Treating Leg Veins

Leg veins present in multiple sizes shapes, and depths. The main approach to treating leg veins is to treat the veins starting from groin and progressing to the toes and treating from the largest to the smallest veins. It is important to treat the highest, largest area of backflow before treating the lower dilated (diseased) veins or the lower veins will continue to come back despite proper treatment.

No matter what size of vein being treated, the basic approach is always to damage the inner lining of the veins and compress the injured lining so that the veins heal (scar) closed. Once the backflow in the diseased veins is stopped, blood can flow to the heart in a normal manner.

After treatment, compression needs to be maintained for three weeks; the most critical time is the first three days. Adequate time is required for the veins to heal tightly prior to removing the compression. The stockings prevent gravity and backflow from holding the veins open while they heal.

Spider & Small Veins
Spider and small veins are not always the result of genetics or aging (thinning of the skin). These veins may be caused by backflow from the higher and larger diseased veins. It is important to determine whether or not upstream backflow is present with a continuous-wave Doppler examination prior to treating the smaller veins. Failure to treat the upstream veins first will result in the treated veins opening and new veins appearing. The main trunk varicose veins must be treated before the spider veins in order to treat the cause of the problem.

Sclerotherapy is the primary treatment for spider, small, and medium size leg veins. Each laser (light) wavelength is absorbed by a particular color and penetrates the skin to a particular depth. It is hard to get consistent results with lasers because leg veins are multiple colors and are located at different depths. Additionally, lasers cause more discomfort than sclerotherapy. This is why lasers are the second line of treatment for leg veins. Sclerotherapy and lasers can be used together if necessary to treat resistant leg veins.

It often takes multiple treatments to remove the smaller leg veins. One leg is usually done at a time. Treatments are usually done on one a leg or specific area and can be done every three (3) to four (4) weeks. As a rule, treatments continue until you are satisfied with the results or the small veins are gone. Small leg veins develop to one extent of another throughout your lifetime.

Varicose Veins
Large varicose veins, and the diseased main trunks that cause them, are treated with Radiofrequency or Laser. Although sclerotherapy can be used to treat the larger veins, the concentration and amount of sclerosant required to get lasting results is more risky than using Radiofrequency and Laser techniques. These are most often a one-time treatment; however, the main trunks, perforators, and tributaries are usually treated during separate sessions. Duplex Doppler Ultrasound is used to determine the location and extent of the diseased veins and to guide each treatment of the large veins and trunks.