Are painful varicose veins for over 30 years still treatable? (Photo)

Right leg full of hot, itchy bulging continuous painful veins. Right calve is approximately 2 inches wider due to bulging veins. In your opinion what is the best type of treatment?

Doctor Answers 11

Varicose Vein Treatment

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Many patients live unnecessarily with severe varicose veins.  There is no problem seeking medical care at this point. You can have a dramatic result. Please see a vein expert for the best results!

Clifton Vascular Surgeon
5.0 out of 5 stars 3 reviews

Hidef vein treatment in Los Angeles

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Our office focuses on Hidef vein treatments. As the only vein surgeon board certified in plastic surgery and vein surgery, our goal is to improve your legs medically and cosmetically. 


Dr. Karamanoukian

#Realself100 Surgeon

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
4.8 out of 5 stars 95 reviews

Vein treatment

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It is definitely not too late to treat your veins. I recommend you undergo an evaluation by a vein specialist. Based on your symptoms he will order an ultrasound to determine which veins are the cause of your symptoms and varicosities.  Usually the GSV or SSV  have valves that are incompetent thus resulting in blood pooling in the lower extremities; ablation and venaseal can treat this. Sclerotherapy can be used for cosmetic treatment.  In some cases there a deep venous problem in which case you may be referred to a vascular surgeon.

Painful varicose leg veins - what are treatment options?

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As the panel members suggested, it's not too late.  

We believe you will benefit from a treatment plan that will offer relief from the symptoms, improve vascular health, and offer a nice cosmetic benefit.  

Harold J. Kaplan, MD
Los Angeles Facial Plastic Surgeon
4.4 out of 5 stars 7 reviews

Varicose veins

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 EVLT with phlebectomy and foam sclerotherapy to treat your varicose veins. You will have great results. 

Vein specialists in Santa Monica

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Yes. There are a lot of things that can be done. Come see us in our Santa Monica office, approx 30 miles from Kakewood. 

We have 2 ABVLM certified vein specialists and board certified surgeons.

H Karamanoukian MD FACS

Leg Varicose Veins.

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Your posted pictures are the kinds of veins that I treat every day.  Having them for many years is a common complaint of many patients.  You should see a vein specialist for a full venous evaluation including a venous duplex ultrasound to identify the source of the veins.  Most likely you will need saphenous vein ablation and microphlebectomies or sclerotherapy for the remaining veins. 

John Landi, MD
Naples General Surgeon

Venous Mapping Ultrasound needed to guide treatment

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Knowledge of the functional venous anatomy is required to appropriately diagnose, plan and perform treatment of venous disorders of the legs.   Duplex ultrasonography  is an essential part of the evaluation of patients with most forms of superficial venous insufficiency. Duplex ultrasonography has also become an important tool in directing and assessing the results of a variety of minimally invasive treatments of this disease. Venous ultrasound is always performed to map the veins prior to and during all endovenous ablative procedures (Endovenous Laser, Radiofrequency, Venaseal).

If the source is saphenous vein with venous insufficiency then treatment with the endovenous ablation procedures to treat venous insufficiency. In my experience one third of cases, endovenous ablation will be the only procedure needed, eliminating varicose veins as well as ablating the saphenous vein. In one third of cases, there is reduction in the size and distribution of varicose tributaries. In the latter third, there will be no change in the tributary varicosities.   The larger tributary varicosities are not expected or likely to disappear with the ablation procedure and they may need additional treatment sessions with either foam sclerotherapy or phlebectomy.An experienced vein specialist will be able to tell you what the likely outcome will be depending on the extent, size and distribution of tributary varicosities prior to the ablation procedure.

Ralph Carullo, MD
Las Vegas Phlebologist

Bulging varices

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You should definitely seek a vein consult.  The veins you have been living with for the past 30 years can easily be treated.  As well, you may consider trying a medication like Vasculera to help with your symptoms and possibly decrease the onset of new veins.  First you should see a physician for a consult who is a vein expert.  They will most likely obtain a venous ultrasound to evaluate for any clots in the deep or superficial veins and look at the valves and see the direction the blood is flowing.  This ultrasound will determine the best treatment(s) for you and your veins.  Most likely you will need a combination of a few venous procedures to get rid of all of your varicose.  Most of these can be done minimally invasively in the office with little to no scarring.  Please see a vein doctor for a consultation.  I would recommend EVLA or RFA first and then possibly microphlebectomies or foam for what remains and sclerotherapy of the smaller veins.  First off a consultation and ultrasound is key. 

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

Signs and symptoms

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Very common to see and yes it is treatable. Consider a full venous reflux evaluation with a vein specialist. Healthy leg veins contain valves that open and close to help the blood return back to the heart. Using ultrasound to scan your legs, your physician will determine the extent of your venous reflux. 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 like varicose veins, leg or ankle swelling, leg heaviness and fatigue, leg pain, aching or cramping, burning or itching of the skin among others. Your physician will help you make informed healthcare decision on the best treatment or combination of treatments for you. 

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.