Visible varicose veins are a widespread condition in the United States, affecting more than 25% of adult women and over 15% of adult men. For many people, varicose veins are simply a cosmetic concern; however, for in some cases, they can cause aching pain and discomfort. Left untreated, varicose veins may lead to more serious problems.

What are varicose veins?

Varicose veins are enlarged, twisted veins close to the surface of the skin. Any vein may become varicose, but legs and feet are the most affected areas.

Varicose veins occur when the blood flow from the legs to the heart decreases and blood begins to pool in the veins. Normally, valves within our veins help to keep blood flowing upward against gravity. When these valves malfunction, this allows blood to flow backwards and pool in the vein. Plus, as we age, vein elasticity decreases, allowing them to stretch and appear bulging or rope like.

Varicose veins affect the superficial veins of the legs. They usually develop slowly, over several years, and, if left untreated can eventually cause symptoms of aching or burning pain or a sensation of heaviness or swelling in your legs.

Who is at risk for varicose veins?

Some families have a predisposition to varicose veins. If one of your parents or a brother/sister has varicose veins, this may increase your risk. They can also be the result of certain lifestyles, including jobs that require pro-longed sitting or standing, sports or activities that may have caused injury to your legs or carrying excess weight that stresses your legs.

What happens if varicose veins are left untreated?

Varicose veins can become painful, especially when standing or walking and if they start to itch, scratching them can cause open sores that are slow to heal. Varicose veins might also signal a higher risk of other circulatory system disorders.

When blood pools in the veins, it increases the risk of a clot developing. When this occurs in a deep vein, it’s known as deep vein thrombosis (DVT), which can be extremely serious and require urgent medical care.

Treatment Options

Varicose veins will not get better left untreated and there is no medication to improve varicose veins. If you or your physician are concerned about your varicose veins, Georgia Heart Institute offers a variety of treatment options with the expertise of our vascular surgeons and care team, including:

Ambulatory phlebectomy

A phlebectomy, also known as ambulatory phlebectomy is an outpatient procedure where diseased veins are removed through several small incisions in the skin.

Who is a candidate for a phlebectomy?

You may be a candidate for an ambulatory phlebectomy if you have large veins that are located very close to the skin or bulge above the surface of the skin.
In some cases, ambulatory phlebectomy is used in combination with other venous disease treatments.

Will I be given any medication before the procedure?

Yes, one of our clinical staff members will call in medication 1-2 days prior to your procedure so you are prepared on procedure day.

What to expect during a phlebectomy?

A phlebectomy is performed under anesthesia, so you will not experience any pain or discomfort. During the procedure, your doctor will mark the diseased veins and inject a local anesthesia into the skin. The bulging veins are surgically removed through small incisions.

How long will the procedure take?

While the procedure only takes approximately 45 minutes to an hour, please plan to be at the office for 1.5 hours.

Can I drive myself home after the procedure?

No, due to the medication given to you by your doctor, you will not be allowed to leave unless you have a driver.

When will I be able to return to normal activities?

You should be able to return to all regular activity 5-7 days after the procedure. We recommend avoiding heavy lifting, squatting and intensive exercise for several weeks. You will be required to wear graduated compression stockings for a week after surgery.

Endoscopic vein surgery

Used for more severe varicose veins, often when the vein has begun to cause sores, endoscopic vein surgery involves threading a thin tube into the vein and using a small surgical device at the end of the tube to close the vein. Our team has specialized expertise in minimally-invasive surgical vein and vascular procedures.

Laser treatment

Laser treatment is used to damage the varicose vein, creating scar tissue which closes the vein up, causing the varicose vein to lose its source of blood and die. After time, the varicose vein will likely disappear entirely.


Sclerotherapy is a minimally-invasive treatment for varicose and spider veins. During the procedure, your provider will treat small superficial veins with a single injection into each vein. The vein will collapse, forcing the blood to re-route to healthier veins and improving the appearance of the leg.

In some cases, it may take a few treatments for the varicose vein or spider vein to completely fade.

Who is a candidate for sclerotherapy?

Anyone suffering from small varicose veins or spider veins in their legs is a potential candidate for this treatment. If you are suffering from aching, swelling, burning or night cramps, book an appointment with one of our vein and vascular specialists at Georgia Heart Institute.

If you are a pregnant or nursing mother, you may want to defer treatment.

How is sclerotherapy done?

Sclerotherapy is performed by injecting a solution (usually glycerin or polidocanol solution) directly into the vein. It is done in office, is minimally-invasive and the you return to normal activities in one day post-procedure.

How to prepare for sclerotherapy?

Wear loose, comfortable clothing to your procedure appointment. Do not use any lotion on your legs the day of your procedure. Do not wear compression the day prior to or the day of your treatment.

Risks associated with sclerotherapy

There are few risks associated with this procedure, but extreme redness, soreness and warmth to touch should be reported to our office. Rare side effects and risks include hyperpigmentation, swelling, localized hives or allergic reaction or infection.

How much does sclerotherapy cost?

Some insurance companies will pay toward sclerotherapy. Georgia Heart Institute’s self-pay cost is $350, which includes the consult and two syringes of treatment. Both legs can be treated, as much as possible in the 30-minute appointment and with the product available. Every patient is different, and it may require multiple sessions to achieve optimal results.

What to expect after sclerotherapy?

Patients can resume their normal activities the next day. Seven days of compression is required post-procedure. Spider veins take time to diminish. It can take up to six months for bruising, redness and pigmentation changes to diminish. Follow-up sclerotherapy treatment is sometimes recommended.

Why Choose Georgia Heart Institute? 

We understand that every person is unique, and so is every treatment plan. Georgia Heart Institute’s vein specialists are experts in the most innovative procedures for treating venous disease. We offer both advanced minimally-invasive techniques and expertise in traditional surgery to ensure that our patients receive the care they need to look and feel their best.

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