Best Treatment for Blue Leg Veins?

I have very visible normal (not varicose) blue veins running up the front of both calves. Can these be treated and what would the best treatment be? Thank you.

Doctor Answers 14

What is the best treatment for blue veins on the legs ? Buffalo Niagara, NY

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The important point is to have a comprehensive examination by a certified vein specialist, as one who has added qualification from the American Board of Venous and Lymphatic Medicine. A comprehensive history will be taken, an examination done and veins mapped with Vein Lite and a Doppler US scan can be done to look for associated reflux and to measure the size of the veins with B mode ultrasound which guides the type(s) of therapies which would treat these veins. 

Pale, "see-through" skin with lots of normal blue veins is hard to treat

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It sounds like you have translucent (see-through) skin that allows normal blue veins to show through. Many times these blue veins can be effectively shrunk with sclerotherapy by a skilled physician.  Sometimes it's just the way your legs are, and you might need to use fake tanner to try to hide it until something red or purple starts to show.  Avoid unnecessary surgery. 

Margaret Weiss, MD
Baltimore Dermatologic Surgeon
3.9 out of 5 stars 8 reviews

Leg Veins

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Thank you for your question! It is fairly common for blue veins to be prominent, but not varicose veins in your leg. The first step I would recommend taking is visiting a Vein Specialist for a free vein screening to determine if it is a medical or cosmetic issue. If you're certain they're not varicose or spider veins, unfortunately there's not much I would recommend you do with them. You certainly don't want to ablate or inject a healthy vein, without certainty of venous reflux disease. 

Sclerotherapy or no treatment

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The veins you are describing are called reticular veins, because they are run in the reticular dermis which is close to the surface of the skin. The veins are normal part of the skin but the can be very visible or prominent in people with fair skin or thin and or muscular individuals. People come in with request for treatment of these veins frequently.  Often just reassurance that they are normal is all that is necessary. However, for some people who are very bothered by their appearance, I will treat with sclerotherapy which is an effective treatment for them.  Sclerotherapy of these veins can take 2- 3 treatments and does has some risks. The risks of sclerotherapy are temporary bruising, [common] hyperpigmentation, [Brownish color where the vein\s were, usually goes away but can persist in ~ 1% ] and even in rare case ulceration. After all this is explained most people will chose not to have the sclerotherapy.  I hope this information is helpful. 

Thomas Wright, MD
Saint Louis Phlebologist
5.0 out of 5 stars 11 reviews

Blue veins be gone

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A thorough evaluation should be conducted for your blue veins in order to determine if there is a medical condition causing these blue veins to appear. During the evaluation you will be asked if you present with any symptoms such as: pain, heaviness, restless leg, itching. If you answer yes to any of these the specialist will order an ultrasound. If it turns out that you have no other issues besides the "blue veins"  then sclerotherapy can most likely get rid of them. 

Reticular veins, spider veins,varicose veins, venous ultrasound

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There are several types of blue veins.  Smaller blue veins in the range of 2-3 mm are called reticular veins and larger veins could be normal leg veins.  These blue veins can be very prominent in people especially if thin and fair skin color.  The smaller reticular veins are those veins that fall between spider veins and varicose veins.  If you have a lot of these veins then you may want to have a venous reflux ultrasound to see if they are coming from another source such as leaking valves in the saphenous system.  If you do not have leaking valves then usually the easiest way to eradicate these veins would be with sclerotherapy,  Larger veins can be removed by 2mm small micro incisions which are cosmetically very acceptable. If you have leaking(refluxing) valves then laser closure of these may be necessary first. 

John Landi, MD
Naples General Surgeon

Treatment for blue veins in the leg

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Without seeing your veins it is difficult to say for sure, but generally speaking for veins like you are describing we have had great results with both sclerotherapy as well as laser vein treatment with a 1064nm Nd:YAG laser.  The vessels can require multiple treatments and may go through stages of bruising and looking more noticeable before they plan well in advance if you have a big event or trip you're trying to look your best for.

Take care~

Good Luck!

Dr. Grant Stevens      

Grant Stevens, MD
Los Angeles Plastic Surgeon
4.7 out of 5 stars 152 reviews

Regicular veins is what you are referring to i believe...

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In this situation, sclerotherapy, or injection of a sclerosant is the treatment of choice.

As a board certified phlebologist we treat all sizes of veins and sclerotherapy is still the treatment of choice for most veins.  Laser therapy can work but side effects such as pigmentation problems and scarring remain significant.

Consult with a board certified phlebologist to determine the best course of action.


Craig Crippen, MD
Kelowna Physician

Treatment of blue spider veins and varicose veins

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The color of a vein is less important than the caliber of the vein, anatomic location, and the source of the vein based on functional ultrasound studies and vein mapping. 

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

Blue leg veins

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For the blue vessels on the calves I recommend a Sclerotherapy treatment.  This involves injecting a solution into the vessels that causes the vein to collapse and then resolve.  Lasers just do not have the power to treat the larger veins and surgical stripping is just to invasive for that size. 

Lee Robinson, MD - RETIRED
Portland Facial Plastic Surgeon

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.