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If the patient has no symptoms or discomfort and is not bothered by the sight of the varicose veins, treatment might not be necessary. However, if there are symptoms , treatment may be required to reduce pain and/or discomfort, address complications, such as leg ulcers, skin discoloration or swelling. Some patients may also want treatment for cosmetic reason they want to get rid of "ugly" varicose veins.

Ligation and Stripping:

This involves tying off the vein and then removing it. Two incisions are made, one near the patient's groin at the top of the target vein, and the other is made further down the leg, either at the ankle or knee. The top of the vein is tied up and sealed. A thin, flexible wire is threaded through the bottom of the vein and then pulled out, taking out with it the vein through the lower incision. Surgery will not affect blood flow in the leg, because veins deep within the patient's leg will assume the role of the damaged veins. Ligation and stripping can sometimes result in bruising, bleeding and pain. In extremely rare occasions there may be deep vein thrombosis.

Compression stockings:

Compression stockings squeeze the patient's legs and improve circulation. They are generally very tight around the ankles, and gradually get looser higher up the leg. Compression stockings encourage proper blood flow upwards - against gravity - back towards the heart. Many patients also find that compression stockings help with discomfort, pain and swelling. No studies have convincingly demonstrated whether they stop the varicose veins from worsening, or even prevent them.

Sclerotherapy:

A chemical is injected into small and medium-sized varicose veins which scars and closes them. A few weeks later they should fade. A vein may need to be injected more than once. Radio frequency ablation - the wall of the varicose vein is heated using radiofrequency energy. A small incision is made either above or below the knee, and with the help of an ultrasound scan, a narrow tube (catheter) is threaded into the vein. The doctor inserts a probe into the catheter which emits radiofrequency energy. The radiofrequency energy heats up the vein, causing its walls to collapse, effectively closing it and sealing it shut. Radiofrequency ablation is usually done with a local anesthetic. Some patients may experience paresthesia (pins and needles) and minor skin burns. After the procedure, compression stockings need to be worn for a few weeks.

Surgery:

If varicose veins are large they may need to be removed surgically. This is usually done under general anesthesia (the patient is unconscious during the procedure). In most cases the patient can go home the same day - if surgery is required on both legs, he/she may need to spend one night in hospital.

Laser treatments are often used to close off smaller veins and also spider veins. Strong bursts of light are applied to the vein, which gradually fades and disappears. In such cases there are no incisions or needles used.