Charles K. Lee, MD

Most patients have a combination of spider veins, reticular veins, and varicose veins.   The reason that patients develop these types of "extra" veins is that there is likely venous reflux of some sort.

What is venous reflux? It means that the veins that usually let blood flow in one direction (back to the heart), are malfunctioning because the valves that allow blood to flow toward the heart, are actually allowing the blood to flow back down to the feet. This causes blood to pool in the veins under pressure and create "varicose veins" and "spider veins."

Therefore, the optimal treatment for the different types of veins that form on your legs depends on the diagnosis or evaluation of the deeper veins (with a duplex ultrasound), to evaluate the health of the deeper veins which give rise to the smaller veins (varicose and spider veins). If this is not done, and the root cause of your veins are not treated appropriately, you are destined to have failure of therapy.

Far too often, I have seen patients have multiple treatments of sclero or laser, etc.  If you want to avoid having the same treatment over and over, my advice is to see someone who uses all of the available technology that treat your veins appropriately and effectively.