Our DermatologistsNYU UPN Dermatologists
- Roy G. Geronemus, M.D.
- Robert T. Anolik, M.D.
- Yoon-Soo Cindy Bae, M.D.
- Jeremy A. Brauer, M.D.
- Roy Seidenberg, M.D.
- Leonard J. Bernstein, M.D.
- Wilfred Brown, M.D., F.A.C.S.
- Ronald Shelton, M.D.
- Jessica J. Krant, M.D.
- Paul M. Friedman, M.D.
- Dana Stern, M.D.
- Elliot T. Weiss, M.D.
- Michelle F. Henry, M.D.
Sclerotherapy injections are the treatment of choice for most spider veins. We perform Sclerotherapy treatments in our NYC office.
For symptomatic venous disease, including varicose veins, we may perform sclerotherapy with duplex (ultrasound) guidance or you may be a candidate for CoolTouch Endovenous Ablation (CTEV™ ).
Leg vein treatments:
What is venous insufficiency?
Veins are blood vessels in the body that return blood from the limbs and organs back to the heart; leg veins contain valves that prevent the backflow of blood. Venous insufficiency occurs when forward flow through the veins is blocked (such as in a blood clot), or if there is backward leakage of blood flow through damaged valves. Venous insufficiency can be caused by a number of disorders, and present as spider veins, varicose veins, and reticular veins.
What are spider veins?
Spider veins, also called telangiectasia, are small, fine veins that exist close to the surface of the skin. These thin veins are connected to the larger venous system, but are not needed for normal circulation. Spider veins are often caused by pregnancy, hormonal changes, weight gain, professions or activities that require prolonged sitting or standing, certain medications, or genetics (family history).
What are varicose veins?
Varicose veins are gnarled, enlarged veins, which may be dark purple or blue in color, and have a twisting or bulging cord-like appearance. While they are not usually painful, varicose veins may sometimes cause achy or heavy feeling in the legs, burning or pain sensation after extended sitting or standing, swelling, or itching feeling.
What are reticular veins?
Reticular veins are usually blue or purple in color, and lie flat on the skin. They commonly form on the thighs, legs and ankles, and face, causing some patients to be wary of revealing skin where these veins are visible. Additionally, they may cause pain and discomfort in the surrounding area. Reticular veins are considered ‘feeder veins’ because they supply excess blood to spider veins, filling their dilated venules. Thus, treating reticular veins may subsequently eliminate spider veins in a patient.
What are the symptoms of venous insufficiency?
· Edema (swelling)
· Skin color changes
· Prominent varicose veins or ropy veins
· Skin ulcers
· Pain, burning, or throbbing sensations in the legs and feet
· Restless legs
· Leg weakness and Fatigue
What are the risk factors for venous insufficiency?
· Old age
· Previous deep vein thrombosis (blood clot)
· Family history
· Muscle weakness
How is venous insufficiency treated?
There are many treatment options for venous insufficiency, depending on the underlying condition.
A conservative option to treat venous insufficiency is to wear prescription compression stockings. These special stockings put pressure at the ankle and lower leg and improve venous blood flow and decrease swelling. A board-certified dermatologist will determine the type of compression stocking that is most appropriate. Additional measures may be recommended: exercise is encouraged to improve circulation, weight loss is beneficial in overweight patients, and blood thinners and anticoagulants can alleviate venous insufficiency issues caused by blood clots. However, compression stockings are limited in that they do not eliminate venous insufficiency, but are used as an adjunct to treatment.
Sclerotherapy is a safe and effective procedure used for treating spider veins, reticular veins and varicose veins. This procedure entails a series of painless injections of a medicine directly into an unwanted vein by a board-certified dermatologist. The injected solution irritates the lining of the vein, causing it to stick together, close and ultimately be reabsorbed by the body. Several treatments may be necessary at least 4 weeks apart, and patients must wear compression stockings after treatment to prevent recurrence. While sclerotherapy targets already existing veins, it does not prevent the future development of new spider and varicose veins. As a result, many patients require occasional treatments to maintain their legs’ appearance. It is important to note that there are minimal side effects associated with sclerotherapy, including temporary redness at the site of injection, bruising and swelling; patients may also experience an itchy sensation after treatment.
In addition to sclerotherapy, lasers can also be used to treat some of these vessels, particularly smaller veins on the face, trunk and extremities (Excel V, Nd:YAG and PDL).
Endovenous Laser Therapy (EVLT):
Endovenous laser therapy is a minimally invasive treatment to close the saphenous vein. With ultrasound guidance, a thin laser fiber is funneled into the diseased saphenous vein through a small needle incision. The laser heats the lining of the vein and seals it closed as the fiber is pulled out. EVLT treats the underlying cause of varicose veins by permanently shutting off the diseased vein to any future blood flow. As a result, the body uses other healthy veins to circulate blood to the heart.
The procedure takes place in the office and lasts approximately 1-2 hours. Patients remain awake during the procedure (under local anesthesia), and experience little to no pain. There is minimal down time and patients can resume walking within minutes of the procedure and continue with normal activities in a few days. EVLT is an excellent option for treating leg veins, with patients achieving wonderful cosmetic outcome with limited swelling, bruising and no scarring.
How can venous insufficiency be prevented?
· Maintain a healthy body weight and exercise regularly
· Don’t smoke, as it is harmful to the circulation
· Avoid standing or sitting in one place or position for extended periods of time