A 55-year-old woman comes in for evaluation of large, bulging veins in her legs, which she finds cosmetically unappealing. She denies any leg pain, swelling, or skin changes. What are her options for management?
This patient has varicose veins, but it appears her primary concern is cosmetic. Although conservative measures such as exercise, weight loss, and compression stockings may improve symptoms if they arise in the future, they are unlikely to improve the appearance significantly. She may consider cosmetic treatments such as sclerotherapy, endovenous laser ablation, or radiofrequency ablation. These procedures aim to close off the affected veins, causing them to gradually fade, but potential risks and benefits should be discussed with the patient.