It is impossible to prevent an inherited tendency towards having varicose veins, but it is certainly possible to take measures that will help. Remember that varicose veins are veins that have been stretched so often that they become chronically dilated. The trick is to limit the opportunity to distend the veins.

That means medical compression stockings in individuals with a strong family history of varicose veins. It means avoiding occupations that require prolonged standing, and it means being careful about how you sit. Always try to sit in a chair that is low enough or with the seat tilted in such a manner that there is little or no pressure on the back of the thighs.

Do not sit for prolonged periods of time. Do get up and walk around to speed up circulation through your veins. And it is important for women who are pregnant to wear compression stockings at least during the last trimester of pregnancy.

The use of pressure garments is helpful. Medical graduated compression stockings are designed to provide the greatest pressure at the level of the ankle and diminishing pressure as the stocking goes up over the thigh. This design is important to prevent tourniquet-like compression to the leg. You should know that many stockings that provide mild pressure are not adequate to prevent tissue swelling and the complication of varicose veins and venous insufficiency.

In many instances the chief indication for treatment of varicose veins is cosmetic. This is most often true of the smallest varicose veins called “spider veins.” These very small veins that become dilated do not mean that the larger veins that form the major superficial venous system will necessarily become or already are varicose veins. There is an inherited tendency to have spider veins. The condition is aggravated by prolonged standing, injury or pregnancy.

Recurrences of varicose veins do occur with both procedures. Controlled double blind prospective studies have shown that compression sclerotherapy can give the same results as stripping 99% of the time.  However, some doctors still believe recurrence occurs earlier after sclerotherapy than after stripping. Any recurrences can be retreated as before, but this is a simpler procedure for sclerotherapy than surgery.  Patients with recurrences who are allowed to choose how to have the recurrences treated nearly always choose sclerotherapy over surgery.

Studies show that patients who choose sclerotherapy over surgery cite these as the most important advantages:

• They want to minimize pain and scarring
• Want to avoid anesthesia
• Don’t like the idea of being cut open
• Don’t want the risk of wound infections
• Want the ability to continue to work and exercise
• Want to avoid hospitalization.

Now with EVLT (Endovenous Laser Treatment) even the largest varicose vein with the worst leakage can be treated as an office procedure allowing the patient to resume normal activity the same day.