[Kneipp hydrotherapy, sclerotherapy, crossectomy. What really helps in varicose veins and spider veins?]

Varicose veins are irreversibly dilated epifascial and perforating veins resulting from degenerative vascular wall changes. Depending on etiology, they are classified into primary and secondary forms. The majority of the primary varicosities (75%) are hereditary. A clinical differentiation is made between varicosities of major vessels, side branch varicosities, varicosis of the perforating veins, reticular, and cutaneous vessel varicosities, with mixed forms also being known. Inspection and palpation are of predominant importance for the diagnosis, while Doppler and duplex ultrasonography serve mainly to document valvular incompetence. Treatment is determined by the findings, symptoms and the individual situation, and comprises, in addition to such general measures as activity, hot/cold foot baths, obliteration and surgery. A conservative alternative is rigorously applied compression treatment, which is also the most important concomitant measure to sclerotherapy and surgical operation.