Vein problems present in a wide variety of ways. Sometimes they are simply cosmetic issues such as undesired small spider veins just under the surface of the skin, which can be treated with a localized injection to direct blood flow out of these abnormal blood vessels.


Many patients and unfortunately some doctors feel that this is only a cosmetic problem. We now more clearly understand that this abnormal back flow of blood in these abnormal veins also produce significant symptoms which can interfere with patient’s lifestyles. In particular patients often tell us that they have experienced leg pain or aching, skin itching or rash and often a sense of heaviness, or restless legs, which is worse after standing. This can progress to significant edema or swelling in the legs along with skin changes and even breakdown of the skin with development of skin ulcers which can be very difficult to heal. We have been surprised how many patients have had years of leg swelling and had no idea this was related to disease of their leg veins.

This is often a progressive problem over many years. It not uncommonly runs in families. It can be worsened by pregnancy. Any occupation or activity that requires prolonged standing also significantly increases the problem.


We make the diagnosis by listening to your symptoms, examining your legs and then when appropriate doing a pain ultrasound picture of your leg veins. This ultrasound picture can be done in our office.


Treatment can include low-sodium diet, leg elevation or increased activity. Support stockings are often recommended. In some cases these lifestyle changes are not enough to improve the patient’s symptoms and additional treatment is required. In these cases, one option is localized injection of material into abnormal veins to close off the veins, which can be performed particularly if they are small veins. This is called sclerotherapy. Larger veins often require our specialized techniques of catheter thermal ablation. All of these procedures can be performed in our office.

Recovery after these procedures is very quick. We encourage use of support stockings for at least one week after the procedure. Our patients are encouraged to continue to be active. Patients often have some leg aching during the first week which quickly decreases.