Persistent reticular veins after sclerotherapy sessions over few years. (photos)

I have reticular veins that pop up in the same area on my legs even after several sclerotherapy sessions over a span of years or new ones form around the treatment area and the Doppler ultrasound of the legs show no major problems. Aside from sclero, can endovenous ablation work if the reticular veins keep popping back up and all over the place?

Doctor Answers 6

Residual tributaries not reticular veins

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What you are showing are large tributary varicosities which are best treated with microphlebectomy.

H Karamanoukian MD FACS

certified vein specialist from ABVLM

Vein sclero on large veins

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Vein treatment is a specialty. I would caution against anyone performing sclero on the greater saphenous vein as proposed in these answers; unless it is done by a board certified vein surgeon. 


Dr. Karamanoukian

Los Angeles vein expert

Recurring Reticular Veins

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this is common and can be re-treated with sclerotherapy or lasers.  surgical removal or venus ablation may be needed.  Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 202 reviews

Recurring reticular veins.

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If you have not responded to sclerotherapy then microphlebectomies should eliminate these veins. Also, the posterior veins are almost varicosities.  The small saphenous vein should be evaluated with an ultrasound as this may be the source of the veins. If an ultrasound shows reflux then endovenous ablation will help. See a vein specialist. 

John Landi, MD
Naples General Surgeon

Reticular veins

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I treat reticular veins daily and this is completely normal. Most of the time there is no saphenous insufficiency  and it is probably just a small branch feeding the skin in that area that presents with some reflux. Endovenous ablation is not an option and sclerotherapy stays the gold standard treatment for those veins. You should find a clinic where the doctor use an ultrasound himself, not one that works on a report made by someone else. These little branches can be hard to find on hi-def ultrasound but can be easily injected at time of treatment.

Hugo Pin, MD
Brisbane Physician

Recurrent reticular veins

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I can't tell how recent the ultrasound study of your legs is.  If it's been more than a year, I would recommend you have the study repeated.  When you ask about endovenous ablation, I assume you're talking about endovenous laser or radio frequency devices that are used for the saphenous veins.  Those are not suitable for use directly on the reticular veins, and should not be used on a saphenous vein that is competent (no venous insufficiency).A cutaneous laser can be used to treat spider and reticular veins, but will not keep them from recurring and becomes more uncomfortable with the larger veins.Venous insufficiency, whether it involves the saphenous veins or just the small, more superficial reticular and spider veins, is a chronic disorder.  You will always be prone to developing new ones.  Your best bet is to be sure there is no saphenous insufficiency with a current ultrasound exam, use compression stockings when you can to keep venous pressures low and slow the progress of venous insufficiency, and treat the veins that bother you as they occur.

Suzan McGary, MD
Williamsport Thoracic 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.