Compression Therapy. Compression therapy is often considered the first-line treatment and is the most frequently used treatment for varicose veins and its associated complications, including venous edema and leg swelling, skin changes, and ulcerations.[14] Compression therapy involves wearing elastic compression stockings, multilayer elastic wraps, paste gauze boots, elastic and nonelastic bandages, nonelastic garments, or dressings.[3] Gloviczki et al[3] argues that compression treatment compensates for the increased venous pressure of the lower limbs during ambulation. Compression stockings have been shown to be effective in managing varicose veins symptoms, including pain, skin hyperpigmentation, and edema.[3,14] However, data from a recent systematic review[15] regarding whether compression therapy is effective in slowing the progression of varicose veins or preventing their recurrence were inconclusive. Moreover, Palfreyman and Michaels[15] also note in their review that many of the patients were noncompliant and reluctant to wear the compression stockings for various reasons, including that the stockings are not effective, they are too tight, or they make the patients feel too hot. Besides discomfort, badly fitting compression stockings can also lead to more severe complications, including pressure necrosis, inadequate perfusion of the lower limb, and the need for amputation, especially if there is already arterial disease in the leg.[15] Therefore, careful assessment is required for choosing the correct size of compression stockings, and only those with proper training should prescribe stockings for patients. At this time, the Society for Vascular Surgery and the American Venous Forum recommend compression therapy with at least knee-high stockings for patients presenting with simple varicose veins.[3] Conservative management that includes lifestyle changes related to weight loss and the elevation of the legs may also be included along with compression therapy.[3] Patients should also be educated on the importance of putting the compression stockings on before getting out of bed and the importance of wearing the stockings when ambulatory.[13]