Recently, an excellent article appeared in The Wall Street Journal, written by medical writer Laura Landro, which provided an excellent summary of the current state-of-the-art treatment for varicose veins.

Interesting statistics show that over the age of 50, one of two people is affected by veins. Apparently there is even a hereditary factor. Most varicose veins occur, of course, on the legs and represent our anatomy’s constant battle with gravity.

The traditional means of dealing with varicose veins in the legs has always depended on the size of the veins. For larger veins, there was always the classic “ligation and stripping,” which involves several incisions made along the course of the veins and literally pulling the veins out from their beds. But, that often left quite a bit of swelling and bruising and took a lot of time to heal, and was not really a fabulous procedure. Now, the so called “endovascular procedures” are performed, whereby, thin tubes or catheters are placed within the hollow of the veins, and either using radio frequency or laser treatments, the veins literally become shriveled up.

The only way of dealing with smaller varicose veins is to inject them with a solution that, again, causes such irritation that the veins tend to collapse on themselves and are no longer prominent. That is known as sclerotherapy. Typically, the medications involved in sclerotherapy are very irritating. Even normal saline solution (sterile salt water) can be used.

For many years, there were just a few medications available. Apparently, a drug from Europe, known as polidocanol, marketed in the United States as Asclera, is recommended for the tiniest veins that are known as spider veins. Spider veins are known as that because there is usually a feeder central vein from which smaller veins radiate.

As the article pointed out, when surgery is indicated, it is an outpatient procedure done under local anesthesia and, perhaps, a bit of sedation.

Remember that it is important to wear compression stockings after these treatments to help reduce the bruising and swelling, and hasten healing and resolution.

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