The best way- in fact, the only effective way- to get rid of spider veins is to close the feeding green veins. It’s even more important to treat the feeding green veins that it is to treat the spider veins themselves. But a decade ago, most physicians didn’t know this. If they had, they couldn’t have done much about it anyway, because the medical techniques at that point simply weren’t up to the task. Hypertonic saline injections and spider vein laser therapies are just “surface treatments” that ignore the underlying disease process. So, until fairly recently physicians treated spider veins while ignoring the underlying feeding green veins. No wonder the results were limited and transitory! In gardening analogy, it’s like cutting off the weeds and leaving the roots behind. Fortunately, that has all changed. There are now excellent methods for treating feeding green veins. And to add to the good news, doctors are now able to automatically close incompetent perforator veins by simply treating the adjoining feeding green veins. However, very large incompetent perforator veins may need additional treatment.