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San Francisco
Vein Center
Seton Medical Center
1850 Sullivan Ave Ste 300
Daly City, CA 94015
650-991-1122
St Mary’s Medical Center
2250 Hayes Street Ste 612
San Francisco, CA 94117
415-752-1122
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Varicose Veins and Treatments

Looking for answers?

Varicose veins are not always a cosmetic issue. Treatment is typically covered by insurance.

What Are Varicose Veins?

Varicose veins are enlarged, twisted veins most commonly found in the legs. They develop when the valves in your veins weaken and allow blood to pool. Over time, this pressure causes veins to bulge and become visibly distorted. In addition to cosmetic concerns, varicose veins can cause pain, swelling, and other uncomfortable symptoms that often worsen without treatment.

Patients often ask us, “How do I get rid of varicose veins?” The answer depends on the severity of your condition, but today’s minimally invasive vein treatment options make it easier than ever to address varicose veins safely and effectively—with little to no downtime. Our clinic specializes in leg vein treatment for patients throughout the San Francisco Bay Area.

Symptoms of Varicose Veins

Varicose vein symptoms may begin with subtle discomfort or visible leg veins, but the symptoms can become more pronounced over time. Many patients come to us seeking treatment for painful varicose veins, which can interfere with daily activities and quality of life. Varicose veins are swollen and usually purple or blue. The blue color is because blood that pools in the veins is deficient of oxygen. Most varicose symptoms are worse at the end of the day, around the time of a menstrual period, in hot weather, and with prolonged standing or sitting. Symptoms are often improved with leg elevation, or the use of compression stockings.

Common signs include:

  • Leg pain or heaviness
  • Swelling in the ankles or calves (edema). One of the most telltale signs are indentations in your legs from socks.
  • Aching or throbbing sensations. This feeling is due to the increased pressure of the blood against the vein wall.
  • Night cramps
  • Restless legs
  • Numbness
  • Itching or burning along the vein path. This may lead to severely dry skin and can be a form of eczema.
  • Skin discoloration or inflammation
  • Worsening symptoms during menstruation or pregnancy

If you’re experiencing any of these symptoms, evaluation by a board-certified vein specialist is recommended.

What Causes Varicose Veins?

Healthy veins have one-way valves that help blood return to the heart. When these valves fail, blood flows backward and collects in the vein—a condition known as venous reflux or venous insufficiency. This can cause the vein to stretch, swell, and become varicose.

Several factors can increase your risk:

  • Family history of vein disease
  • Pregnancy or hormonal changes
  • Prolonged standing or sitting
  • Obesity
  • Aging
  • Injury

Understanding the cause of your vein issues is a crucial first step in determining the most appropriate treatment plan.

Are Varicose Veins Dangerous?

Many people assume varicose veins are purely cosmetic, but in reality, they can indicate underlying vein disease called venous insufficiency. Left untreated, varicose veins can worsen and lead to complications such as:

  • Skin discoloration
  • Bleeding
  • Superficial thrombophlebitis (inflammation and clotting in surface veins)
  • Venous leg ulcers

Another common question we hear: “Do varicose veins go away on their own?” Unfortunately, they do not. While symptoms may fluctuate, the underlying condition tends to progress without proper treatment.

Diagnosis and Personalized Treatment Planning

Your treatment should begin with a detailed evaluation. Diagnosis typically includes a physical exam and a non-invasive ultrasound vein mapping to assess blood flow and pinpoint the affected veins. Ultrasound allows us to observe the characteristics of blood flow to determine if the vein valves are failing. This will determine if you have venous reflux.

Based on your symptoms, ultrasound findings, and treatment goals, we’ll design a personalized plan tailored specifically to your needs. Most procedures are medically necessary and covered by insurance. An ultrasound study is actually one of the requirements insurance companies require in order for a vein treatment to be covered.

Conservative Treatments

Conservative varicose vein treatment is sometimes sufficient to alleviate symptoms. These are mainly lifestyle changes that may not cure or prevent vein disease. They typically slow disease progress and help with uncomfortable symptoms but don’t eliminated the diseased veins. Examples of conservative vein treatments are::

  • compression stockings or compression therapy
  • exercise
  • weight loss
  • avoiding standing for prolonged periods of time
  • lowering cardiovascular risk factors like LDL cholesterol, blood pressure, and smoking

Minimally Invasive Varicose Vein Treatment

We specialize in minimally invasive varicose vein treatment that addresses both cosmetic and functional concerns. These procedures are performed in our San Francisco office, typically using local anesthesia.

Our treatments are designed to:

  • Eliminate the underlying reflux
  • Improve symptoms and appearance
  • Minimize recovery time

You’ll be able to walk immediately after your procedure and return to most normal activities the same day. For more complicated cases, some patients need to be brought to the operating room. However, post-operative process is the same as when done in the office. The patient can walks out with little pain and recovery time.

Best Treatment for Varicose Veins

For most patients, radiofrequency ablation (RFA) is the gold standard in varicose vein care. RFA uses thermal energy to close off malfunctioning veins, redirecting blood flow to healthy veins nearby. It is safe, effective, and virtually painless.

We’ve dedicated an entire page to explaining how RFA works and why it’s considered the best treatment for varicose veins:
Learn more about RFA

Varicose Vein Removal

Varicose vein removal refers to the physical elimination of damaged veins that no longer function properly. While RFA closes faulty veins internally, some cases may also benefit from procedures like microphlebectomy—where small sections of vein are removed through tiny incisions. These options are cosmetic, functional, or both, depending on your condition. This procedure is also commonly done in the office.

Do You Need Varicose Vein Surgery?

Today, varicose vein surgery usually refers to office-based procedures like RFA or microphlebectomy. Traditional vein stripping is rarely performed due to advances in modern technology. Most patients can achieve excellent results without the need for invasive surgery, downtime, or general anesthesia.

What to Expect Before, During, and After Treatment

Before: You’ll undergo a full consultation and ultrasound. We’ll review your medical history, symptoms, and goals.

During: Most procedures take under an hour. Local anesthesia is used to ensure comfort, and you’ll remain awake and relaxed throughout.

After: You’ll walk immediately and can typically resume normal activity the same day. Compression stockings are not necessary after radiofrequency ablation but some patients opt to wear them. Follow-up visits help monitor healing and long-term results.

Varicose Veins Can Be More Than Cosmetic

Unfortunately, varicose veins don’t improve without treatment. Left untreated, they will usually get bigger and more painful over time. Varicose veins are not just cosmetic—they represent a physical condition caused by insufficient valves and increased pressure in the veins of the legs. Without treatment, the condition typically gets worse, including a more noticeable appearance, leg swelling, leg throbbing, leg pain, and the formation of new spider veins or varicose veins. In extreme cases, if the condition continues to be left untreated, venous ulcers can develop, which are serious and can take months to heal.