Conservative treatment:
is commonly required by insurance companies before they will approve surgical intervention. This involves leg elevation, NSAID therapy, and compression stockings. If these measures fail to relieve the patient’s symptoms, most insurance companies will approve other treatment options such as laser therapy.

Sclerotherapy treatment:
is commonly used for treating the smaller spider veins. This procedure involves injecting a liquid into the vein with a small needle which causes the vein walls to collapse. Compression stockings are used after treatment with sclerotherapy and the veins will disappear over time. These veins can reappear or new veins can develop and so multiple treatments may be requires.

Phlebectomy
treatment:
involves removing the visible large bulging veins under local anesthetic. This is done through a small puncture over the vein, grasping it with forceps and removing it. There is minimal to no visible scarring and the cosmetic result is often excellent. This procedure is often utilized during laser ablation of the great saphenous vein.

Vein Stripping:
is the surgical removal of an incompetent saphenous vein. Years ago this was the standard method of treatment. This method is no longer used, unless medically necessary. It involves making an incision in the groin region, and surgically tying the top of the vein. A rod is then inserted into the saphenous vein. This small rod turns the vein inside-out and peels the vein out from the soft tissue of the leg.

There are no advantages to this methos and the disadvantages are significant bruising, pain, nerve damage, poor cosmetic results, and days of recuperation.

EVLT - Endovenous Laser treatment:
deals with the incompetence of the greater saphenous veins. Unlike surgical stripping, EVLT permanently closes off the vein while leaving it in place.