What are the current treatments for leg veins?

By Dr. Mary Lupo

Unsightly leg veins are often a source of embarrassment and concern for patients. Dilated and discolored, they can prevent even young women from wearing shorts, bathing suits and enjoying shorter skirt lengths. Spider and varicose veins tend to be seen more often in women, but men can suffer too. Heredity is the greatest risk factor, but hormonal, occupational, and child bearing are important causative factors. Even chronic constipation can increase the severity of leg veins. If left untreated, the legs can not only look ugly, but the legs can feel heavy, tire easily and have sensations of burning. Over time, it can increase your risk of leg ulcers and a chronic inflammation of the skin of the lower legs called stasis dermatitis. While the primary benefit of treatment is cosmetic, elimination of these dilated veins often results in the legs feeling better too. Remember: these dilated veins are not only unnecessary, they pool blood out of your circulation, so removing them is a very good idea.

By far and away, the most effective and utilized treatment for leg veins is compression sclerotherapy. This involves a liquid injection called sclerosant being injected into the abnormal blood vessel. This sclerosant acts likes a detergent to disrupt the lipids between the cells that line the blood vessel. Over several weeks, the inflammation of these lining endothelial cells results in the occlusion of these dilated, abnormal vessels. Sclerotherapy typically involves several sessions. These sessions are spaced at 4-8 week intervals to allow the sclerosis process to be fully complete. Compression of the vessels immediately after treatment facilitates the closure of the vessels, prevents pain, and prevents any risk of unusual complications like phlebitis. The vessels injected gradually fade over several weeks. The winter is an ideal time to be treated since the stockings look more fashionable, like leggings! The length of time that the stockings must be worn depends on the size of the vessels injected. The recent release of Asclera by the FDA has been a great breakthrough for effective and virtually painless sclerotherapy.

There may be cases that need more aggressive treatment for their leg veins. Ambulatory phlebectomy and invasive laser treatment such as endovenous closure may be necessary for severe cases.

Always review your options with a board certified dermatologist or vascular surgeon before deciding which treatment is best for you.