What Is the Best Vein Treatment for Your Condition?

Top Vein Specialists Rank the Best Spider and Varicose Vein Treatments

If you suffer from painful varicose veins, leg heaviness, cramping or swelling, you should be evaluated for an underlying disease called venous reflux. You don’t have to live with unsightly and painful veins, thеrе are many safe and effective treatment орtіоnѕ available, often covered by insurance. Yоu should dіѕсuѕѕ уоur situation wіth уоur doctor, so thаt he or she can evaluate your venous disease and prescribe the bеѕt trеаtmеnt орtіоn fоr уоu.

Fоrtunаtеlу, if you’re seen by a clinic which offers the latest technology, the treatments dо not rеquіrе a long or uncomfortable rесоvеrу and often patients are back to work the same day. Due to new, minimally-іnvаѕіvе and nearly-painless рrосеdurеѕ, mоѕt vein dіѕеаѕе саn nоw be trеаtеd оn аn outpatient bаѕіѕ.

Are you wondering whether vein treatment
is right for you? Are you confused by the multiple treatment options?

Our vein experts in Long Island explain the pros and cons of each varicose and spider vein treatment available. You’ll learn how to choose the best vein doctor in Suffolk County and Nassau County, and also the ideal vein treatment for you.

Medical technology has improved significantly in the last 30 years. But no field has advanced faster than vein treatment. Once a painful and laborious process, spider vein and varicose vein treatment is now gentle and swift with the introduction of minimally invasive techniques. These prolific developments are a welcome change for patients and vein doctors alike. But the array of options can be overwhelming when you’re trying to choose the right vein treatment. This article provides an in-depth look at the various treatments so you can determine the right treatment and the best vein doctor in Long Island to administer it.

The first step in successful vein treatment is understanding the cause of spider veins and varicose veins. These unhealthy veins are primarily caused by an underlying issue called venous insufficiency. The veins in your legs are designed to pump blood up and away from your feet, carrying it to the heart. When the valves that facilitate this one-way transit fail, blood pools in the veins. This increased pressure forces the bulging of varicose veins or the offshoot of spider veins to accommodate the accumulating blood. In order to successfully treat spider and varicose veins, your doctor needs to examine you for venous insufficiency. Simply treating the veins cosmetically, without treating the disease, will result in a recurrence of spider or varicose veins and won’t relieve the other symptoms of vein disease. With a qualified doctor, venous insufficiency is often easy to treat.

Vein Treatment Options


Also Known As: Laser Ablation, Radiofrequency Ablation, Ablation

Best For:Treating venous insufficiency or varicose veins that are large or symptomatic, causing cramping, heaviness, leg fatigue, discomfort, or restless legs.

What Is Endovenous Ablation?

The veins that cause varicose or spider veins to appear at the surface of your skin are located a bit deeper under the skin. When the valves within them break, allowing blood to accumulate or flow the wrong way, the resulting pressure builds and forms varicose or spider veins near the skin’s surface. Endovenous ablation uses thermal energy to eradicate those damaged veins, eliminating the malfunction.

How Does Endovenous Ablation Work?

Ablation technology developed a decade ago and is now an essential tool for any reputable vein clinic. Previous treatments like vein stripping were more painful and time-consuming. Endovenous ablation has replaced such procedures with safer, gentler techniques. With ablation, your vein doctor numbs the skin’s surface and inserts a tiny device into the offending vein. The vein is surrounded with a protective numbing fluid before your vein doctor activates the device. Using radiofrequency, the device generates thermal energy through sound waves to deliver heat to the vein. This causes the walls of the vein to collapse, and eventually be absorbed by the body. The result is improved circulation, as blood re-routes into healthier veins. In most vein clinics, patients remain awake for this painless procedure that lasts about 15-30 minutes. Patients love that it’s an outpatient treatment which requires no downtime, allowing them to resume working the same day. All ablation devices serve the same function, but they generate heat in different ways. Radiofrequency ablation (also called ClosureFast, RF therapy, or RF ablation) uses sound waves to create heat energy, whereas laser ablation (EVLT) uses light to generate thermal energy. The best vein doctors will explain the differences and determine the best type of ablation for you. The doctors at Long Island Vein Clinic are extremely proficient at ablation therapy, having treated hundreds of patients successfully with this technique.


Radiofrequency ablation is far safer and more efficient than vein stripping surgery. It targets the underlying venous insufficiency, not just the appearance of veins. It’s often covered by insurance. The absence of downtime allows most patients to go back to work right after the procedure. Its proven track record reflects both efficacy and safety, making it a top choice for spider and varicose veins.

Pros Summary:

• Outperforms surgery
• Zero downtime
• Proven safe
• Often covered by insurance


Endovenous ablation is safe and effective when performed by qualified doctors with sufficient training and proper tools. There are several devices available to practitioners, so inquire about your doctor’s level of experience with your condition and the tools they use before beginning treatment. Ablation is a precise procedure to execute, particularly the delivery of tumescent anesthesia around the vein walls. An inexperienced doctor might subject you to undue pain and additional injections if they lack training.

Cons Summary:

• Experienced provider required
• Difficult to execute

Is Endovenous Ablation a Good Option for You?

Endovenous ablation is typically covered by insurance and advisable for most patients. Long Island Vein Clinic prefers radiofrequency ablation over laser ablation, since it produces less discomfort following treatment. Endovenous ablation might be the perfect solution for you.


Also Known As: Vein glue.

Best For: Relieving venous insufficiency and its common symptoms like heaviness, cramps, discomfort, restless legs, and leg fatigue that accompany varicose and spider veins.

What Is VenaSeal?

Medtronic, an esteemed medical technology provider, developed VenaSeal, one of the latest treatments for vascular disease. This method uses cyanoacrylate glue, rather than heat, to seal off unhealthy veins. Cyanoacrylate glue has a long history of safety and efficacy for multiple medical procedures.

How Does VenaSeal Work?

Vein doctors use the latest ultrasound technology to locate unhealthy veins. They then numb the ideal access point gently and insert a small catheter into the vein. The ultrasound confirms placement of the catheter tip, and then the doctor slowly delivers the cyanoacrylate glue into the vein, forcing it to seal itself shut. This procedure forces blood to flow into the appropriate, healthy veins.


Since VenaSeal doesn’t involve tumescent anesthesia, there is no swelling after treatment. It’s also advantageous over endovenous ablation for veins with several branches, since the cyanoacrylate solution flows into those branches, potentially closing off multiple faulty pathways with one treatment.

Pros Summary:

• Advanced technology
• Optimal choice for vascular disease that’s been treated previously


The long term impact of VenaSeal is still being determined, since the modality is so new. The glue solution remains in the body, hardening as it implants, which is undesirable for certain patients. Allergic reaction is possible in a small percentage of patients. Some insurance companies do not currently cover VenaSeal since it’s a very new technology.

Cons Summary:

• Technical experience required in provider
• Glue is a permanent deposit
• Allergic reaction possible
• Many insurance companies won’t cover it

Is VenaSeal a Good Option for You?

If you’ve treated your vein disease in the past with other methods, VenaSeal might be the best choice for you. Complete a thorough allergy assessment with your doctor before attempting VenaSeal. Our insurance specialists will check with your insurance company before treatment to determine your coverage.


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

Best For: Small varicose veins and spider veins.

What Is Sclerotherapy?

Doctors inject a sclerosant medication into unhealthy superficial veins to irritate the vein walls. This irritant forces them to close, making veins much smaller, lighter, and less visible.

How Does Sclerotherapy Work?

Your vein doctor will locate the problematic vein either by examining your skin’s surface or performing an ultrasound. Your doctor can then use either the ultrasound machine or a small needle to inject a sclerotherapy solution into the veins, depending on how deep the vein is located. Several medicines serve as sclerosants, including the oldest one, hypertonic saline. However, the newer solutions are more effective and eliminate the discomfort caused by the concentrated salt water of older sclerosants.


Damaged veins are often tortuous (having many twists and turns), which is why sclerotherapy is effective. Since it’s a liquid medicine, it flows through those twists and turns to access places a catheter (such as those used in ablation or VenaSeal) cannot. Sclerotherapy is particularly effective for spider veins near the skin’s surface, offering immediate resolution. With the right doctor, sclerotherapy is recommended over laser treatment for spider veins.

Pros Summary:

• Best solution for spider veins
• Requires no downtime


Sclerotherapy has many forms and a wide range of price points. Each liquid solution has pros and cons, and vein clinics don’t all use the same medication. Results depend largely on which medicine is injected and which doctor performed the procedure. Some solutions require dilution with sterilized water for correct dosing. Only a certified vein clinic is likely to perform this step correctly. The quality and dosage of the solution determine whether you’ll experience discomfort or skin discoloration. In addition, untrained technicians could mistakenly inject the solution into an artery, instead of a vein, prompting necrosis. For these reasons, only allow a board certified vein doctor to administer sclerotherapy treatment.

Cons Summary:

• An experienced doctor is required
• Results will vary based on chosen medication and proper dilution

Is Sclerotherapy a Good Option for You?

If you’re ineligible for radiofrequency ablation or VenaSeal, sclerotherapy may be a great choice for you. In addition, if appearance, rather than vein disease, is prompting you to seek treatment, sclerotherapy is a good option.


Also Known As: Foamed sclerosant ablation, vein injections

Best For: Both large and small varicose veins

What Is Foam Sclerotherapy?

Foam sclerotherapy uses medication to close off a vein, much like liquid sclerotherapy. It’s administered to the vein walls to force them to seal shut. However, with foam sclerotherapy, the sclerosant is agitated and mixed with air to create a bubbly consistency. This enables your vein doctor to treat a larger vein without increasing the dose of medicine, since it fills the veins, rather than being diluted. This process minimizes the amount of medicine necessary and is also more visible via ultrasound for your doctor as they close off tiny veins.

The Procedure:

Through ultrasound-guided technology or visual examination, your doctor identifies the unhealthy vein. Once your doctor has numbed and prepped the surface and the vein, they will combine air and medication rapidly with two syringes to optimize foam consistency just before injecting it. Your physician will then observe the injected foam via ultrasound to monitor its movement throughout the vein.


Twisted and tortuous veins are good candidates for foam sclerotherapy, since they’re hard to maneuver with other methods. Vein disease that recurs also responds well to foam sclerotherapy.

Pros Summary:

• Ideal treatment for tortuous veins
• Recurrent vein disease responds well to this method


Only an experienced vein doctor proficient in venous anatomy should administer foam sclerotherapy. Since varicose veins at the skin’s surface connect to deeper veins via perforating veins, it’s essential to prevent the foam from traveling into these deeper veins. A qualified physician will map out these connections before injecting foam sclerosants.

Cons Summary:

• A physician proficient in vein mapping is essential

Is Foam Sclerotherapy a Good Option for Me?

Patients with reticular veins (unhealthy yet smaller than varicose veins) or varicose veins seeking cosmetic treatment will benefit from foam sclerotherapy. Foam injections are also effective in patients who’ve tried other treatments unsuccessfully.


Also Known As: Foam sclerotherapy

Best For: Venous insufficiency, larger varicose veins and accompanying symptoms like pain, heaviness, discomfort, restless or fatigued legs, and cramping.

What is Pre-Mixed Foam Sclerotherapy?

A highly effective version of foam sclerotherapy, this medication comes in a specially sealed canister. Instances of air embolism have occurred in patients receiving traditional foam therapy if air from the room pervaded their sclerosant solution. With an embolism, air moves through the bloodstream to the lungs, impairing blood cell transport and blood oxygenation. The pre-mixed method mixes a higher concentration of nitrogen and carbon dioxide with the sclerosant to expedite travel through the bloodstream and it also deactivates more quickly than foam solutions mixed with regular air. Theoretically, this yields a more safe and accurate delivery of the foamed medication.

How Is Pre-Mixed Foam Sclerotherapy Performed?

Much like other types of sclerotherapy, your doctor will isolate problematic veins with a visual inspection or ultrasound guided imagery. For deeper veins, foam sclerotherapy is injected via the ultrasound machine. Veins near the surface of the skin are injected directly with a small needle. The primary differences between pre-mixed foam sclerotherapy and traditional foam therapy are the concentration of elements, and that the doctor doesn’t need to agitate the sclerosant with air, since it comes ready to inject.


Pre-mixed foam sclerotherapy is an excellent alternative to surgery, particularly for patients with large varicose veins that can’t be eliminated with other procedures. It’s extremely effective against recurrent vein disease.

Pros Summary:

• Superior method for large varicose veins to avoid surgery
• Highly effective
• Excellent for addressing recurrent varicose veins


Some insurance companies don’t cover pre-mixed foam sclerotherapy, which means it can be quite expensive. The medicine’s potency requires a highly trained vein physician.

Cons Summary:

• Medication’s potency requires trained physician
• Some insurance companies don’t cover it

Is Pre-Mixed Foam a Good Option for Me?

Check with your vein doctor to see if pre-mixed foam is a realistic financial option for you. This highly effective alternative to foam sclerotherapy is an excellent way to avoid vein surgery.


Also Known As: Mechanochemical Ablation

Best For: Addressing the underlying venous insufficiency that causes spider veins and varicose veins, as well as symptoms like discomfort, restless legs, heaviness, cramps, and leg fatigue.

What Is ClariVein?

Both medication and mechanical agitation are utilized in this modality that shuts down unhealthy veins. An innovative rotating catheter mechanically traumatizes the vein wall at the inner lining to provoke closure. The ClariVein then secretes sclerosant medicine, adding chemical irritation to the mechanical damage to close off the diseased vein.

How Is ClariVein Performed?

The injection site is first prepped with a gentle cleaning solution. Through ultrasound guidance, the doctor locates the problematic vein and numbs the access point above the vein. The special ClariVein catheter is inserted and rotates to disrupt the vein walls, then transports the sclerosant solution to the vein. Your doctor guides the catheter along the entire vein for comprehensive treatment.


Since the catheter is quite small, it’s adept at navigating tortuous veins. Unlike VenaSeal, ClariVein doesn’t implant a substance permanently in your body. There’s also no need for tumescent anesthesia with ClariVein.

Pros Summary:

• No tumescent anesthesia required
• No permanent substance implanted
• Navigates tortuous veins well


The majority of insurance companies don’t cover this procedure. Some doctors have reported complications including trouble navigating past venous valves, prompting patient discomfort.

Cons Summary:

• Unlikely to be covered by insurance
• Uncomfortable for some patients

Is ClariVein Right for Me?

Some patients are allergic to lidocaine, which prevents treatment with tumescent anesthesia. Others aren’t comfortable with permanent implants by procedures like VenaSeal. These patients are great candidates for ClariVein, but it’s important for them to know that insurance might not cover it and results can vary.


Also Known As: Vein removal, phlebectomy, vein stripping

Best For: Very large varicose veins

What Is Vein Stripping?

Typical vein surgery requires an open incision to reach the diseased vein. Once they gain access, doctors use a variety of techniques and equipment to extract the vein.

How Is Vein Stripping Performed?

Ultrasound guidance identifies the diseased vein, and then the patient is given anesthesia prior to operation. A vein doctor will cut down into the skin that covers the vein and identify the damaged vein. They will then employ surgical tools, most commonly, a hook, to pull the vein loose forcefully and remove it from the body.


Certain large and tortuous veins might require surgery

Pros Summary:

• Currently, it’s the best treatment for certain veins in rare cases


Multiple minimally invasive and non-invasive procedures now outperform surgery in both safety and effectiveness, causing fewer complications. Good vein doctors no longer consider surgery a first line of treatment.

Cons Summary:

• Minimally invasive techniques supplant outdated surgical technology

Is Vein Surgery Right for Me?

Patients should only consider vein surgery if their vein is remarkably large and tortuous and all prior treatment attempts have failed. Patients with blood clots might also need surgery to treat vein disease.

Talk to a renowned vein doctor at our vein clinics on the North Shore or South Shore of Long Island if you have questions about vein treatments. Each of our physicians is board certified and has extensive experience executing these procedures. Our team delivers exceptional results with the highest level of care and precision.

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

Speaking with an experienced vein doctor at a premiere vein clinic will help you determine the best solution. Vein anatomy and medical history are unique to the individual, so a customized treatment plan is essential. Choosing the right vein doctor is the first step toward successful vein treatment. Here are five characteristics of a top vein clinic to assist in your selection.

The vein doctor takes time to listen to your symptoms and concerns:


Many doctors don’t build enough time into their schedule to fully listen to each patient. You deserve answers to all of your questions and a thorough explanation of your condition and treatment during your appointment. At Long Island Vein Clinics, we prioritize understanding your treatment goals and medical history, rather than having one foot out the door while you speak, like some doctors do.

Our NJ vein doctors are world-class physicians.

Each of our doctors is a leader in the field of venous medicine who sets the standard for all other NJ vein centers. Our esteemed physicians frequently train other doctors on our superior diagnostic and treatment techniques. Our Harvard-trained medical directors developed superior systems and the highest safety standards for each of our centers to follow. Each doctor at our vein centers is a highly qualified, board-certified vein expert, and also an expert listener, adept at customizing treatment to the individual. You’ll never have unanswered questions with our caring physicians.

The vein clinic uses ultrasound technology to investigate beneath the surface:


Some patients think of spider veins or varicose veins as a cosmetic problem. But a top vein doctor knows to evaluate the deeper veins to determine what’s causing the damage at the surface. Surface treatments won’t address the underlying problem, so the results are only temporary.

Our treatment plans always incorporate your input.

Each vein doctor in our practice takes a collaborative approach, sharing your symptoms with other experts on our team for the most comprehensive analysis. We understand that patients are in tune with their own bodies, so we always use your goals and preferences in our diagnostic process. Every patient’s case is submitted to our medical directors for quality assurance and rigorous review. At our Paramus and Clifton vein centers, you work with an esteemed doctor who applies the expertise of our entire team.

The vein specialist is trained in the latest uses for ultrasonography:


The newest minimally invasive procedures require specific ultrasound training. Some doctors use assistants trained in ultrasonography, rather than completing training themselves. For these intricate vein procedures, it’s important to choose doctors who are expertly trained in ultrasound guidance, like our Long Island Vein Clinic physicians.

The vein clinic is accredited:


The Intersocietal Accreditation Commission (IAC) assesses vein clinics to select and recognize those meeting the highest quality standards. Our Long Island Vein Clinics, and each of our vein clinics, are IAC certified, possessing the latest equipment, expert technicians, and doctors with expert-level training.

Our vein
centers offer
state-of-the-art care.

Our premiere NJ vein centers hold the unique distinction of dual accreditation in vascular imaging and venous medicine. Following a rigorous approval process, we achieved this rare recognition from the Intersocietal Accreditation Commission for the exceptional level of care in all of our vein centers. The extensive review of our practice revealed the highest marks in quality, safety, and performance, proving us supremely qualified to treat vein disease.

*New clinic locations might be in the approval process at the time of publication.

Our board-certified vein doctors are distinctly trained.

The Intersocietal Accreditation Commission (IAC) assesses vein clinics to select and recognize those meeting the highest quality standards. Our Long Island Vein Clinics, and each of our vein clinics, are IAC certified, possessing the latest equipment, expert technicians, and doctors with expert-level training.

Your vein treatment plan is designed only for you:


No vein treatment is right for everyone, since our bodies, preferences, and lifestyles are so diverse. It’s important for your vein doctor to design treatment around you, rather than taking a generalized approach. Long Island Vein Clinic tailors treatment plans to the individual, often using multiple top technologies for the perfect resolution. We involve you in each step of the process, always ensuring you’re completely informed and comfortable with the plan.

Our 5-star
reviews speak for themselves.

Patient satisfaction is guaranteed at our New Jersey Vein Centers. Check out our favorable reviews on Facebook, Google, and RealSelf to see why patients love our NJ vein centers.

If you’re experiencing chronic leg discomfort, you might be wondering if poor circulation is the cause. Whether you want to eliminate spider veins, varicose veins, or uncomfortable symptoms, our Long Island Vein Clinics have the solution. The Ivy-League trained vein specialists at all three of our highly accredited vein clinics in Long Island will help you select the perfect treatment for your vascular health.

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Vein Treatment

Our vein doctors are some of the best in the field, having written multiple books and articles. They are constantly on the lookout for new and innovative treatment options. If we believe a new therapy is safe to employ in our clinic, we will add it to our list of alternatives to guarantee that our patients receive the minimally invasive, most painless, and most successful vein treatments available. Sclerotherapy, radiofrequency ablation, venaseal, and laser vein ablation are the best solutions for most venous problems.

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(631) 305-2827


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