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Leg vein treatment is a specialty of Dr. Michele Green’s and she has spent years as a NYC top doctor researching and implementing the best procedures. Dr. Green is among the best leg vein treatment doctors in NYC and treats a full range of vein disorders including varicose veins, spider veins, facial veins, venous insufficiency, and bulging veins on your hands and legs. As one of NYC’s best dermatologists, she will implement the most effective leg vein treatment for you, whether it be with non-invasive injections of sclerotherapy or laser treatments.  Dr. Green will provide you with the least invasive, and most effective leg vein treatment to eliminate the veins on your legs and face, quickly and painlessly.

Varicose Veins and Spider Vein Treatment NYC

Varicose veins and spider veins are a common skin condition affecting up to 60% of the adults in the United States. Spider veins, or superficial leg veins, appear as red superficial blood vessels, which lie close to the skin.  Spider veins often appear like webs. Spider veins can also appear commonly on the face. Varicose veins are typically blue in color, are larger in diameter, and often bulge out into the skin. Varicose veins usually cause more discomfort and can ache or throb and pop out like “ropes” on the skin’s surface.

Source: Syneron Candela

Why do we get leg veins and spider veins?

Spider veins and varicose veins occur when blood pools in veins near the surface of the skin.  As we age, the valves in our veins tend to weaken and push some blood flow backwards, away from the heart, and this blood accumulates in the veins.  The veins have tiny one-way valves, which allow the blood to flow in only one direction, back to the heart.  When these one-way valves are weakened or defective, blood flows backwards and pools in the legs. This extra blood in the leg veins puts pressure on the walls of the vein, causing this unsightly appearance.

What factors contribute to spider veins?

Although the exact cause of spider veins and varicose veins are not know, the following factors contribute to their formation:

  • Hereditary;  a family history of leg veins
  • Obesity
  • Trauma
  • Hormone levels
  • Pregnancy
  • Age
  • Long periods of sitting or standing
  • Sunburns or tanning 


How can Sclerotherapy in NYC Best Treat your Leg Veins?

If you have painful and unsightly spider or varicose veins, sclerotherapy is the treatment of choice.  Sclerotherapy is one of the best non-invasive leg vein treatments in NYC. Dr. Green uses Asclera®, a leading sclerosing agent, to inject your veins in a cosmetically elegant way. When your veins are injected with Asclera®, the solution irritates the lining of the blood vessel wall, causing the vessel to seal up and become invisible. After the vein collapses, the body slowly absorbs the remaining vessel until the skin becomes smooth and spider vein-free.  Sclerotherapy is an extremely popular procedure at Dr. Green’s office because most of her patients do not want the downtime and discomfort associated with invasive procedures. Foam sclerotherapy can be used on some larger veins as well. One of the benefits of noninvasive treatments, is that after your sclerotherapy treatment, you can resume your normal activities the same day.

What is the Process of leg vein treatment with sclerotherapy?

You will consult with Dr. Michele Green about your leg veins.  She will review your complete medical history including current medications, allergies, and surgeries.  The nurse will take photographs of your leg veins and determine if you are a good candidate for sclerotherapy.

  • The treatment area, your leg veins,  is numbed topically with a local anesthesia for 30 to 45 minutes.
  • The legs are cleaned with alcohol and prepared for injection.
  • Dr. Green injects a sclerosant, called Asclera, into the spider or varicose vines. This sclerosant irritates the wall of the vein, and sometimes causes bruising. Multiple injections are performed on all of the various leg veins in a single session.
  • After the injections, your legs are cleaned and compression stocking are worn home after the procedure.
  • You should walk as much as possible after the sclerotherapy procedure, exercise, and wear compression stockings for at least two weeks.
  • Most patients can return to normal activities  immediately after the procedure.
  • The only side effect is local irritation and bruising at the injection site.
  • Repeat injections are scheduled one month apart.
  • Patients are advised not to fly for several days after sclerotherapy and avoid saunas and stream rooms for two weeks.
  • Depending on the number and depth of your spider veins or varicose veins, it can take 3 or more treatments to make these veins disappear.

Best Laser Treatment Options for Leg Vein Treatments in NYC

V-Beam Laser is the best laser used to treat spider veins, as well as facial capillaries, blood vessels, and surface veins. V-Beam is a pulsed dye laser and is the gold standard in treating spider veins and telangiectasias. There are no needles, numbing cream, or discomfort involved with this laser leg vein treatment. Sunscreen is important as you cannot be tanned or use  self-tanner before having the V-Beam laser treatment. It is also important to avoid the sun immediately  after your laser treatment to prevent hyperpigmentation and an increase in spider veins.  Sunscreen is important year round as sun damages and thins the skin and can creates new spider veins. There are no side effects from this laser treatment except for some possible bruising of the treated area.  You can resume your normal activities the same day as the laser treatment.  Some of there treated veins disappear after just one treatment.  Other spider veins take multiple treatments to disappear completely. Laser treatment has become the preferred non-invasive method of leg vein treatment.

Combining Sclerotherapy and Vbeam laser for leg vein treatment

Dr. Green combines sclerotherapy with VBeam® laser treatments to address smaller veins and capillaries which may not be suitable for treatment with traditional sclerotherapy. The VBeam® is a pulsed dye nonablative laser system which is designed to remove vascular lesions as well as other skin pigmentations. The laser delivers a burst of energy that’s intense enough to treat the targeted blood vessel, but gentle enough to preserve the surrounding tissue and ensure patient comfort. Sclerotherapy will treat the larger spider veins which are too large to treat with the laser. By combining these two procedures, for all types of spider veins, Dr. Green can treat your spider veins with the best, painless, non-invasive methods available in NYC.

What is chronic venous insufficiency?

Venous insufficiency is caused by a refluxing the of the valves at the saphenofemoral junction.  This reflux leads to varicose veins.  25% of the white population have varicose veins and the incidence increases in age. The signs of venous insufficiency are:

  • Lower leg and ankle edema
  • Phlebitis which is painful swelling of the legs with inflammation
  • Stasis dermatitis
  • Lower leg heaviness
  • Ulceration
  • Skin color changes and discoloration of the lower legs
  • Skin ulcers
  • Pain, burning, leg cramps
  • Venous disease
  • Risk factors such as smoking and diabetes can worsen this condition

What is Ambulatory phlebectomy?

Ambulatory phlebectomy is another procedure developed in dermatology where surgeons remove superficial veins through small incisions in the skin to address venous insufficiency.  Ambulatory phlebectomy allows the removal of incompetent veins below the saphenofemoral and saphenopopliteal junctions. This surgical procedure is done on an outpatient basis and has a short recovery time. The junctions themselves cannot be removed and endogenous laser therapy is needed to treat this problem.

Ligation or Vein Stripping was a previous invasive procedure where the vein was removed, or ligated.  The varicose vein was cut off and and the affected vein ligated and the vein stripped or surgically removed. This invasive surgery has been replaced by radiofrequency ablation and other safer noninvasive procedures.

Radiofrequency Ablation (RFA) often replaces the need to surgically remove a vein, for larger varicose veins. This type of vein surgery uses endovenous occlusion with radiofrequency energy to collapse the vein.

This procedure is similar to Endovenous Laser Therapy (EVLT).  EVLT is a minimally invasive ultrasound guided technique using a thin laser fiber to treat varicose veins. Typically a vascular surgeon or interventional radiologist will perform this laser treatment. All veins have valves to make sure that blood flows in the correct direction.  Varicose veins are veins whose valves are broken and blood flows backwards in the vein, causing the veins to swell and become twisted from this poor circulation. The laser is guided via ultrasound into the veins through a small incision.  The laser heats the wall of the vein, via laser energy, and permanently closes the damaged vein and prevents blood from flowing and pooling in the vein.  The blood flows stops through the unhealthy vein and gets re-directed to other healthy veins which increases your circulation.  ELVT can be performed on the great and short saphenous veins. There is minimal recovery time with this procedure.  Again, RFA and ELVT have replaced vein stripping, or ligation, since it is safer and has less downtime for varicose vein treatment.  It takes about one year after RFA or EVLT for the treated veins to disappear.

EVLT takes one hour to perform and most patients can return to their normal actives immediately after the procedure is performed. Compression stockings are indicated for several weeks after EVLT to help improve the circulation, and decrease swelling and bruising. Rare side effects of endogenous laser therapy include nerve injury, deep vein thrombosis, and pulmonary embolism.

What are the best ways to treat these leg veins at home?

Simple self-care tips can improve the appearance of leg veins.

  • Regular Exercise has been shown to improve the appearance of leg veins.  Exercise increases the circulation of blood thoughout the body and away.  By increasing the circulation, the appearance of leg veins improve.  Exercise has been showed to even help some varicose veins from forming.
  • Avoid sitting by your desk or computer for long periods of time.  It is important to take breaks and walk around to increase your circulation.
  • Avoid Standing for long periods of time as this allows the blood to pool in your legs and increase the pressure on these veins.  It is important to take frequent breaks when standing for long periods of time.
  • Avoid Saunas or hot tubs for prolonged periods of time as this also makes the leg veins worse.
  • Weight loss is important as it improves circulation and leg veins.
  • Compression Stockings supply constant steady pressure on your legs. It is important to wear compression stockings if you already have leg veins, and to prevent you from creating even more deep veins. Wearing compression stockings is important in preventing blood clots.  If you have a job which requires you to sit or stand for extended periods of time, it is important to wear compression stockings.  These stockings will improve venous blood flow and decrease swelling of your leg veins. Compression stockings come in different sizes and pressure.  Dr. Green generally recommends wearing support hose with mild compression.  You do not have to wear the compression stockings during exercise. Compression stocking are not a cure for venous insufficiency but they can help improve the swelling and pressure on the legs.

Does leg vein treatment hurt?

Both Sclerotherapy and V-Beam laser treatment are non-invasive and painless.  For patients who are sensitive, a topical numbing cream can be applied before either procedure.  No additional pain medication is needed either before or after the treatment.

How much does leg vein treatment cost?

Leg vein treatment varies in cost depending on which method is needed and the extent of the spider veins or varicose veins.

What is the downtime associated with leg vein treatment?

Generally, after laser treatment, such as the V-Beam treatment for leg veins, there is no downtime.  Sclerotherapy can often leave the treated area bruised for a week after the injections. Dr. Green generally recommends having sclerotherapy treatment done during the Fall and Winter months so that possible bruising is not an issue.

How many sessions of leg vein treatments does it take to remove the leg veins?

Generally, it takes 3 or 4 seasons to remove these spider veins and each treatment must be spaced approximately one month apart for the best results.  If you have an excessive amount of leg veins, more treatments may be needed.

Is leg vein treatment a permanent solution?

Some leg vein treatments are a permanent solution, especially if caused by pregnancy, trauma, or other environmental factors.  If these spider veins are genetic, repeat maintenance injections of sclerotherapy or V-Beam laser treatments may be needed yearly or every few years.

How do I get started with my leg vein treatment?

If you’re frustrated with the appearance of your spider veins or varicose veins, there’s finally a solution that can help. Contact us online today or call 212-535-3088 to learn more about whether our combination approach toward vein treatment may be right for you.

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