Does EVLT work to prevent future spider veins?

Doctor Answers 15

Spider Veins less likely after EVLT

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Spider veins and varicose veins are often associated with reflux or backwards flow in larger veins that transmit pressure to the smaller veins causing them to enlarge.  An ultrasound evaluation can determine which of these veins are affected. Treatment with EVLT of these larger veins eliminates the source of pressure and makes it less likely to develop complex spider and/or varicose veins in the future.  The smaller veins that are already there should be treated with sclerotherapy after EVLT for the best results.

Future Spider Veins

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Veins with poorly functioning valves will dilate.  The patient can develop rope-like varicose veins.  This also increases spider veins.  When the cause is treated - both the rope-like veins disappear and spider veins lessen.

Donna M. Mendes, MD, FACS
New York Vascular Surgeon

Possibly - could also possibly create new veins

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If there is a vein with venous insufficiency and reflux feeding an area of spider veins, then yes, EVLT is a component of treatment. 

I have, however, heard of physicians telling patients to treat these veins as prophylaxis, even if they are normal, in order to prevent spider veins. This is not good advice. Closing normal veins may stimulate the formation or appearance of additional spider veins.

Albert Malvehy, MD
Miami Beach Physician
5.0 out of 5 stars 8 reviews

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EVLT addresses root cause

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Yes, it does. EVLT fixes the underlying, deep-root cause of your spider veins. Spider veins arise from high pressure in connecting, underlying deeper veins that you can only see with ultrasounds. Therefore, fixing the deeper causes first fixes the prevalent spider veins and stops more from occurring. 

Spider veins

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If EVLT is being considered will not specifically be to treat spider veins that you might already present or for future prevention purposes. However, Endovenous laser therapy (EVLT) could be used to treat an underlying venous insufficiency problem in one or more of the superficial veins actively presenting reflux. Almost alway an ultrasound evaluation of your legs is part of your initial evaluation by your vein specialist. This diagnostic test will help determine if an underlying venous insufficiency is causing more superficial changes in the form of spider veins that are very close to your skin. Other signs and symptoms are varicose veins, leg or ankle swelling, leg heaviness and fatigue, leg pain, aching or cramping, burning or itching of the skin, restless legs, skin changes or rashes, ulcers, open wounds, or sores. Many factors contribute to the presence of venous reflux including age, gender, family history, heavy lifting, multiple pregnancies, obesity, and prolonged standing. Healthy leg veins contain valves that open and close to help the blood return back to the heart. Venous reflux disease develops when the valves that keep blood flowing out of the legs and back to the heart no longer function, causing to pool in the legs and leading to signs and symptoms already mentioned. Your physician can help you make informed health care decision on the best treatment for you according to the ultrasound results if they are positive for reflux. On the other hand if reflux is not present and you want to treat spider veins cosmetically there are options that you can also discuss with your physician about. If venous reflux is not present in the diagnostic test and signs and symptoms are not significant, EVLT or any other thermal energy more traditional treatment or any other closure system to treat the main superficial veins are not recommended. Consider other treatments like sclerotherapy or laser sclerotherapy to treat spider veins. 

All the best, 

Does EVLT work to prevent future spider veins?

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The short answer is No. EVLT, or EVLA, is performed for venous insufficiency with reflux, which is the underlying cause of varicose veins. Although having this done may improve the appearance of spider veins, and may reduce their future progression, the fact is that spider veins and varicose veins are completely separate issues.

The general rule with spider veins is, "once they are there, they are there", and they typically have to be treated separately, which is best done by a combination of topical, or superficial laser, and injection sclerotherapy. Removing any underlying insufficiency will definitely help with the overall treatment of the spider veins, but it will not prevent new ones from forming in the future.

Craig Schwartz, DO
Leawood Vascular Surgeon
3.4 out of 5 stars 6 reviews

EVLT and future spider veins

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EVLT treatment in the presence of saphenous vein reflux will improve the appearance of spider veins but generally won't completely clear them without combined sclerotherapy treatment.  With EVLT done correctly the chances of "significant" spider vein complexes in the future is significantly reduced.

Spider veins in the future

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By treating the varicose or insufficient veins, spider veins should decrease in the future.  The varicose veins or veins with insufficiency increase the pressure downstream in the veins and make spider veins more likely.  By treating the source of the problem or by getting rid of the varicose veins feeding the area of the spider veins, these spider veins should lessen

Susan Fox, DO
Hollywood Phlebologist
5.0 out of 5 stars 8 reviews

Spider veins

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Treating your varicose veins will reduce developing further thread veins in the future. However, this is not a 100% guarantee . Spider veins in some people might be hereditary 

Sameh Dimitri, MD
London Vascular Surgeon


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Thank you for your question. Typically after EVLT the occurrence of new spider veins tends to lessen.

Dr. Daniel Ritacca

Daniel J. Ritacca, MD
Chicago Oculoplastic Surgeon
4.4 out of 5 stars 20 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.