Should I get a Venous Reflux Exam for my spider veins?

I have a lot of spider veins on my legs, but no pain and no visible varicose veins. However, if I get bruised it takes months to heal and my feet are always cold, even in the summer. Should I get a reflux exam to find out what's going on?

Answers from doctors (10)


More About Doctor David Green, MD

Published on Jul 16, 2021

If only spider veins are present, that is not an indication for duplex ultrasound examination. Even if asymptomatic reflux is discovered, treatment of the spider veins can proceed without the need to treat any other veins. And if reflux is discovered and treated, it rarely has any effect upon the existing spider veins.

Easy bruising is common - although rarely, it can represent a problem with the coagulation system or blood platelets. Often, easy bruising is related to medication such as aspirin and NSAIDs (Non-Steroidal Anti-Inflammatory Drugs) - among other medications - that are commonly taken for many musculoskeletal problems.

Cold hands and feet are also common - although rarely, it can be a symptom of a vascular condition. If you have lived for decades with cold hands and cold feet, you are likely not afflicted with any osuch problem. However, if you are concerned, you should, certainly, discuss with your personal physician.

Answered by David Green, MD (View Profile)

If only spider veins are present, that is not an indication for duplex ultrasound examination. Even if asymptomatic reflux is discovered, treatment of the spider veins can proceed without the need to treat any other veins. And if reflux is discovered and treated, it rarely has any effect upon the existing spider veins.

Easy bruising is common - although rarely, it can represent a problem with the coagulation system or blood platelets. Often, easy bruising is related to medication such as aspirin and NSAIDs (Non-Steroidal Anti-Inflammatory Drugs) - among other medications - that are commonly taken for many musculoskeletal problems.

Cold hands and feet are also common - although rarely, it can be a symptom of a vascular condition. If you have lived for decades with cold hands and cold feet, you are likely not afflicted with any osuch problem. However, if you are concerned, you should, certainly, discuss with your personal physician.

Published on Jul 11, 2012


Vanish Vein and Laser Center

Published on Aug 20, 2010

The short answer is that you should have a reflux exam for spider veins and prior to any vein treatment this would be prudent. Your response to sclerotherapy may be poor if you have underlying reflux. the long answer is that your symptoms of cold feet and poor healing may be due not to venous but rather to arterial problems. You should see a vascular surgeon.

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Answered by Vanish Vein and Laser Center

The short answer is that you should have a reflux exam for spider veins and prior to any vein treatment this would be prudent. Your response to sclerotherapy may be poor if you have underlying reflux. the long answer is that your symptoms of cold feet and poor healing may be due not to venous but rather to arterial problems. You should see a vascular surgeon.

Published on Jul 11, 2012


Miller Vein

Published on Feb 26, 2010

I would recommend a complete history and physical examination. Your feet being cold is not a typical symptom of venous insufficiency. If you have other symptoms such as lower extremity fatigue, heaviness, aching, or swelling then a reflux exam would be helpful.

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Answered by Miller Vein

I would recommend a complete history and physical examination. Your feet being cold is not a typical symptom of venous insufficiency. If you have other symptoms such as lower extremity fatigue, heaviness, aching, or swelling then a reflux exam would be helpful.

Published on Jul 11, 2012


More About Doctor Laser Vein Center

Published on Feb 24, 2010

For most patients the spider veins are the tip on an iceberg and the also have venous insufficiency/reflux, therefore it is always important to perform a Doppler study and look for reflux. There is a small percentage of patients that have just few spiders and minimal or no reflux.

Answered by Laser Vein Center (View Profile)

For most patients the spider veins are the tip on an iceberg and the also have venous insufficiency/reflux, therefore it is always important to perform a Doppler study and look for reflux. There is a small percentage of patients that have just few spiders and minimal or no reflux.

Published on Jul 11, 2012


Heart and Vein Center

Published on Feb 24, 2010

For most patients the spider veins are the tip on an iceberg and the also have venous insufficiency/reflux, therefore it is always important to perform a Doppler study and look for reflux. There is a small percentage of patients that have just few spiders and minimal or no reflux.

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Answered by Heart and Vein Center

For most patients the spider veins are the tip on an iceberg and the also have venous insufficiency/reflux, therefore it is always important to perform a Doppler study and look for reflux. There is a small percentage of patients that have just few spiders and minimal or no reflux.

Published on Jul 11, 2012


Angelo N. Makris MD

Published on Feb 23, 2010

I don't suggest a reflux exam unless symptomatic. Your current symptoms are unlikely related to venous reflux.

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Answered by Angelo N. Makris MD

I don't suggest a reflux exam unless symptomatic. Your current symptoms are unlikely related to venous reflux.

Published on Jul 11, 2012


More About Doctor Innovative Vein

Published on Feb 23, 2010

Anytime legs are being evaluated for symptoms like aching and heaviness or for surface veins or spider veins, an ultrasound is important to determine if there are larger vessels that are contributing to the problem.? Many times spider veins are associated with larger unseen veins.? These must be dealt with in order to get the best result possible.

Answered by Innovative Vein (View Profile)

Anytime legs are being evaluated for symptoms like aching and heaviness or for surface veins or spider veins, an ultrasound is important to determine if there are larger vessels that are contributing to the problem.? Many times spider veins are associated with larger unseen veins.? These must be dealt with in order to get the best result possible.

Published on Jul 11, 2012


VeinCare Centers of Tennessee

Published on Feb 23, 2010

Generally, a lower extremity venous color duplex ultrasound exam with reflux testing is helpful to evaluate patients with significant varicose veins, leg swelling, leg pain, or abnormal skin changes consistent with vein problems. Your phlebolgist or vascular surgeon would need to examine you and recommend the appropriate work up.

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Answered by VeinCare Centers of Tennessee

Generally, a lower extremity venous color duplex ultrasound exam with reflux testing is helpful to evaluate patients with significant varicose veins, leg swelling, leg pain, or abnormal skin changes consistent with vein problems. Your phlebolgist or vascular surgeon would need to examine you and recommend the appropriate work up.

Published on Jul 11, 2012


VeinSolutions - Edina

Published on Feb 23, 2010

Typically we wouldn't recommend a reflux exam for patients unless they have bulging varicose veins and/or pain and swelling.

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Answered by VeinSolutions - Edina

Typically we wouldn't recommend a reflux exam for patients unless they have bulging varicose veins and/or pain and swelling.

Published on Jul 11, 2012


Center for Venous Disease - Glendale

Published on Feb 23, 2010

Our doctors recommend a consult and ultrasound for anyone who has numerous spider veins. This is usually an early sign of venous reflux.

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Answered by Center for Venous Disease - Glendale

Our doctors recommend a consult and ultrasound for anyone who has numerous spider veins. This is usually an early sign of venous reflux.

Published on Jul 11, 2012


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