Sarasota manufacturer Rick Wheeler has always been physically fit, even swimming competitively in his youth. He attributes his strength to good genes, but genetics were against him when it came to his vascular system.

As they had in his mother and sister before him, the veins running through Wheeler's thighs throbbed with pain, itched and burned constantly. His wife, Susan, fared no better. Each of her three pregnancies left behind a new, prominent vein, prompting Rick to joke, "It's almost as if every vein got its own name."

At 41 and 43 years old, Rick and Susan Wheeler are typical varicose vein patients. Although much of the advertising for vein treatments targets young women sprucing up for swimsuit season, vein problems usually afflict those between the ages of 30 and 70, causing a lot more pain than the psychological trauma of looking bad in a bikini.

As they worsen over time, varicose veins can swell the feet and calves, creating the itching or burning sensations that plagued Rick Wheeler. Some victims develop deep vein thrombosis (blood clots), and others suffer painful skin ulcers around the ankle, making the pursuit of relief far more than a simple case of vanity.

The American Society of Plastic Surgeons estimates that at least half of all women are affected by varicose veins, and that 41 percent of them will have some type by the time they reach the age of 50. (Men are also affected, though they're less likely to seek treatment because their legs are covered by hair.)

Varicose veins strike pregnant women because of diminished circulatory flow from the legs to the pelvis. They're caused in others by malfunctions in the valves that veins use to pump blood throughout the body. Hormonal fluctuations, synthetic hormone therapy and oral contraceptives can all cause the condition. Also, as we age, our veins lose their elasticity, causing blood to pool in their stretched remnants.

Thankfully, removing them does little harm; as Dr. Joseph Pecoraro of Bradenton's Cosmetic Vein Clinic of Florida notes, "They're unhealthy veins, anyway." Pecoraro explains that blood will always reroute to nearby healthy veins. "Most of the veins we remove, if they were healthy, would be the veins we'd take to do bypass surgery," he adds.

In fact, modern medicine has given us an arsenal to combat the two types of veins that bedevil us. The first, spider veins, are known by their tree-branch appearance and jagged lines that often result from sun exposure. True varicose veins are darker in color and can protrude like twisted cords. They lie deeper below the skin than spider veins and are most common in the legs, but can appear elsewhere.

"In the past, people had been told this is something they have to live with," says Dr. John Dunne, of Erasers Body Enhancement Centers, Inc. "That's just not true." But traditional methods for removing deep varicose veins involved surgically "stripping" them from beneath the skin, as was done to Rick Wheeler's mother 20 years ago and his sister in 1996. Side effects could include anything from infection to inflammation, swelling and redness. The procedure also caused occasional permanent scarring, damage to surrounding nerve tissue, numbness, burning sensations and blood clots. "Stripping is only rarely done now because it requires hospitalization," says Dunne. Not only is it painful, but with stripping, varicose veins have a 30-percent rate of recurrence.

Today, Dunne and many doctors prefer "closure" techniques that use radio frequency to send energy into the vein via a small catheter or tube, causing the vein wall to shrink and seal. This type of treatment usually requires only a single incision and little down time for patients. One hour-long session is generally sufficient, but severe cases may require up to five visits.

Closure procedures have a 94 to 98-percent success rate, and lasers are making the process even more attractive. Endovenous laser therapy, or EVLT, "does the same thing that [closure] does, only it does it with a laser in a matter of minutes," says Pecoraro.

"This is just amazing," raves Wheeler, who, along with his wife, underwent EVLT last summer. He admits that after his session he felt as if he'd been punched in the legs a few times, but, "It wasn't unbearable. I didn't even need a Tylenol."

Lasers and intense pulse lights (IPLs) have been used for years to treat small spider veins along the nose and face, but until recently, they've proved ineffective for deep leg veins. Dunne says a recently approved FDA model produces results that are equivalent to radio frequency closure, with the same lack of side effects, only faster. And unlike older lasers, this one is just as effective on darker-skinned people, including those of Asian, African-American or Middle Eastern descent.