Sclerotherapy

Unfortunately it is not unusual or "abnormal" for varicose veins to recur many years after having procedures to treat superficial venous insufficiency.&nbsp;There can be many reasons for this and sometimes they are treatable. Over time you can develop deep venous insufficiency, or an accessory vein that was inconsequential can enlarge and cause symptoms or the appearance of surface varicosities. Weight gain and the use of steroids can accelerate this process. It would probably be worthwhile to follow up with your vascular surgeon.

I had vein stripping, ablation, and sclerotherapy 8 years ago. My varicose veins have returned and appear the same as they were prior to having the procedures. I have gained 40lbs from taking steriods and lack of exercise due to a back injury this past year; however, the veins started to return 3 years following. Is this normal?

Is it normal for varicose veins to return after having vein stripping or endovenous ablation? (Photos)

Most patients with varicose veins can be adequately evaluated using venous duplex ultrasound from the level of the groin crease and below. There are circumstances where a CT scan or MRV might be needed and valuable before proceeding with treatment. If your examination or history suggests a problem above the groin crease then these tests may be necessary. If you have a prior history of blood clots or varicose veins involving the labia, lower abdomen, or buttocks then a CT scan/MRV may be important to determine if there is a blockage or venous insufficiency in the veins of the pelvis or abdomen. An ultrasound is more than adequate in the case of routine varicose veins.

My doctor said i had to get a ct scan to see where my veins were located but i do not want to get radiation just for veins.

Do I have to get a CT scan previous to removing my varicose veins? My Dr suggested yes.

Vein Treatment

There is generally no need to discontinue or change your HRT therapy before or after routine sclerotherapy or spider veins.&nbsp;
If you are having a more involved procedure like saphenous vein ablation then your surgeon may wish you to discontinue HRT in the period immediately before and after the procedure. Unfortunately there is not much reliable data on this situation though many surgeons and patients "would rather be safe than sorry".

Will I have to stop my hrt 0.5 mg estrogen and cycled 200mg progesterone prior to sclerotherapy and if so how long?

Will I need to stop HRT for menopausal symptoms prior to having sclerothapy for spider/varicose veins?

Spider veins can appear on your ankles as a result of venous reflux in the saphenous vein. They can also occur without reflux being present. The fact that your spider veins are most prominent at the level of the ankle suggests that they are the result of a poorly functioning saphenous vein.&nbsp;Your vascular surgeon properly examined the venous circulation to determine if reflux is present so that the proper treatment is recommended.
You can certainly have sclerotherapy without having the other procedures. Unfortunately, if the spider veins are caused by the underlying problem of saphenous insufficiency the results of sclerotherapy are not likely to be long lasting and more veins are likely to appear over the next 6-12 months. "Chasing" these new veins with further sclerotherapy is likely to become expensive and not very effective. Treating the saphenous reflux as a first step removes the underlying cause that produces the spider veins and will improve the results of sclerotherapy while reducing the chances of new spider veins appearing.
If the results of the ultrasound are correct you&nbsp;are probably best off having an ablation of the saphenous vein before proceeding with sclerotherapy to achieve the best, and longest lasting results. If you are hesitant to proceed with intervention you might want to consider getting another ultrasound at an independent, accredited vascular lab which does not stand to gain financially if the results show reflux.
Good luck whatever you decide to do.
J.S. Stein, M.D.
Epic Vein and Vascular Center, Inc.

I have spider veins around my ankles which are unsightly. I went to vascular surgeon who did an ultrasound and found that I have saphenous vein insufficiency. I have no other symptoms other than a couple of small slightly varicose veins Dr said that I needed to have these veins eliminated or treating spider veins would be a waste of time.I understand that these bad veins can cause problems later but I’m on the fence about having 3 procedures for what I consider to be cosmetic. Thoughts?

Should I have saphenous veins treated for spider veins? (Photo)

Forehead veins may be appropriately treated with either microsurgical phlebectomy or sclerotherapy. Both methods give good results with a low risk of complications. It is very important to be examined by a qualified and experienced specialist prior to the procedure to be sure that these are actually veins (and not arteries) and to assess whether there is an underlying condition that caused the problem.&nbsp;

I am a 32 year old male with an uneven forehead due to large veins. I wanted to know what my best options are for reducing or removing them? I was looking into Sclerotherapy and Microphlebectomy (which I know are for varicose veins) but I wanted to know if those types of treatments would be an option or if there is something better? I have tried fillers in the past but I want a more long term solution. I have attached photos of the veins (primarily between and just above the eyebrows).

Can I have treatment to reduce or remove veins in my forehead? (Photo)

EVLT and RF ablation of the saphenous vein is the treatment of choice for demonstrated reflux in these veins. Not all people with varicose veins and many patients with spider veins do not have reflux. Sometimes the deep veins have significant reflux which may make ablation much less effective&nbsp;or even contra-indicated.&nbsp;Before proceeding with ablation patients should have an ultrasound to evaluate the deep and superficial veins of the extremity so that a proper diagnosis is obtained and the appropriate treatment is carried out. It goes without saying that patients should see a properly qualified and experienced vascular specialist.

Including RF and EVLT are not very popular any more and arent a first line of treatment and the result arent as good as expected. Is this so?

I get an impression that ablation is not the first line of treatment. Is this so?

These may be telangiectasia which are very common on the face and limbs. Usually telangiectasia is visible without stretching the skin and what you are seeing may be an early form of this problem. They are not dangerous or a cause for worry and if you only see them when you stretch the skin you probably do not need to do anything about them. On the other hand if they are annoying to you they can be easily treated. Without seeing them it is difficult to be sure about the appropriate treatment.

Hi, I'm 24 and have an olive color complexion. I'm wondering if it is normal to see small capillaries on the face if I pull my skin taut , particularly on the chin and around the grooves of the nose. They are no longer visible if the skin is not stretched. Are these telangiectasia?

Are these telangiectasia? I'm wondering if it is normal to see small capillaries on the face if I pull my skin taut

Jeffrey S. Stein, MD

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Dr. Stein was very caring and took the time to explain the procedure to me. I needed a few sessions and now my spider veins are gone. Well worth it and Dr. Stein was terrific. I am recommending my friends to see him.

My spider veins are gone!

mls280

7 Answers from Board Certified Vascular Surgeon Jeffrey S. Stein, MD See Education, Board Certification, and Treatments Offered.

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General Surgery, Mount Sinai Medical Center, New York City, New York

Surgical Critical Care and Vascular Surgery, Mount Sinai

Physics, Massachusetts Institute of Technology, Cambridge, Massachusetts

MD, Washington University School of Medicin, St. Louis, Missouri

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