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What is the least painful spider and varicose vein removal option?

I am pretty much a wimp when it comes to any type of pain. I have spider veins near my temples and varicose veins right behind my knees, and I want to get rid of them all in one go. But I don't want the surgery to hurt at all! What is the least painful treatment for removing spider and varicose veins?

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Doctors Answers (3)

In general, I would recommend a painless ultrasound evaluation to determine the cause of the varicose vein(s). If a refluxing saphenous vein is found, you can have a fiber-optic laser procedure such as EVLT, ELVS (etc) which is done in a physician's office with optional pre-medication to help you relax and is very effective. Typically you will only experience the sensation of small injections of anesthetic fluid prior to using the laser which is then painless. Your legs should feel normal after the treatment and there is no "down-time." You would wear compression hose on your legs for several weeks and stay active after the procedure. Depending on the size and location of the varicose veins, a micro-phlebectomy may also be considered which removes superficial segments of the vein after it is anesthetized through 1mm incisions along the side of the vein. Again, you will only experience some injections before this office procedure and usually only minimal soreness later on, which is handled with regular walking and medication for a few days if needed. For the small spider veins and medium-sized reticular veins, sclerotherapy injection is preferred using one of the modern sclerosants such as sotradecol (Sodium Tetradecyl) or asclera (polidocanol) with very small needles for injection. This is more comfortable and a more effective treatment than with a surface laser, especially on the blue-colored veins. Sclerotherapy is a non-surgical, minimally invasive procedure that can be used to treat the smaller but more visible veins.

The best on the face is laser with a cooling device or numbing cream. For the veins on the leg probably injections are the best, but it depends on the vein size. I would recommend using a numbing cream if you really are afraid of pain and see if that helps. Again, usually the numbing creams can shrink the veins so we do not like to use them too much prior to injections.

With spider veins of the legs, we use sclerotherapy only.

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