This is a challenging area to treat in the leg since there is very little tissue underneath the skin between the skin and the anterior tibial bone service also known as the shin. The options are to proceed with a formal venous insufficiency ultrasound evaluation to see if there’s a deeper vein feeding this prominent blue vein. If you have other signs or symptoms of venous insufficiency this would be my recommendation. If the cosmetic appearance of the blue Vein is your primary concern, I would proceed directly to injection Sclerotherapy which is A very effective course of treatment. Asclera is the most widely used sclerosant and when injected will cause the vein to clot and scar down over the course of a few weeks. Drainage of the old blood may be required 4-6 weeks later to minimize residual pigmentation.
Your photo appears to demonstrate residual spider veins and some matting. I would be interested in knowing the details of your sclerotherapy, laser or injection? If injection, what solution and what concentration and foamed or not? If laser I am afraid I am not much help as my experience with laser for the treatment of spider veins has never been very favorable. My preference is to treat the underlying veins with transillumination and injection sclerotherapy with Asclera brand of polidocanol in a dilution appropriate for the size vein.
