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What Is the Most Effective Vein Treatment for Spider and Varicose Veins? Our Texas Vein Experts Share Their Preferred Methods.

Are you ready to do something about your damaged veins? Are you confused about how to proceed? Our Ivy-League vein doctors share insight on the pros and cons of each vein treatment. We’ll help you find the cause of your vein issues and also find the top Texas vein specialist near you for relief. 

Options for vein treatment have multiplied and improved dramatically over the last few decades. Minimally invasive procedures like radiofrequency ablation, sclerotherapy, and laser ablation began replacing surgery for most patients by the early 2000s, and the more recent introductions of foam sclerotherapy, VenaSeal, and ClariVein provide even more options for patients. Selecting the right treatment is tough for patients to do on their own, since so many choices exist. This article describes each treatment in detail, noting which vein conditions it’s designed for, and also how it’s performed. This guide will arm you with the knowledge you need to select the right method, as well as the right vein doctor in Houston. 

First, it’s important for patients to know what causes spider veins and varicose veins, and how they relate to each other. Finding the reason behind defective veins steers the course of treatment. One commonality of spider and varicose veins is that both can stem from a vein disease called venous insufficiency. In other words, the superficial veins (just below the skin’s surface) aren’t circulating blood correctly. When spider veins or varicose veins occur in the leg, it’s often because a valve has failed inside the leg vein. These valves are what keep blood moving up through the vein to the heart. If they don’t do their job, blood pools or moves backward (venous reflux), imposing pressure on the vein walls. That pressure can cause the vein to swell, bulge, and contort (spider vein formation), or force new tiny thread veins to branch off from the saphenous vein (spider vein formation). A trained vein doctor knows to look for venous insufficiency, since treating it is the only way to prevent the resultant veins from returning. 


Vein Treatment Options

Endovenous Ablation

Also Known As: Ablation therapy, radiofrequency ablation, laser ablation

Best For: Enlarged varicose veins, venous insufficiency (the underlying cause of varicose and spider veins), discomfort, leg fatigue, restlessness in the legs, heaviness, cramps

What Is Endovenous Ablation?

Since valve failure in leg veins often results in spider and varicose veins, this innovative technique treats the problem at the source, destroying broken valves and damaged veins with thermal energy. Using either laser waves or sound waves (radiofrequency), doctors close damaged veins, re-routing blood to the heart and eliminating the pressure that causes these unhealthy veins to form.  

How Does Endovenous Ablation Work?

Revolutionizing vein care for the 21st century, thermal ablation has largely replaced vein stripping, ligation, and surgical removal of varicose veins.  Ablative procedures begin with numbing the skin above the vein and surrounding the outside of the vein with tumescent anesthesia. This local anesthetic serves several purposes, providing a protective buffer to absorb the heat, preventing discomfort, and facilitating contact between the vein and the heating device through venoconstriction. The doctor then delivers thermal energy via radiofrequency (often called RF therapy or ClosureFast), or laser (EVLA) through a small catheter inserted into the vein. Once activated, the device delivers heat to vein walls, which causes them to seal shut. Blood can now flow into healthy veins and return efficiently to the heart. The process takes 30 minutes or less and doesn’t require general anesthesia. Eventually, the useless vein is harmlessly reabsorbed by the body. Ask our Texas vein doctors about the different types of endovenous ablation and why they recommend radiofrequency or laser ablation. These procedures have a proven track record since their approval in the U.S. in 1999 (RF) and 2001 (EVLA). Our Houston doctors have successfully performed countless ablations and are experts at explaining and administering this technology to their patients. 



Our TX vein doctors frequently recommend endovenous ablation, not just because of its strong track record, but also because it’s safer and more convenient than surgery. In addition, it’s less invasive and prevents the downtime surgical patients endure. It’s also covered by most insurance companies, which makes it more affordable than surgery. With ablation, you can be back at work the very same day. 

Pros Summary: 

-Proven safe and effective for 10+ years

-Several advantages over surgery

-Routinely covered by insurance

-Return to work without down time



 Several companies manufacture and market ablation devices. They are not all created equally. Choose a vein treatment in Texas known for high-quality doctors and high-quality equipment. Experience with these devices is essential, particularly regarding the injection of tumescent anesthesia. If it’s mistakenly injected into the vein, the medicine will rapidly cycle through the cardiovascular system, instead of buffering the outside of the damaged vein. Inquire about the vein doctor’s expertise with endovenous ablation, and ensure they use ultrasound guidance to deliver the medicine accurately. 




Cons Summary: 




-Requires precise application




-Heating devices differ in quality




-Uncomfortable with inexperienced providers 





Is Endovenous Ablation a Good Option for You?




The doctors at Texas Vein Treatment recommend endovenous ablation for most patients, since it’s so effective and commonly covered by insurance. We prefer radiofrequency ablation since laser ablation causes more lingering pain and bruising.


Also Known As: Vein Glue 

Best For: Addressing venous insufficiency and symptoms like discomfort, fatigue, heaviness, cramps, and restless legs occurring with unhealthy veins

What Is VenaSeal?

Introduced for vein disease recently by Medtronic, this treatment is backed by the safety and success rates of cyanoacrylate, a medical “superglue,” used in other procedures for decades. In venous procedures, it seals diseased veins closed with an adhesive, rather than thermal energy.  

How Does VenaSeal Work?

One of the latest solutions for venous insufficiency, VenaSeal injects cyanoacrylate adhesive into the vein with the help of ultrasound guidance and a catheter. Your doctor will find the problematic vein with an ultrasound scan and numb the entry point to access it. They will then advance a delivery catheter into the saphenous vein and carefully inject the glue with a gun-handle mechanism on the device. After retracting the catheter, they’ll apply a bit of external manual pressure to help the vein glue itself shut, so compression wraps are not necessary afterward. Doctors performing VenaSeal require ultrasound guidance to ensure proper placement of the tip, so the glue doesn’t migrate in the wrong direction. Once the vein is sealed off, blood begins flowing into veins capable of transporting it back to the heart.  



Since tumescent anesthesia isn’t required for VenaSeal, patients avoid the swelling caused by that anesthetic. Doctors can often seal more than one diseased venous pathway with each application of VenaSeal, since the glue can travel into adjacent branches.


Pros Summary: 

-New innovation

-Migration of glue can seal multiple unhealthy veins

-Works well for veins treated previously 



Certain patients are allergic to the adhesive. Others are uneasy about the glue remaining in their body. Introduced for vein treatment just a few years ago, the long-term implications of VenaSeal are unclear. Your insurance might not cover VenaSeal just yet.  


Cons Summary: 

-Vein doctor must know how to prevent glue’s migration

-Many insurance companies don’t cover VenaSeal yet

-Some patients have an allergic reaction

-Glue hardens and remains in the body 


Is Venaseal a Good Option for You?

If you’ve tried other vein treatments for your venous insufficiency, VenaSeal is a new solution that might work well for you. Have our vein doctors perform an allergy assessment to make sure it’s a safe choice for you. Our insurance specialists can also determine whether you’re covered for VenaSeal. 



Also Known As: Salt solution injections, saline injections, STS, cosmetic sclerotherapy, vein injections

Best For: Smaller varicose veins and spider veins 

What Is Sclerotherapy?

Our doctors inject a medical irritant, known as a sclerosant, into the veins to irritate the vein walls, causing them to collapse. This closure makes unsightly veins shrink and fade, becoming less visible.

How Does Sclerotherapy Work?

Doctors will visually check for the presence of defective veins at the surface of the skin, or deeper in the leg with ultrasound assistance. The vein specialist will then perform an intravenous injection of the sclerosant into the vein, which causes the vein’s occlusion and obliteration. Many different medicines can be used in this procedure. The older solutions, like hypertonic saline, are less comfortable than the newer formulas. Sclerotherapy is a versatile treatment that works well against all spider veins, as well as smaller varicose veins



Sclerotherapy in its liquid form can travel through the twists and turns of varicose veins better than the catheter used in ablation. It’s also an excellent choice for spider veins, since it can be injected quickly at the surface of the skin for visible telangiectasias. With a trained doctor, sclerotherapy is more advantageous than laser treatment to patients.    


Pros Summary: 

-Unrivaled efficacy for spider veins

-Accesses varicosities better than ablation

-Requires absolutely no downtime 






Providers can choose from a wide selection of sclerosing solutions. Each has certain advantages and disadvantages. The range in both sclerosant quality and practitioner experience means results aren’t consistent from one treatment to another. Some sclerosants require dilution with a specific ratio of medicine to sterile water. Imprecise mixtures can subject the patient to pain, discoloration, or overdosage. In addition, injecting sclerosants into arteries or surrounding tissue by mistake leads to skin necrosis (a risk in vein treatment that don’t use ultrasound guidance). When done correctly, sclerotherapy is one of the safest, most efficacious vein treatments. Choose board-certified physicians, like the doctors at Texas Vein Treatment, to avoid any unnecessary complications. 








Cons Summary: 




-Different sclerosants yield different results




-Proper dilution and accurate injection site required









Is Sclerotherapy a Good Option for You?

Patients with recurrent vein disease are excellent candidates for sclerotherapy, especially if they’re ineligible for radiofrequency ablation or VenaSeal. In addition, Sclerotherapy is the best solution for those with cosmetic vein issues that don’t stem from vein disease.

Foam Sclerotherapy

Also Known As: Foamed sclerotherapy, foam injections 

Best For: All sizes of varicose veins

What Is Foam Sclerotherapy?

Foam sclerotherapy is also an injection that occludes and obliterates a damaged vein, but the sclerosant is foam, rather than liquid. The foam’s consistency fills the vein more fully, coating the venous walls with medication. Since most sclerosants, like sodium tetradecyl sulfate (STS), are detergents, they foam up with agitation. Increasing the volume of the sclerosants by adding air allows doctors to treat veins with less medicine, minimizing dosage. The consistency is also easier to track on an ultrasound, since it displaces blood in the vein, rather than mixing with it. 

The Procedure: Using ultrasound assistance, the vein doctor will pinpoint the targeted vein and prep your skin for injection. The doctor will then combine air with the sclerosant by drawing it into a syringe and vigorously injecting the mixture back and forth between two syringes to create foam. It’s important for the vein doctor to complete this step just before injection to maximize the foam’s consistency and efficacy. After injection, the vein specialist monitors the foam’s dispersion throughout the vein to verify the vein’s closure.   



Conventional therapies can’t reach twisted portions of varicose veins the way foam sclerotherapy can. Foam sclerosants are agile and coat the vein better than liquid ones, using less medicine. Foam sclerotherapy is a good option for patients with chronic vein disease.  


Pros Summary: 

-Very agile in tortuous veins

-Coats vein walls better with less medicine

-Strong option for chronic vein disease 



An experienced vein doctor is always important, but particularly so with foam sclerotherapy. The foam’s agility and dispersion ability can carry it into healthy connecting veins (perforating veins) deeper in your legs, causing serious damage. It’s essential to partner with a doctor who maps these connections prior to treatment to avoid the harmful migration of medicine. 


Cons Summary: 

-Risk of medicine invading healthy veins with inexperienced doctors

-Locating perforating veins prior to treatment is crucial



Is Foam Sclerotherapy a Good Option for Me?

Foam sclerotherapy performs very well in the tortuosity of varicose and reticular veins. In addition to treating difficult, deeper veins, it’s also highly effective for cosmetic treatment of unsightly superficial veins. It’s a safe option for those who have already tried different treatments.

Pre-Mixed Foam Sclerotherapy 

Also Known As: Injectable foam sclerotherapy

Best For: Chronic venous insufficiency, large varicose veins, and symptoms including discomfort, cramps, restless legs, and fatigue

What Is Pre-Mixed Foam Sclerotherapy?

Pre-mixed foam has the potential for enhanced safety, potency, and efficacy over the foam that doctors mix on site. It comes already mixed in an injectable state in a sterile canister. One complication of regular foam is an air embolism in the lungs caused by the air added to the foam. Pre-mixing the foam with higher concentrations of nitrogen and CO2 eliminates this error and also accelerates medicine through the vein so it deactivates sooner, reducing risks and complications. 

How Is Pre-Mixed Foam Sclerotherapy Performed?

With pre-mixed foam sclerotherapy, your doctor will either use a tiny needle to inject veins at the surface or use ultrasound imaging to accurately inject deeper veins with foam. One differentiating factor between foam and pre-mixed foam is that the doctor doesn’t need to agitate this solution between syringes to create foam, since it’s already primed for injection in its canister. A second difference is that the concentration of the solution makes it more expeditious in transit and activation.



Pre-mixed foam sclerotherapy is arguably safer and more effective than foam mixed in a doctor’s office. It’s a great choice for recurrent venous disease. With the right doctor, pre-mixed foam outperforms surgery for large varicose veins


Pros Summary:

-More swift and potent than traditional foam

-Superior alternative to surgery for patients with large varicosities 

-Safe solution for patients with recurrent vascular disease



Since injectable foam is extremely powerful, only the most qualified doctors should administer it. This state-of-the-art procedure can be pricey for those whose insurance plan doesn’t cover it. 


Cons Summary: 

-High level of training and precision required

-Not covered by every insurance company yet


Is Pre-Mixed Foam a Good Option for Me?

Those whose insurance plan includes pre-mixed foam sclerotherapy should strongly consider this option. It’s safer and more effective than standard foam and is often a better option than surgery. If you’re interested but don’t have coverage, talk to our Houston doctors about why this might still be more affordable than surgery.


Also Known As: Mechanochemical Ablation

Best For: treating venous insufficiency and its common symptoms, like discomfort, cramping, heaviness, restlessness, fatigue, spider veins, and varicose veins

What Is Clarivein?

ClariVein is a new innovation that targets defective veins in two ways, traumatizing the vein both mechanically and chemically to ensure its collapse. ClariVein is a special infusion catheter with a rotating wire tip that damages the vein wall physically, and then secretes a chemical agent to the targeted area, causing occlusion and closure.  

How Is Clarivein Performed?

Our Houston vein doctors clean and numb the entry point on your skin and then locate the defective vein with ultrasonography. The doctor then advances the catheter into the vein through a pin-sized entry and directs the wire tip to begin rotating. The device deliberately damages the vein’s walls while secreting an irritant that further aggravates the vein. This procedure allows for 360-degree coverage of the vein for thorough treatment. 



ClariVein does not leave glue behind, like VenaSeal, and it doesn’t require tumescent anesthesia, like ablation, since no thermal energy is used. It only makes a pinpoint-sized injection, yet accesses large, twisted veins better than larger catheters. 


Pros Summary: 

-No tumescent anesthesia means no swelling

-No glue left in the body

-Small injection but accesses all 360 degrees of the vein






This new technology is not yet approved by many insurance carriers. Some patients experience discomfort when doctors struggle to advance the catheter past a valve. So, using trained doctors, like those at Texas Vein Treatment, is essential. 








Cons Summary: 




-Insurance carriers don’t always cover it 




-Can be uncomfortable with the wrong doctor





Is ClariVein Right for Me?

Those who aren’t comfortable with glue remaining in their body should consider ClariVein over VenaSeal. In addition, patients with an allergy to lidocaine should choose ClariVein over ablative procedures with tumescent anesthesia. Results of this procedure are highly dependent on choosing a qualified physician, so partner with our TX vein doctors who will also determine your insurance coverage.


Also Known As: Vein removal, phlebectomy, venous ligation, vein stripping  

Best For: The largest, most tortuous varicose veins 

What Is Vein Stripping?

Vein surgery typically involves multiple open incisions in the leg through which the doctor exposes the vein and manually extracts it with wires or hooks.  

How Is Vein Stripping Performed?

Using ultrasound guidance, the doctor will identify the diseased vein, and then administer general or spinal anesthesia before performing surgery. The doctor makes a few incisions, typically in the groin and then the ankle, calf, or thigh, depending on the vein’s location, and cuts down to the vein. They then insert metal or plastic wires into the vein, or a hook around the vein, and pull it from the body. The incisions are then stitched closed and wrapped with pressure dressings. 



In some cases, for patients with exceptionally large varicose veins or blood clots, surgery is the only option. 


Pros Summary:

-The best solution for some with blood clots or large, twisted varicosities




For most patients, the risks and complications of surgery far outweigh the benefits, since minimally invasive procedures outperform surgery with fewer risks and less downtime. The doctors at Texas Vein Treatment don’t view surgery as a first line treatment method.  




Cons Summary: 


-Surgery is now an outdated method, widely displaced by minimally invasive techniques



Is Vein Surgery Right for Me?

Talk to our Texas vein specialists before considering surgery. If you have current blood clots or very enlarged, tortuous veins, surgery might be your best bet. But for many patients, less invasive treatments are recommended. 


Before starting any vein treatment plan, make sure all of your questions are answered. If you’d like to know more about these options, contact the experts at Texas Vein Treatment. Our doctors love teaching patients about the new, less invasive spider and varicose vein treatments. Each of our physicians is board-certified and offers a premium patient experience near River Oaks.

So How Do You Know Which Vein Treatment Option Is Best for You?

Choosing a reputable vein doctor is the best way to identify which vein treatment is right for you. Since diseases like venous insufficiency lie beneath the surface, you need an expert’s trained eye to determine the best course of action. Here are five things to consider when choosing your vein doctor.  







  1. The vein doctor seeks your input: Many doctors squeeze too many patients into their schedule to maximize profit. As a result, they don’t have enough time to hear what their patients have to say. This delays results, since patient input helps doctors understand your medical history, failed treatment attempts, preferences, and coexisting conditions. At Texas Vein Treatment, we spend ample time listening to each patient and even consulting other doctors on our team about your condition. You’ll never feel frustrated or unheard with our compassionate physicians.  
  2. The vein treatment uses ultrasound guidance for diagnosis: While spider veins and varicose veins can often be seen on the surface, what lies beneath can’t be ignored. You might be interested in cosmetic spider vein treatment, but good doctors know to investigate the cause. If venous insufficiency is to blame, those veins will continue to reappear until it’s treated. Treating superficial veins might be a waste of time if you choose a doctor who doesn’t conduct a thorough venous assessment. 
  3. The vein doctor is trained on ultrasound treatment devices: Some vein doctors use assistants or ultrasound technicians to locate damaged veins. But today’s treatments use ultrasonography in countless ways beyond locating veins, including administering foam through a catheter or dispensing adhesive into a vein. It’s essential that your vein doctor is trained to use ultrasound-guided procedures, rather than relying on an assistant, since it’s no longer limited to scanning for images. These procedures are extremely technical and require skilled expertise. The doctors in our Texas vein treatment are all highly trained in ultrasound vein treatment. 
  4. The vein treatment achieved national accreditation: Only the top vein treatment in the nation achieve accreditation by the Intersocietal Accreditation Commission. This exacting process evaluates the center’s commitment to quality care by assessing every aspect of daily operations. Approval is granted by an intersocietal board of experts following comprehensive review. Texas Vein Treatment is one of the few treatment that is IAC certified as having the top doctors, equipment, and technicians.
  5. The vein treatment is created specifically for you: Some vein treatment dole out one-size-fits-all treatment plans, but venous anatomy is far from identical between patients. Your care plan should be designed after your doctor performs a thorough examination, complete with a medical history, and possibly duplex ultrasound scanning or additional tests. You should leave the appointment feeling like the treatment was tailored to your specific anatomy. And you should only engage in treatment once you fully understand the plan. The vein doctors at Texas Vein Treatment take time to explain each aspect of your condition and each step in the treatment process, so you’re fully informed at all times. We routinely use multiple technologies in conjunction to deliver the perfect results. Each patient presents a unique case that our doctors are thrilled to solve. 








Don’t let the visibility or symptoms of your veins hold you back any longer. There’s no reason to endure discomfort or dissatisfaction with your appearance, when such swift and gentle solutions abound. Our highly certified and accredited Texas Vein Treatment is home to the top vein specialists in the nation, as well as the top varicose and spider vein treatment technologies. We look forward to helping you choose the best option for your damaged veins.