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As a result of genetics or standing for long periods of time, many of us have spider veins and varicose veins which we wish to have removed. Having beautiful smooth legs is the goal of spider vein treatment and sclerotherapy. After a series of treatments, these unwanted blood vessels are treated without any invasive procedures, and without any delay in your normal activities. 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 has perfected these types of injections, as well as other cosmetic injectables such as Botox, Juvederm, Restylane, and Sculptra injections.

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. 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.

If you are frustrated by the appearance of varicose veins or spider vein’s on the legs, 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.  Dr. Green will provide you with non-invasive, highly effective leg vein treatments to eliminate the appearance of visible legs quickly and painlessly.

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, or superficial leg veins, appear as red superficial blood vessels, which lie close to the skin.  Spider veins are named after their common spider web-like appearance. 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 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.

Source: Syneron Candela

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 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 

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.

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. 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 anesthetic, 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.

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
  • Ulceration
  • 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

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

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) 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.

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. 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.

Is leg vein treatment covered by insurance?

For many patients, leg vein treatment is considered a medically necessary procedure. For this reason, many different leg vein treatments are regularly covered by insurance plans. However, when considering leg vein treatment, it’s best to contact your insurance company directly to determine whether your recommended treatment will be covered.

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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.

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 NYC office.  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.

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