Varicose veins occur most often in the legs; they are a common problem that affects twenty to thirty percent of women, and ten to fifteen percent of men. Doctors consider pregnancy and obesity to be the most significant risk factors. They are caused by valves in the veins becoming damaged or breaking, which can result in blood pooling in the veins permanently, especially when the patient is standing. There are three ways of treating varicose veins: by removal (vein stripping), by injection with a saline solution that causes the veins to scar closed (sclerotherapy), or, most recently, heating and cauterizing (endovenous ablation). Contrary to what patients might think, these treatments do not cause circulation problems, because blood flow is re-routed around the blockage to healthy veins, an adaptive process called "collateral circulation."

Vein stripping is done using general anesthesia; the surgeon makes incisions at each end of the varicose vein. The surgeon then slides a thin wire-like instrument into the vein to clear it from the inside. Finally, the surgeon may make small incisions over the veins to remove them if necessary.

Vein sclerotherapy is done with the patient standing up. The surgeon injects a saline solution into each varicose vein, which causes the vein to scar closed. After the procedure, to aid healing, an elastic bandage is wrapped snugly around the leg or legs that have been treated. Endovenous ablation therapy is a recently developed, less invasive (i.e. outpatient) procedure. The therapy uses heat to destroy the unhealthy vein tissue. Using only local anesthesia, the surgeon inserts a thin catheter (or tube) into the vein through a tiny skin incision. Then, using either a laser or radio wave (radio frequency) energy, the vein is heated and cauterized. This closes off the vein.

Today, fewer doctors are performing the traditional vein stripping surgery, as more patients opt for the endovenous ablation procedure, which causes less pain and gives a quicker recuperation. Research thus far has indicated that the endovenous ablation procedure works the same as or better than the previous two surgical methods.