Visible leg veins are a common part of the aging process for many patients. As we age, wear and tear on a vein’s valves can disrupt steady blood flow, which allows for blood to flow back into the veins rather than continuing directly to the heart. The appearance of visible leg veins, such as varicose veins or spider veins, can become more obvious as the extra blood in these veins puts pressure on the walls of the veins, which then leads to a weakening and bulging of the vein walls. Characterized by blue or red skin discoloration, and aching or heavy legs, visible leg veins are typically caused due to sitting or standing for extended periods of time, and they are more common with advanced age, during pregnancy, as well as due to hormonal changes, birth control pills, or injury. These leg veins are often unsightly, and can also be very uncomfortable or painful as well but luckily, there are many treatment options available.
If you are frustrated by the appearance of varicose veins or spider vein’s on the legs or experiencing discomfort as a result of the condition, board-certified cosmetic dermatologist, Dr. Michele Green, is here to help. 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 cosmetic 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, such as the V-Beam laser. Dr. Green will provide you with non-invasive, highly effective leg vein treatments to eliminate the appearance of visible legs quickly and painlessly for smooth, blemish and pain-free legs.
Dr. Michele Green is a specialist in cosmetic laser treatment for leg veins and sclerotherapy and has perfected this treatment over the past 25 years in her private New York office. Voted one of the best cosmetic dermatologists in NYC, Dr. Green is an expert in other cosmetic injectables such as Botox, Juvederm, Restylane, Kybella, and Sculptra injections. Dr Green specializes in non-invasive cosmetic dermatologic procedures. With minimal or no down time, you can achieve the best cosmetic results and remove those spider veins.
What are Varicose Veins and Spider Veins?
Varicose veins and spider veins are a common skin condition affecting up to 60% of the adults in the United States. Spider veins, known as telangiectasia or superficial leg veins, appear as red superficial blood vessels, which lie close to the skin. Characterized by skin discoloration in affected areas, spider veins are most likely to appear on the legs but may also appear on the face. Named after their common spider web-like appearance, spider veins are typically more commonly found in women than in men.
Spider veins are a mild, more common variation of the condition varicose veins. Symptoms of varicose veins can be differentiated from spider veins in that varicose veins are typically blue in color, are larger in diameter, and often bulge out into the skin. Varicose veins usually cause more discomfort due to the pressure on the wall of the vein, and can ache or throb and pop out like “ropes” on the skin’s surface. These aches and pains can manifest as a heaviness in the legs, muscle cramping, swelling in the leg, and itching. In more severe cases, the pressure on the vein can lead to a condition known as thrombophlebitis, which are blood clots that occur due to enlarged veins. Varicose veins can also lead to deep vein thrombosis (DVT), which is another condition in which a blood clot develops as a result of swollen veins.
What causes 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. This issue can also lead to other issues, such as blood clots.
What factors contribute to spider veins?
Although the exact cause of spider veins and varicose veins are not know, the following factors may contribute to their formation:
Genetics – Having a family history of spider veins and/or varicose veins may mean that you are more likely to develop the condition yourself. Varicose and spider veins have a potential hereditary link.
Obesity – Another risk factor for the development of spider legs and varicose veins is obesity. Being overweight leads to more pressure being put on the leg veins, increasing the risk for damage to the veins.
Trauma – Patients who have suffered any other form of vein damage may be more likely to develop spider veins or varicose veins due to the pre-existing trauma on the veins.
Changing Hormone levels – Shifting hormones can occur in many situations and can increase the risk of developing spider veins or varicose veins. Going through puberty, pregnancy, or menopause are all periods of time in which hormones are in flux and, as such, patients experiencing hormonal shifts as a result of puberty, pregnancy, or menopause are more likely to develop varicose veins.
Age – The risk of developing varicose or spider veins increases with age. As we move through life, there is natural wear and tear on the leg veins and valves that are responsible for the regulation of blood flow. Eventually, valves can wear out, which can lead to the reverse flow of blood into the leg veins.
Long periods of sitting or standing – When you sit or stand for long periods of time, the blood flow in your legs is poor. As such, standing or sitting for an extended amount of time can lead to wear and pressure on the valves in the veins.
Will varicose veins go away on their own?
Unfortunately, varicose veins do not disappear on their own. When spider veins and varicose veins first appear, they can distressing cosmetically and may also be uncomfortable. If left untreated, the pain and discomfort associated with varicose veins can worsen over time as the valves in the veins continue to weaken. Further, the risk of developing more serious conditions such as DVT or thrombophlebitis can also increase over time if the condition is not treated. For that reason, it is best to visit a doctor’s office or board-certified dermatologist, such as Dr. Green, in order to seek treatment.
Should varicose veins be treated?
If left untreated, varicose veins can become very painful or progress into more severe conditions involving blood clots, such as deep vein thrombosis and thrombophlebitis. Further, varicose veins and spider veins will not go away on their own and so for patients who are experiencing the discomfort of these conditions, it is important to seek treatment. Expert, board-certified dermatologist, Dr. Green, is very experienced in treating these conditions and employs several different treatment methods at her office, including sclerotherapy and laser treatment.
What is the most effective treatment for Varicose Veins?
Varicose veins can often be painful and unsightly, and many patients seek the best possible treatment to help treat both varicose and spider veins. When it comes to successful and efficient treatment of leg veins, Dr. Green typically turns first to sclerotherapy. In addition to sclerotherapy, there are other treatment options available at Dr. Green’s office, including laser therapy, which can also be combined with sclerotherapy for more effective results. In advanced cases of varicose veins, when the condition is leading to skin ulcers, the most effective treatment may be vein surgery. To perform vein surgery, Dr. Green will refer you to a qualified healthcare provider, typically a vascular surgeon. The vascular surgeon will make a small incision to surgically remove the effected vein. The first step to treatment is a consultation with Dr. Green where she will be able to determine the best treatment for you.
Sclerotherapy to remove leg veins
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 such as vein surgery. 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?
The process of leg vein treatment is quite simple and convenient. First, you will have a consultation with Dr. Green about your leg veins, during which she will review your complete medical history – including current medications, allergies, and surgeries–engage in a physical exam of the affected area. The nurse will take photographs of your leg veins and Dr. Green will determine if you are a good candidate for sclerotherapy, as well as provide expert medical advice on a leg vein treatment plan. Additionally, a doppler ultrasound device may be used in order to check on blood flow within the veins.
If sclerotherapy is the appropriate leg vein treatment option for you, you will be able to undergo the standard sclerotherapy procedure. Typically, this starts with topical numbing of the treatment area using a local anesthesia, which will take about 30-45 minutes. Then, the legs are cleaned with alcohol and prepared for injection. At this point, Dr. Green injects a sclerosant, called Asclera, into the spider or varicose veins. This sclerosant irritates the wall of the vein, which can sometimes causes bruising. Multiple injections are performed on all of the various leg veins in a single session in order to reduce the appearance of the treated veins.
After the injections, your legs are cleaned and compression stocking are worn home after the procedure. Most patients can return to normal activities immediately after the procedure, and generally the only side effect is local irritation and bruising at the injection site. Dr. Green recommends that you walk as much as possible after a sclerotherapy procedure, and encourages you to exercise regularly and wear compression stockings for at least two weeks. Additionally, patients are advised not to fly for several days after sclerotherapy and avoid saunas and stream rooms for two weeks.
After your initial sclerotherapy treatment, any repeat injections will be scheduled one month apart. 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. However, for small varicose veins or spider veins, significant results are common after just 1-2 treatment sessions.
What is the best Laser Treatment Option for Leg Veins?
There are a variety of laser treatment options for leg veins, and these treatments have become very popular among patients due to their non-invasive nature that requires zero recovery time. When it comes to laser treatment for visible leg veins, Dr. Green typically recommends the V-Beam laser. Laser treatments can be combined with sclerotherapy to treat both the smaller veins that are best targeted with lasers and larger veins that benefit from sclerotherapy.
V-Beam Laser treatment for spider veins
The 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 is no needle, numbing cream, or discomfort involved with this laser leg vein treatment. Sunscreen is important before and after V-Beam laser treatment in order to prevent hyperpigmentation and a potential increase in spider veins. Additionally, Dr. Green advises all of her patients to wear sunscreen year round, as sun damages and thins the skin and can creates new spider veins.
There are no side effects from V-Beam laser treatment, aside from some possible bruising of the treated area. You can resume your normal activities the same day as the laser treatment. Some of the treated veins disappear after just one treatment, while other spider veins may take multiple treatments to disappear completely.
Combining Sclerotherapy and Vbeam laser for leg vein treatment
Dr. Green often 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 visible veins that are too large to treat with the laser. By combining these two procedures, Dr. Green can treat your varicose and 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 (painful swelling of the legs with inflammation)
- Stasis dermatitis
- Lower leg heaviness
- Skin color changes and discoloration of the lower legs
- Skin ulcers
- Pain, burning, leg cramps
- Venous disease
- Other Risk factors, such as smoking and diabetes
Alternative Treatment Options for Leg Veins
In addition to sclerotherapy and laser treatments for leg vein reduction, there are several alternative treatment options that can be used.
Ambulatory phlebectomy is another procedure developed in dermatology during which 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
Ligation or Vein Stripping was a previously common 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 when it comes to treating larger varicose veins. This type of vein treatment inserts a small catheter within the vein, which is heated by radiofrequency energy. It’s similar to laser ablation, but relies on radiofrequency energy in order to collapse the varicose vein. This procedure is similar to Endovenous Laser Therapy.
Endovenous Laser Therapy
Endovenous Laser Therapy (EVLT), also known as endovenous ablation, is a minimally invasive ultrasound-guided technique that uses a thin laser fiber to treat varicose veins. Typically, a vascular surgeon or interventional radiologist will perform this laser treatment.
The laser is guided via ultrasound into the veins through a small incision. The laser heats the wall of the varicose vein, via laser energy, and permanently closes the damaged vein, thus preventing blood from flowing and pooling in the vein. The blood flow 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 recommended for several weeks after EVLT to help improve the circulation, and to 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 and changes in routine can improve the appearance of leg veins or prevent the appearance of varicose veins or spider veins. These shifts include:
- Regular Exercise has been shown to improve the appearance of leg veins. Exercise increases the circulation of blood throughout 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.
- Wearing flat or low-heeled shoes can help to engage the calf muscles, which in turn can improve your leg veins.
- 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 compression stockings during exercise. Compression stockings are not a cure for venous insufficiency, but they can help improve the swelling and pressure on the legs.
What is the treatment for painful varicose veins?
Varicose veins can be very uncomfortable and painful, and symptoms of varicose veins can include heaviness and aching in the legs, swelling, burning, throbbing, muscle cramping, and an increase in pain after sitting or standing for long periods of time. Painful varicose veins should be treated in order to alleviate discomfort and prevent further progression of the condition. The first step is to book a consultation appointment with Dr. Green. Dr. Green will begin by assessing the treatment area to make a determination about the treatment or series of treatments that will work best to address your particular condition. Typically, Dr. Green recommends sclerotherapy for painful varicose veins. The treatment works by causing the blood vessel responsible for the bulging veins to collapse, which causes blood to be rerouted to healthier veins.
Can leg vein valves be repaired?
Spider veins and varicose veins is caused by a weakened or damaged valves in the veins. These valves, when working correctly, stop the backwards flow of blood. However, when damaged, blood can flow backwards and pool in the vein, leading to spider veins or varicose veins. There are surgical methods that can be used to repair the valves in the veins, such as valvuloplasty, however, this is an invasive procedure. There are many treatment methods for varicose veins that do not repair the valves but are still extremely effective at eliminating the symptoms of varicose veins without the need for surgery. As such, Dr. Green does not typically recommend valve repair surgery when many other non-invasive options exist.
Should varicose veins be removed?
The appearance of varicose veins can be accompanied by much pain and discomfort. Further, varicose veins can lead to additional health concerns such as blot clots and ulcers. For that reason, varicose veins can be easily eliminated through treatments such as sclerotherapy or laser treatment. These non-invasive treatments still work effectively to eliminate the problematic varicose veins without the need for surgery or downtime.
Are leg veins dangerous?
Varicose veins on its own can be very uncomfortable and painful but the backwards flow of blood in the veins can also lead to more serious conditions. The appearance of varicose veins can lead to the formation of ulcers on the surface of the skin near the varicose vein. These ulcers can be very painful and patients should see their healthcare provider immediately if they notice the development of ulcers on the skin. Further, twisted veins that are characteristic of varicose veins can lead to swelling in the leg as circulation of blood worsens. This can lead to blood clots, which are also harmful to your health. It is a good idea to see a healthcare professional, such as Dr. Green, about your varicose veins before the condition advances.
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.
What medicine can cure varicose veins?
There are many treatment options for varicose veins, including oral medication that you can take to relieve the symptoms of the condition. According to the national heart, lung, and blood institute, there is only one medication approved to treat varicose veins, which is Diosmiplex. This plant-based medication can help, over the course of several weeks, to relieve the symptoms of the condition, including ulcers and swelling in the leg.
How expensive is varicose vein treatment?
Leg vein treatment varies in cost depending on which method is needed and the extent of the spider veins or varicose veins. When you work with Dr. Green, she will be able to develop a treatment plan that will successfully reduce the appearance of unsightly leg veins, and these treatment plan can be curated to balance both effectiveness and budget.
Does medical insurance cover varicose vein treatment?
Sclerotherapy, lasers, and other leg vein treatments are considered a cosmetic procedure, not a medically necessary medical procedure. However, when considering leg vein treatment, it’s best to contact your insurance company directly to determine whether your recommended treatment will be covered.
What is the downtime associated with leg vein treatment?
Generally, after non-invasive laser treatments for leg veins, such as V-Beam treatment, there is no downtime. Sclerotherapy can often leave the treated area bruised for about week after the injections, but normally activity can resume immediately post-treatment. Dr. Green generally encourages patients to engage with sclerotherapy treatment during the Fall and Winter months so that the appearance of bruising will not be 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 spider veins or other visible leg 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 a patient’s spider veins are genetic or recurring, repeat maintenance injections of sclerotherapy or V-Beam laser treatments may be needed yearly or every few years.
Why do varicose veins happen?
Varicose veins are caused as a result of damage to the valves in the veins or to the wall of the veins themselves. The circulatory system in the body is bi-directional: arteries carry blood away from your heart to the rest of the body while veins carry blood back to your heart. In the legs, veins have to work against gravity to pump blood back to the heart. As such, if the valves that keep blood from flowing backwards are damaged, blood can pool in the veins, which leads to the appearance of spider veins or varicose veins.
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. Dr. Michele Green is an expert in treating leg veins with over two decades of cosmetic dermatology experience in her discreet, private, NYC office. Dr. Green is consistently voted as one of the best cosmetic dermatologists in New York by Castle Connolly, New York Magazine, The New York Times, and Super Doctors. An expert both in sclerotherapy and laser treatment, Dr. Green will give you beautiful clear legs and the best leg vein treatment in New York. To schedule a consultation today contact us online or call 212-535-3088 to learn more about which leg vein treatment will be best for you.