Not all patients need treatment for their varicose veins or spider veins. Many people have no pain or other symptoms. For these individuals, no treatment is necessary unless they want the veins removed for cosmetic reasons. There are many different treatments available for varicose veins. These treatments vary based upon the size and location of the varicose veins, the presence of symptoms, or complications. Sclerotherapy, laser and intense-pulsed-light therapy, radiofrequency (RF) or laser ablation, and ambulatory phlebectomy are the modern techniques used to ablate varicosities. Numerous reports describe greater than 90% success rates for more minor invasive procedures associated with fewer complications with comparable efficacy. The selection of the correct sclerosant and the exact volume and concentration of sclerosant depends on the type and location of disease, internal amount of the vessel to be treated, positioning of the patient, and many other factors. I should always use the minimum effective concentration and volume because sclerosant inevitably passes into the deep venous system, where endothelial injury can lead to disastrous consequences. Now here's the bad news. Are you wearing a support hose? yes, we're talking; the dreaded pantyhose is recommended for anyone with visible veins or for people who have had a procedure done. "Wear them every waking hour," says Prof Moawad.