Do I need vein treatment for venous reflux at age 24?

I am 24 years old, and I have spider veins and visible blue veins behind knees on both legs. Ultrasound showed 0.4 sec reflux in GSV right leg. Some doctors told me this is normal, but is it normal? And, if not, is it dangerous or weird for my age? I am scared and confused. Can you offer any advice?

Answers from doctors (9)


More About Doctor David Green, MD

Published on Aug 19, 2021

Less than 0.5 seconds of reflux in the GSV is normal; there will always be some 'reflux' as blood refills a vein that has been emptied such as when your leg is elevated and you suddenly stand - this is normal.

Spider Veins and Reticular Varicose Veins behind the knees are common; their presence is not the result of insufficiency of the Great Saphenous Vein or Small Saphenous Vein. If there is also insufficiency of the Great Saphenous Vein or Small Saphenous Vein, then it is most likely coincidental and not causal.

If you are developing Spider Veins and Reticular Varicose Veins then there is probably a family history of this problem. Even if there is reflux in the Great Saphenous Vein or Small Saphenous Vein and if these veins are treated, the Spider Veins and Reticular Varicose Veins still remain and will not be diminished.

Answered by David Green, MD (View Profile)

Less than 0.5 seconds of reflux in the GSV is normal; there will always be some 'reflux' as blood refills a vein that has been emptied such as when your leg is elevated and you suddenly stand - this is normal.

Spider Veins and Reticular Varicose Veins behind the knees are common; their presence is not the result of insufficiency of the Great Saphenous Vein or Small Saphenous Vein. If there is also insufficiency of the Great Saphenous Vein or Small Saphenous Vein, then it is most likely coincidental and not causal.

If you are developing Spider Veins and Reticular Varicose Veins then there is probably a family history of this problem. Even if there is reflux in the Great Saphenous Vein or Small Saphenous Vein and if these veins are treated, the Spider Veins and Reticular Varicose Veins still remain and will not be diminished.

Published on Jul 11, 2012


Owensboro Heart & Vascular

Published on Nov 25, 2020

Yes if this is clinically indicated

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Answered by Owensboro Heart & Vascular

Yes if this is clinically indicated

Published on Jul 11, 2012


Intermountain Vein Center

Published on Oct 03, 2012

This is very mild reflux, which is normal, so based on that alone it would not be necessary to treat those veins. It also can depend on your pain level. If your legs ache and feel heavy/tired, itch, and/or swell, then seeking treatment would be a good idea. Maybe a simple spider vein treatment would be a good idea.

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Answered by Intermountain Vein Center

This is very mild reflux, which is normal, so based on that alone it would not be necessary to treat those veins. It also can depend on your pain level. If your legs ache and feel heavy/tired, itch, and/or swell, then seeking treatment would be a good idea. Maybe a simple spider vein treatment would be a good idea.

Published on Jul 11, 2012


Advanced Vein Center

Published on Sep 25, 2012

The 0.4 seconds of reflux you report is considered normal. That does not change the fact you have veins that cosmetically bother you and, therefore, you should consider having them treated. Many people have a normal ultrasound exam but have superficial veins they don't like.

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Answered by Advanced Vein Center

The 0.4 seconds of reflux you report is considered normal. That does not change the fact you have veins that cosmetically bother you and, therefore, you should consider having them treated. Many people have a normal ultrasound exam but have superficial veins they don't like.

Published on Jul 11, 2012


Vein Specialists

Published on Sep 25, 2012

Venous reflux disease or venous insufficiency is very common, present in approximately 20 percent of the general adult population. Indications for treatment of the refluxing vein by endovenous ablation can be either urgent (ulceration and/or bleeding from veins) and or elective (swollen achy legs, large varicose veins whether painful or not, severe leg cramps or restless legs at night, skin color changes around the lower leg and thickening of the skin, veins which are close to eroding through the skin and bleeding).
Isolated spider veins or blue/green/purple veins behind the knees are not necessarily indications for endovenous ablation or closure procedure. If your legs are asymptomatic and your main concern is that of cosmesis, then I would recommend you proceed with injection sclerotherapy and ignore the minimal amount of reflux noted on your ultrasound exam. In general, I look for more than 3 seconds of reflux over a length of vein 5 cm or more in a patient with symptoms before I consider endovenous ablation. Hope this
helps clarify your situation.

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Answered by Vein Specialists

Venous reflux disease or venous insufficiency is very common, present in approximately 20 percent of the general adult population. Indications for treatment of the refluxing vein by endovenous ablation can be either urgent (ulceration and/or bleeding from veins) and or elective (swollen achy legs, large varicose veins whether painful or not, severe leg cramps or restless legs at night, skin color changes around the lower leg and thickening of the skin, veins which are close to eroding through the skin and bleeding).
Isolated spider veins or blue/green/purple veins behind the knees are not necessarily indications for endovenous ablation or closure procedure. If your legs are asymptomatic and your main concern is that of cosmesis, then I would recommend you proceed with injection sclerotherapy and ignore the minimal amount of reflux noted on your ultrasound exam. In general, I look for more than 3 seconds of reflux over a length of vein 5 cm or more in a patient with symptoms before I consider endovenous ablation. Hope this
helps clarify your situation.

Published on Jul 11, 2012


VeinCare Centers of Tennessee

Published on Sep 24, 2012

The accepted definition for reflux in superficial veins is more than 500 milliseconds (0.5 seconds) for the valves to close after relaxing the pressure causing forward flow in the veins. Thus 0.4 seconds is a normal valve closure time and is not viewed as "reflux". Some young patients need treatment for venous insufficiency associated with significant pain, tenderness, large varicose veins, or edema (swelling) of the calves and ankles. In the absence of clearly demonstrated reflux and in the absence of significant venous symptoms, treatment of small veins and spider veins would be cosmetic.

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Answered by VeinCare Centers of Tennessee

The accepted definition for reflux in superficial veins is more than 500 milliseconds (0.5 seconds) for the valves to close after relaxing the pressure causing forward flow in the veins. Thus 0.4 seconds is a normal valve closure time and is not viewed as "reflux". Some young patients need treatment for venous insufficiency associated with significant pain, tenderness, large varicose veins, or edema (swelling) of the calves and ankles. In the absence of clearly demonstrated reflux and in the absence of significant venous symptoms, treatment of small veins and spider veins would be cosmetic.

Published on Jul 11, 2012


Vein Center of Orange County

Published on Sep 24, 2012

One can inherit varicose veins and spider veins either together or separately. If a deeper vein "feeds" surface veins, the deeper vein must be treated for a durable result. Your description sounds like spider veins
with reticular veins, which usually have no connection to deeper saphenous veins. Saphenous vein reflux is defined as reverse flow greater than 0.5 seconds, so your GSV sounds normal. I am not sure why you had an ultrasound unless your doctor had another reason to suspect GSV problems.

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Answered by Vein Center of Orange County

One can inherit varicose veins and spider veins either together or separately. If a deeper vein "feeds" surface veins, the deeper vein must be treated for a durable result. Your description sounds like spider veins
with reticular veins, which usually have no connection to deeper saphenous veins. Saphenous vein reflux is defined as reverse flow greater than 0.5 seconds, so your GSV sounds normal. I am not sure why you had an ultrasound unless your doctor had another reason to suspect GSV problems.

Published on Jul 11, 2012


Vanish Vein and Laser Center

Published on Sep 24, 2012

Reflux is abnormal when greater than .5 sec. By definition you do not have significant reflux. It is not uncommon at your age to have spider and blue veins. You can treat these with sclerotherapy or by wearing support stockings or just leaving them alone. Most likely, as time goes by, you will develop more veins and future possible pregnancies could worsen this.

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Answered by Vanish Vein and Laser Center

Reflux is abnormal when greater than .5 sec. By definition you do not have significant reflux. It is not uncommon at your age to have spider and blue veins. You can treat these with sclerotherapy or by wearing support stockings or just leaving them alone. Most likely, as time goes by, you will develop more veins and future possible pregnancies could worsen this.

Published on Jul 11, 2012


Heart and Vein Center

Published on Sep 24, 2012

The degree of reflux that you have is minimal, the cut off number is arbitrary and some practitioners put on 0.5 sec, other 1.0 sec others 1.5 secs. Unless you have a lot of symptoms from the legs, you do not need treatment. What you need is prevention. Certainly exercise, and avoiding overweight will help a lot. This is far from being a serious medical condition for you and you should not worry as much. Perhaps in another 3-4 years you should repeat your venous ultrasound study.

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Answered by Heart and Vein Center

The degree of reflux that you have is minimal, the cut off number is arbitrary and some practitioners put on 0.5 sec, other 1.0 sec others 1.5 secs. Unless you have a lot of symptoms from the legs, you do not need treatment. What you need is prevention. Certainly exercise, and avoiding overweight will help a lot. This is far from being a serious medical condition for you and you should not worry as much. Perhaps in another 3-4 years you should repeat your venous ultrasound study.

Published on Jul 11, 2012


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