I had endovenous therapy on R and L leg a year ago,but I still notice visible veins on both legs. I think these may be superficial veins, which need another treatment. Would you recommend laser light therapy as an alternative treatment for these?
It is recommended to follow up with the vein specialist to reassess and perform a follow-up venous ultrasound of your venous circulation. Vein specialists always re-evaluate patients for chronic venous insufficiency before any treatment to make sure to not only treat the superficial concern, but also the underlying cause of the superficial changes that are commonly seen. Methods like ultrasound-guided sclerotherapy and ambulatory phlebectomy are used to treat remaining superficial veins after endovenous ablation therapy, depending on what is appropriate, because not all the cases are the same and not everyone responds to treatment in the same way.
Thank you for your question.
Published on Jul 11, 2012
I would recommend sclerotherapy as the treatment of choice unless the veins are extremely small.
Published on Jul 11, 2012
Superficial veins include varicose veins, reticular veins, and spider veins. Endovenous therapy is used on varicose veins, while light therapy is used on reticular veins and spider veins. Your vein specialist will guide you.
Published on Jul 11, 2012
You may need additional (adjunctive) treatment after endoluminal treatment (EVLT or Radiofrequency Ablation). Depending on the size and character of the remaining vein(s), sclerotherapy and/or laser may be indicated. You should seek the advice of an expert in veins who treats the "entire spectrum" of vein disorders rather than getting referred to several different doctors to complete your treatment.
Published on Jul 11, 2012
We have seen consistently better results addressing spider and reticular veins with sclerotherapy than with laser. While laser therapy is quite effective for some veins, in most cases, the first course of action in attempting to eradicate unsightly superficial leg veins would be sclerotherapy.
Published on Jul 11, 2012
Sclerotherapy is still the gold standard for treatment of spider veins and reticular veins and I would suggest this first.
Published on Jul 11, 2012
Our experience with superficial laser 10 years ago showed that "dual injury"
treatment consisting of laser and sclerotherapy needs to be done simultaneously to address larger
feeder vein components. Since laser on the skin surface can cause pigmentation changes and is
painful, we concluded why do both? Sclerotherapy works just fine by itself, with less fanfare.
Published on Jul 11, 2012
Without seeing the veins in question, it is very difficult to give an answer. Although I do think there is a place for lasers or intense pulsed light in the treatment if spider veins, I prefer sclerotherapy. Additionally, since you mentioned the phrase "visible veins" rather than spider veins, then I suspect you are talking about reticular veins which are best treated with foam sclerotherapy.
Published on Jul 11, 2012
We typically find that sclerotherapy preceded by topical laser (not light) work the best. You need to have someone check for reticular (feeder) veins in that area for long term successful closure. Transillumination with a vein lite will show up these smaller veins. If they are not close, they could reopen the smaller spider veins.
Published on Jul 11, 2012
Your experience is quite common. Studies have shown the best treatment for these superficial veins is sclerotherapy. The lager ones are best treated with foam sclerotherapy and the smaller veins and spider veins are best treated with liquid sclerotherapy.
Wishing you the best of health,
Dr. Wright
Published on Jul 11, 2012
You may need sclerotherapy and laser treatments.
Published on Jul 11, 2012
If you have had the underlying veins treated with ablations, then I would
consider injections sclerotherapy of the residual blue/green reticular veins
or spider veins.
Published on Jul 11, 2012
The best treatment for the superficial veins, "spiders" or telangiectasis is sclerotherapy. Sclerotherapy provides more consistent results and it is not more painful than laser as the advertisement claims.
Published on Jul 11, 2012