Venous insufficiency that is not significant, as determined by the severity of symptoms and the venous ultrasound findings, does not necessarily require any kind of invasive treatment, but just conservative management.
Early stage spider or varicose veins may be primarily a cosmetic problem and it is absolutely reasonable to seek treatment for cosmetic reasons, particularly if the risks of the procedures offered are minimal.
Severe cases of varicose veins, especially those involving ulcers, typically require treatment.
Varicose veins are frequently treated by eliminating the "bad" veins. This forces the blood to flow through the remaining healthy veins. Various methods can be used to eliminate the problem. Advertisements for treating venous disease often tout "unique, "permanent", "painless" or "absolutely safe" methods, making it difficult to decide on the best treatment. Treatment can be lifestyle changes with medical treatment, sclerotherapy, vein laser or radiofrequency ablation and surgery (vein stripping / saphenectomy). All options have a place in contemporary practice and your vascular surgeon will guide you towards the best option.