Question: I live in Sun City and see a vein doctor here. I'm being rushed into getting an endovenous laser ablation. I've been diagnosed with grade 2 venous problems. Also, my symptoms are mild and my reticular and spider veins are both less than 4mm. Can I wait on ELA until my symptoms get worse? Will sclerotherapy do for now?
Answer: The decision to treat venous insufficiency is ALWAYS your decision. There is no urgent need for intervention unless you have an ulcer that is not healing, and even then, there is time. The natural progression is that venous disease progressively gets worse over time, but this is a slow process (several years). It is not unreasonable to hold off on EVLT (ELA) until such time when you feel your symptoms are to the point where you wish to treat. Regarding sclerotherapy for reticular veins and telangiectasia, you can have these treated without doing the EVLT first, however, if these veins are fed by a larger abnormal vein, the sclerotherapy may fail. Above all else, be comfortable in the treatment you chose and do not rush into anything that is elective. Take your time and make the decision that is right for you.