Unslightly vein removal on left bicep? Can it be removed with laser ablation? (photo)

Question

Can it be removed with laser vein ablation? Especially bad sticking after working out or in sun when blood is pumping. I workout 1-2 times a week....but not like a bodybuilder to have this kind of vein. My other arm bicep shows nothing.

Raffy Karamanoukian, MD, FACS · Answer

It’s important to distinguish between varicose veins and spider veins when choosing between laser therapy, sclerotherapy, and vein surgery. With two board certified vein specialists, our center uses a combination of visual examination, functional flow measurements, ultrasound, transillumination, and infrared light to map out vein networks prior to therapy. Lasers can be used to treat deep varicose vein insufficiency, vein perforators, and varicose veins. Sclerotherapy is ideal for spider veins and reticular veins. Whereas surgery is reserved for severely incompetent varicose vein segments.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best,
Dr. Karamanoukian
Realself100 Surgeon

Hratch Karamanoukian, MD, FACS · Answer

Arm veins such as this require microphlebectomy using local anesthesia. There is no down time and you can return to all activities immediately. ABVLM certified vein specialistHratch L Karamanoukian MD FACS

Vahe Melkonyan, MD · Answer

The options are (a) microphlebectomy, i.e. physical vein removal from tiny holes. (b) Sclerotherapy (injection) might be an option too, however as I see the vein is pretty large and you may need several injection sessions and the treatment maybe associated with some post injection discomfort/pain (phlebitis) and temporary local discoloration. Please note the area closer to elbow cannot be treated due to conjunction of some vitals vessels there.

Ivan Brooks, MD · Answer

To be on the conservative side I would encourage an upper extremity ultrasound to verify there is no clot or obstruction of the venous flow from  that arm. Once this is proven, foamed sclerotherapy carefully placed can reduce or completely resolve this enlarged vein. Phlebectomy can also be done but sclerotherapy should take care if it. Since this is considered a cosmetic treatment. Insurance does not cover it.

John Landi, MD · Answer

Usually arm veins are rarely treated and , if they are, this is strictly a cosmetic procedure.  The lower portion of the vein below the elbow I would not treat.  The upper portion above the elbow could be treated by sclerotherapy, microphlebectomy or laser if it is large enough to accommodate the laser.

Scott Powell, MD - Account Suspended · Answer

Normally arm veins are not treated.  However since it is unilateral and large, this one is a good candidate.  Like other posts, probably considered cosmetic.  I can see what looks to be a valve at the branch point, and this may be why it enlarged in this area.  
I would recommend sclerotherapy or micro-phlebectomy.  I do not recommend lasers.  The vein looks too large for external lasers, and too close to the skin for internal ones.  Either case would risk a skin burn and potential discoloration.
I would recommend an experienced vein surgeon, as you do not want to compromise the deep veins of the arm.
Best of luck to you,
Dr. Scott Powell

Unslightly vein removal on left bicep? Can it be removed with laser ablation? (photo)

Answers (6)

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