Leg Vein Treatment in NYC

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, allowing blood to flow back into the veins rather than continuing directly to the heart. The appearance of visible leg veins, such as varicose or spider veins, can become more obvious as the extra blood in these veins puts pressure on the veins’ walls, weakening and bulging 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 long periods of time. They are more common with advanced age, during pregnancy, and due to hormonal changes, birth control pills, or injury. These leg veins are often unsightly and can be uncomfortable or painful, but many excellent treatment options are now available at Dr. Michele Green’s private New York office.

If you are frustrated by the appearance of varicose veins or spider veins on the legs or experiencing discomfort due to the condition, board-certified cosmetic dermatologist Dr. Michele Green is here to help. Dr. Green is among NYC’s best leg vein treatment doctors 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 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. You can achieve the best cosmetic results and remove those spider veins with minimal or no downtime.

What are Spider Veins?

Varicose veins and spider veins are common skin conditions affecting up to 60% of 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. Damage to the blood vessel leads to skin discoloration in affected areas and can cause discomfort or pain for those affected. Spider veins are most likely to appear on the legs and around the ankles 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 men.

What are the symptoms of varicose veins?

Symptoms of varicose veins can be differentiated from spider veins in that varicose veins are typically blue, larger in diameter, and often bulge into the skin. Varicose veins usually cause more discomfort due to the pressure on the vein’s wall and can ache or throb and pop out like “ropes” on the skin’s surface. These aches and pains can manifest as 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 is blood clots that occur due to enlarged veins. Varicose veins can also lead to deep vein thrombosis (DVT), another condition where a blood clot develops due to swollen veins. Due to the risk of serious conditions associated with varicose veins that are left untreated for a long period, it is important to consult an expert, board-certified dermatologist, such as Dr. Green, to alleviate the symptoms of varicose veins and prevent any co-morbidity.

What causes leg veins to bulge?

Spider and varicose veins occur when blood pools in veins near the skin’s surface.  As we age, the valves in our veins tend to weaken and push some blood flow backward away from the heart, and this blood accumulates in the veins.  The veins have tiny one-way valves, allowing the blood to flow back to the heart in only one direction.  When these one-way valves are weakened or defective, blood flows backward 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 known, the following factors may contribute to their formation:

Genetics – Having a family history of spider and/or varicose veins may mean you are more likely to develop the condition yourself. Varicose and spider veins have a potential hereditary link.

Obesity – Another risk factor for developing spider legs and varicose veins is obesity. Being overweight leads to increased blood pressure and, consequently, more pressure being put on the leg veins, increasing the risk of damage to the veins.

Trauma – Patients who have suffered any other form of vein damage may be more likely to develop spider or varicose veins due to the pre-existing trauma on the veins.

Changing Hormone levels – Shifting hormones can occur in many situations and increase the risk of developing spider or varicose veins. Going through puberty, pregnancy, or menopause are all periods in which hormones are in flux. As such, patients experiencing hormonal shifts due to 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 responsible for regulating blood flow. Eventually, valves can wear out, leading to the reverse flow of blood into the leg veins.

Long periods of sitting or standing – When you sit or stand for long periods, 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 and varicose veins first appear, they can distress 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. Therefore, visiting a doctor’s office or board-certified dermatologist, such as Dr. Green, is best 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 and spider veins will not go away on their own, so it is important for patients experiencing the discomfort of these conditions 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 best treatment for leg 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 the successful and efficient treatment of leg veins, Dr. Green typically turns first to sclerotherapy. In addition to sclerotherapy, other treatment options are 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, the most effective treatment may be vein surgery when the condition leads to skin ulcers. 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, or small cut, to remove the affected vein surgically. The first step to treatment is a consultation with Dr. Green; 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 effectively inject your veins. 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 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 and provide expert medical advice on a leg vein treatment plan. A Doppler ultrasound device may also be used to check blood flow within the veins.

If sclerotherapy is the appropriate leg vein treatment option, you can undergo the standard sclerotherapy procedure. Typically, this starts with topical numbing of the treatment area using local anesthesia, which will take 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 vein’s wall, which can sometimes cause bruising. Multiple injections are performed on all of the various leg veins in a single session to reduce the appearance of the treated veins.

After the injections, your legs are cleaned, and compression stockings are worn home afterward. Most patients can return to normal activities immediately after the procedure; generally, the only side effect is local irritation and bruising at the injection site. Dr. Green recommends walking 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 to avoid saunas and steam rooms for two weeks.

After your initial sclerotherapy treatment, repeat injections will be scheduled one month apart. Depending on the number and depth of your spider or varicose veins, it can take 3 or more treatments to make these veins disappear. However, significant results are common for small varicose or spider veins after just 1-2 treatment sessions.

What is the best Laser Treatment Option for Leg Veins?

There are various 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. Regarding laser treatment for visible leg veins, Dr. Green typically recommends the V-Beam laser. Laser treatments can be combined with sclerotherapy to treat the smaller veins that are best targeted with lasers and larger ones 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 the gold standard for treating spider veins and telangiectasias. By targeting the red pigmentation of the spider veins, the V-Beam laser works to erase signs of discoloration present. This laser leg vein treatment involves no needle, numbing cream, or discomfort. Sunscreen is important before and after V-Beam laser treatment to prevent hyperpigmentation and a potential increase in spider veins.  Additionally, Dr. Green advises her patients to wear sunscreen year-round, as sun damages and thins the skin and can create new spider veins.

Aside from some possible bruising of the treated area, there are no side effects from the V-Beam laser treatment.  You can resume your normal activities on the same day as the laser treatment.  Some 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 non-ablative laser system designed to remove vascular lesions and 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?

A refluxing of the valves at the saphenofemoral junction causes venous insufficiency. This reflux leads to varicose veins.  25% of the white population have varicose veins, and the incidence increases with 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, several alternative treatment options 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, the affected vein ligated, and the vein stripped or surgically removed. Radiofrequency ablation and other safer noninvasive procedures have replaced this invasive surgery.

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 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.  The treated veins take about one year after RFA or EVLT to disappear.

EVLT takes one hour to perform, and most patients can return to their normal activities immediately after the procedure is performed. Compression stockings are recommended for several weeks after EVLT to help improve 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 improves.  Exercise has been shown even to help prevent some varicose veins from forming.
• Avoid sitting by your desk or computer for long periods.  It is important to take breaks and walk around to increase your circulation.
• Avoid Standing for long periods as this allows the blood to pool in your legs and increases the pressure on these veins.  It is important to take frequent breaks when standing for long periods.
• Avoid Saunas or hot tubs for prolonged periods as this also worsens the leg veins.
• Wearing flat or low-heeled shoes can help engage the calf muscles, improving 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 that requires you to sit or stand for extended periods, 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 a 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 increased pain after sitting or standing for long periods. Painful varicose veins should be treated 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 decide about the treatment or series of treatments that best 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 are caused by weakened or damaged valves in the veins. These valves, when working correctly, stop the backward flow of blood. However, when damaged, blood can flow backward and pool in the vein, leading to spider or varicose veins. Surgical methods can be used to repair the valves in the veins, such as valvuloplasty. However, this is an invasive procedure. Many treatment methods for varicose veins 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. Consequently, varicose veins can be easily eliminated through treatments such as sclerotherapy or laser treatment. These non-invasive treatments still work effectively to eliminate problematic varicose veins without the need for surgery or downtime.

Are leg veins dangerous?

Varicose veins on their own can be very uncomfortable and painful, but the backward 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 blood circulation worsens. This can lead to blood clots, which also harm your health. It is good 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 treatments are non-invasive and painless treatments. A topical numbing cream can be applied before either procedure for sensitive patients. 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 condition’s symptoms. According to the national heart, lung, and blood institute, there is only one medication approved to treat varicose veins: Diosmiplex. This plant-based medication can help, over several weeks, to relieve the symptoms of the condition, including ulcers and swelling in the leg.

Does Medicare cover varicose vein treatment?

When it comes to determining if any insurance company, including Medicare, covers medical treatment, it is always best to contact the insurance company directly. Most insurance companies consider varicose vein treatment to be a cosmetic procedure and, as such, will not cover the procedure.

How expensive is varicose vein treatment?

Leg vein treatment varies in cost depending on which method is needed and the extent of the spider or varicose veins. When you work with Dr. Green, she can successfully develop a treatment plan to reduce the appearance of unsightly leg veins. This treatment plan can be curated to balance both effectiveness and budget.

What is the difference between spider veins and varicose veins?

Spider veins are a mild, more common variation of the condition of varicose veins. Found closer to the skin’s surface than varicose veins, spider veins are often red or blue compared to varicose veins’ dark purple or blue. While spider veins take on the appearance of a web, varicose veins are enlarged and often knotted or twisted and can cause discomfort in affected patients, making the legs feel heavy and swollen. Risk factors for developing spider and varicose veins are similar and can include aging, pregnancy, family history, and sitting or standing in one position for an extended amount of time.

How do I get rid of the big veins in my legs?

There are many effective treatments for getting rid of leg veins, and many are non-ablative, meaning that no surgery or incisions are required. When you have your initial consultation with Dr. Green, she will examine the affected area and decide about the treatment or series of treatments that will work best to reduce the appearance of big veins in your legs. Typically, Dr. Green recommends a combination approach of Sclerotherapy injectable treatment and V-Beam laser therapy to collapse the lining of blood vessels and reduce the discoloration on the skin. For bigger veins, Dr. Green may recommend radiofrequency ablation (RFA), which requires a small cut for the radiofrequency heating device to seal the vein. According to the National Heart, Blood, and Lung Institute, even after treatment, spider and varicose veins can form again, in which case patients can return for repeat treatment.

What is the downtime associated with leg vein treatment?

Generally, there is no downtime after non-invasive laser treatments for leg veins, such as V-Beam treatment.  Sclerotherapy can often leave the treated area bruised for about a week after the injections, but normal 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 excessive leg veins, more treatments may be needed.

How long does leg vein treatment last?

Leg vein treatments, such as sclerotherapy, endovenous laser therapy, and radiofrequency ablation therapy, destroy the blood vessels causing the appearance of varicose veins. When treated with sclerotherapy, spider veins typically disappear in 3-6 weeks, and varicose veins disappear in 3-4 months as the body absorbs the blood vessel that has been destroyed. Two to three sclerotherapy sessions may be necessary to achieve smooth skin in the treatment area, but once completed, the procedure permanently destroys the weakened blood vessel. Endovenous laser therapy and radiofrequency ablation permanently destroy the damaged blood vessel. Still, it often takes up to a year for the full effects of the treatment to become visible. While these treatments permanently destroy the target blood vessel, spider or varicose veins may form again. However, patients can return to Dr. Green’s office for additional treatment sessions as 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.

What causes vein problems in the legs?

Varicose veins are caused by damage to the valves in the veins or to the veins’ walls. 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 must work against gravity to pump blood back to the heart. As such, if the valves that keep blood from flowing backward are damaged, blood can pool in the veins, leading to the appearance of spider or varicose veins.

What are the benefits of leg vein treatment?

Spider and varicose veins appear discolored, twisted, or corded, making patients self-conscious. However, there can also be a risk of developing complications due to varicose veins. For patients dissatisfied with the appearance of leg veins, there are many treatment options available at Dr. Green’s office to eliminate signs of spider veins and varicose veins, which can improve self-confidence. For some, varicose veins are painful, and treatment can alleviate the discomfort of the condition. Varicose veins can also lead to further complications, and leaving them untreated can create bigger problems down the line. The presence of varicose veins is a risk factor for developing superficial thrombophlebitis, deep vein thrombosis, and even a pulmonary embolism. As such, not only can leg vein treatment be beneficial on a cosmetic level, but it can also be beneficial on a medical level.

Who treats varicose veins?

When seeking treatment for varicose veins, it is important to find an experienced healthcare provider, such as Dr. Green. Varicose vein treatments, such as sclerotherapy and laser treatment, require precision and a practiced hand to target the damaged blood vessel accurately. Dr. Green has extensive experience in expertly treating patients for spider and varicose veins at her Upper East Side New York City dermatology office. To start treatment with Dr. Green, schedule a consultation appointment today.

How do I get started with my leg vein treatment?

Visible leg veins can develop over time with wear and tear on vein valves that disrupt steady blood flow. Leg veins are commonly associated with aging, during pregnancy and due to hormonal changes, birth control pills, or injury. For many, unsightly leg veins can induce feelings of self-consciousness or low self-esteem. Luckily, various non-invasive treatment options for reducing the appearance of leg veins, including VBeam laser and sclerotherapy, are available at Dr. Green’s private dermatology office in Manhattan’s Upper East Side neighborhood.

Dr. Michele Green is an internationally renowned expert in the field of cosmetic dermatology with over two and a half decades of experience providing some of the world’s most discerning individuals with the best cosmetic treatment options available, including for leg veins. Dr. Green is consistently voted one of the best cosmetic dermatologists in New York by Castle Connolly, New York Magazine, The New York Times, and Super Doctors for her dedication to her patients and expertise. Dr. Green takes a holistic approach and embraces a less-is-more philosophy regarding skin rejuvenation, customizing each patient’s treatment plan to cater best to their specific concerns and unique aesthetic goals. An expert in sclerotherapy and laser treatment, Dr. Green will help you achieve beautiful, clear legs with the best leg vein treatment in New York. To schedule a consultation with Dr. Green today, contact us online or call 212-535-3088 to learn more about which leg vein treatment will be best for you.