adjacent tissue. Then, the doctor threads a laser fiber through the needle and places it on the vein. The vein specialist then activates the fiber with thermal energy to ablate the vein.

This method is safer for large veins than surface lasers because it doesn’t damage the skin. It’s also more effective for large veins since doctors can use ultrasound guidance to position the device and observe its success. As mentioned above, vein doctors can also do the same procedure with radiofrequency instead of lasers, which is often preferable. Visit our board certified vein doctors for access to all the safest options.

Is Ambulatory Phlebectomy Safer Than Vein Stripping?

If you aren’t eligible for a minimally invasive procedure, you might still be able to avoid traditional vein stripping surgery. Vein stripping involves multiple deep incisions, often near the groin, knee, and ankle. The doctor will access the vein through one incision and use a tool like a hook to pull the vein out through another incision. Sometimes, they tie the vein off at a certain point, which is called ligation. Other times, they remove the entire vein. It requires general or spinal anesthesia and involves the typical risks associated with surgery.

In contrast, ambulatory phlebectomy uses small punctures instead of incisions and only necessitates local anesthesia. It’s more invasive than minimally invasive procedures but less complicated than traditional vein stripping. Patients remain awake and need less downtime for recovery. If you need vein surgery, ask our vein specialists if you’re a candidate for ambulatory phlebectomy.

Is a Treated Vein Always Safer Than an Untreated Vein?

Some veins don’t require treatment. But there’s no way to determine this on your own. Varicose veins and spider veins often stem from underlying issues like valve failure and Chronic Venous Insufficiency which can’t be detected from the surface of the skin. If CVI goes untreated, more symptoms and damaged veins are likely to develop. Complications include venous ulcerations, bleeding that’s hard to control, venous stasis dermatitis, blood clots, and permanent hyperpigmentation. A treated vein is always the safer choice when treatment is warranted. A vein consultation is the best way to determine whether veins can be left untreated.

Which Doctors Treat Varicose Veins and Spider Veins Safely?

If you want safe treatment for varicose veins, choose a minimally invasive vein center over a cosmetic or dermatological center. These other centers only offer superficial treatments that can’t resolve CVI or large varicose veins. They don’t have the ultrasound-guided procedures to ensure that treatment is not only safe but also effective. In addition, avoid centers that only perform surgery. Most veins don’t need a surgical solution, so choose a vein specialist who won’t recommend unnecessary surgery. In California, visit Dr. Carly Guthrie, Dr. Jasmine Koo, Dr. Walter Lech, or Dr. Billy Schoenfeld for safe results.