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What can I do about my spider and varicose veins

Question posted by Harmony from Maple Ridge

I am a 36 year old mom of four. I have a large amount of spider veins as well as a few varicose veins. I have had injections once before but did PPP and was not satisfied with the results. Would laser treatment be an option for me? If not, what are my options?

Doctor's Response

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One thought on “What can I do about my spider and varicose veins

  • Dear Harmony,

    Thank you for your clinical post and spider veins and varicose veins are a very common cause of aesthetic concern for patients especially after multiple pregnancies, yourself having four children or weight loss/weight gain or inflammatory conditions such as phlebitis which is inflammation of the leg veins.  These processes result in an insufficiency or reflux or leaking of various valves of
    the leg veins.  Leaky valves within the legs themselves in the thigh or the calf can result in spider veins or even localized varicose veins.  However, it’s much more common to have leakiness of a valve farther up in the thigh in the groin called the saphenofemoral junction.  At the place where the saphenous vein meets the deep femoral vein, a large valve which controls flow into the leg can often become leaky after multiple pregnancies.  Rather than shutting off flow of venous blood as it flows back towards the heart, a leaky saphenofemoral valve will result in excessive blood flowing back into the leg.  This spilling backwards of venous blood increases the venous hypertension or blood pressure of the venous system and over many years can destroy smaller valves in the leg resulting in subsequent leaking at these valves and damns and backflow of blood until eventually it reaches the level of the skin veins.  Dilatation and expansion of superficial veins can result in spider veins and little blueberry bulbous swellings called varicose veins.

    The treatment is to diagnose the cause.  If there is saphenofemoral leakiness or insufficiency then the highest level of leakiness in the groin needs to be treated.  In the old days a rather
    invasive treatment called leg vein stripping was required and most patients were elected to undergo this.  Conservative treatments include support hose such as the Sigvaris garment and these do not control the aesthetic concerns as much as the symptoms of pain and discomfort.

    Fortunately, there’s been a renaissance and revolution of the treatment of leg veins and the primary treatment for saphenofemoral valve insufficiency is a process called ELVT.  ELVT stands for Endoluminal venous treatment.  Under local anesthesia a small fiber-optic laser or radio frequency device is gently threaded up the saphenous vein, the entrance point is usually around the knee or proximal inner thigh and under ultrasound guidance the saphenofemoral junction is identified.  Using a small burst of laser or radio frequency energy the valve itself is coagulated so it no longer leaks.  With control of the saphenofemoral insufficiency venous blood no longer leaks into the saphenous vein and there’s a decompression of the varicose veins and sometimes even a resolution diminishment of the spider veins.  With a saphenofemoral valve controlled it usually then requires a small procedure under local anesthesia called a phlebectomy to remove the blueberry distensions or varicosities.  If there are no varicosities then usually 4-6 sessions of traditional sclerotherapy which is injection of a safe chemical into the small veins is combined with laser
    therapy to remove the spider veins.  Generally, an ELVT treatment followed by phlebectomies and 4-6 sclerotherapy and laser sessions can result in 80-90% clearance and improvement of leg vein concerns.

    Although all these treatments are outpatient and under local anesthesia you do require the expertise of a specialist certified in the performance of these techniques.  At SpaMedica we have the longest history of Endoluminal venous therapy using laser techniques and physicians and technicians with many many years of sclerotherapy and laser leg vein treatment expertise.
    I hope this information has been of some assistance and best of luck.

    For more information, please review our leg vein reduction page.

    If you’d like to schedule a consultation please call SpaMedica at (416) 922-2868 or visit us at our website at and fill out an e-mail online consultation request form.

    R. Stephen Mulholland, M.D.

    Certified Plastic Surgeon

    Yorkville, Toronto

Additional Information

Spider Vein Treatment (Sclerotherapy and Laser Vein Treatment)

Read about the procedure

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