Preventing and Treating Varicose Veins?

I'm 30 and I haven't worn a skirt or shorts forever. I started to get varicose veins behind my knee at 20. Now, they're down to my calf. I had laser treatment done last January by a top doctor at NYU. It didn't help me. On my other leg, I am getting a blue small vein and its starting to bulge out a little. I don't know what to do. All winter long, I wore compression stockings. Now, it's warm and I can't wear them anymore. Any suggestions or vein treatments to keep the other leg from getting worse?

Doctor Answers 5

There is no way to totally avoid varicose veins.

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Avoiding standing for long periods, compression hose, leg elevation when at rest all can help in delaying and slowing the progression of varicose veins.  However, there is nothing that can be done to eliminate the problem.  The integrity of the valves has a genetic component as well.  When they do emerge, however, there are forms of treatment but they tend to be a life long problem.

Preventing Varicose Veins

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You need to be evaluated by a phlebologist who specializes in vein care and performs microphlebectomy, sclerotherapy and laser therapy for spider veins, etc.

If you still have symptoms and continue to have varicose veins, reticular veins and spider veins, then you have had an incomplete treatment. This is especially true at your young age.

Neverthelss, things to do include walking and exercises to keep your calf muscles strong. The calf muscles are vey important in pumping blood out of your legs. I recommend that you also take horse chestnut extract, 200 mg twice daily. In rigorous studies done by the Cochrane Group, it has been shown to be as effective as wearing compression stocking in treating venous reflux disease. As well, you must wear surgical grade, properly fitted compression stockings to reduce the likelihood of developing more vein problems.

Remember, there is not one procedure that prevents you from every developing other vein problems. However, once properly treated and once you follow preventative measures, the likelihood of developing more vein problems will be reduced.

Preventing and Treating Varicose Veins

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Not all can be prevented, particularly if you have a family history of them. But limiting your exposure to the sun (which weakens blood vessels) and wearing a daily broad-spectrum sunscreen can help, particularly on the face. Controlling your weight can also help—as can avoiding sitting (particularly with crossed legs) or standing for long periods of time. Diet plays a part, too: cutting down on your sodium intake may help as too much sodium can cause swelling in the veins—which may trigger varicose and spider veins over time. Lastly, not many people want to do this, but regularly wearing elastic support stockings can compress your veins, helping the blood to better flow and avoiding varicose veins and spider veins.

Laser treatment: Using either the V-Beam or Alexandrite lasers, a beam is targeted at the blood vessel. The heat from the laser coagulates the blood inside, causing it to collapse and seal up—all without damaging nearby skin, vessels, or tissue. Over several weeks, the vein will shrink and disappear. One to five sessions, spaced four weeks apart, is typically required.
Sclerotherapy: We will inject a liquid solution (generally a salt or saline solution) directly into the vein. The solution causes the vessel to seal shut and blood flow is redirected to stronger, healthier veins.
Typically 10 to 40 veins can be treated in one session—and sometimes the same vein needs to be treated more than once to get results. Follow-up sessions are required to treat additional veins.

With both methods, we advise our patients to avoid wearing lotions the day of the procedure—and to avoid vigorous exercise; hot baths, hot tubs, and saunas; as well as exposure to sunlight for at least one to two days after treatment. If you take aspirin, NSAIDs or blood thinners, antibiotics, be sure to let our staff know; they may instruct you on how to stop taking the medication for a certain amount of time before the procedure.

Dennis Gross, MD
New York Dermatologist
4.7 out of 5 stars 11 reviews

Varicose veins, venous ultrasound, laser, sclerotherapy

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I always tell patients that of all the information about veins, I feel that there are really only two factors that are of most importance, and if they understand these two concepts, then they will understand veins and their treatment.  First, remember that the diagnosis and subsequent treatment of spider and varicose veins centers around the valves in the saphenous trunk working or not working.  To assess this a venous reflux ultrasound would be necessary.  In all cases of varicose veins and in a significant number of spider veins, malfunctioning(leaking valves) are the cause of the problem.  Think of it like a dam that is leaking-the hole has to be plugged.  Secondly, think of your veins like a tree with the varicose and spider veins being the branches and the trunk being the saphenous system.  The trunk has the valves and if the leaves(varicose and spider veins) are not healthy, they will never get better unless the trunk is treated first.  In your care, I would recommend a full repeat venous reflux exam to look for any other source of refluxing veins and treat these first followed by the treatment of any residual varicose or spider veins. Other types of therapy such as compression stockings, exercise and weight loss will not make anything better is you have an underlying valve issue.

John Landi, MD
Naples General Surgeon

You are going to need

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to see an experienced phlebologist to manage your veins.

the american board of phlebology can give you a list of qualified doctors in your region.

managing varicose veins is a lifetime effort.  you are predisposed to developing them just like you may be predisposed to getting moles as you get older.  find someone you are comfortable with and plan on having a long term relationship with your local phlebologist for best results.

good luck!


Craig Crippen, MD
Kelowna Physician

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.