Video: Spider Vein Sclerotherapy

Watch a video on spider vein treatment with sclerotherapy.

Sclerotherapy is considered the ‘gold standard’ of treatment for leg veins

. Sclerotherapy involves an injection of a medication into the vein.  This will cause the vein to collapse and gradually fade away. Sclerotherapy has been used to treat spider veins for decades, but new solutions such as AscleraTM allow for spider veins to be treated with minimal discomfort and immediate return to activities. Saline solutions are rarely used these days by vein specialists, because alternatives solutions are less painful and better tolerated. Sclerotherapy is preferred by most vein specialists over laser because spider veins often have underlying ‘feeder veins’ that can easily be treated with sclerotherapy, but are not addressed by laser. Many people will require more than one treatment session for optimal results. The national average is 2 to 5 treatment sessions. Wearing compression stockings after treatment will improve results.

VenaSeal ‘Vein Glue’ Approved By FDA To Treat Varicose Veins

VenaSeal ‘Vein Glue’ Approved By FDA To Treat Varicose Veins

Earlier this week, The U.S. food and Drug Administration (FDA) approved the VenaSeal closure system to permanently treat varicose veins by sealing the affected superficial veins using an adhesive agent.

This treatment has been usedvenaseal in Europe, and will soon be available to vein specialists and their patients in the United States.

According to the manufacturer’s website:

‘The VenaSeal Sapheon Closure System is a unique, minimally invasive treatment that uses a safe-for-the-body medical glue to quickly and effectively treat varicose veins (venous reflux disease). Using ultrasound, a doctor will guide a tiny catheter through a small access site in the skin and into the diseased area of the vein. Next, the VenaSeal dispenser delivers a very small amount of medical glue to close the vein. Once the affected vein is closed, blood is immediately re-routed through other healthy veins in the leg.

Unlike other treatments, VenaSeal does not require anaesthesia to be injected into the leg via multiple needle sticks (tumescent anesthesia), and because there are no pre-procedures drugs involved, patients can return to their normal activities right after the treatment. Unlike heat-based procedures, with VenaSeal there is no risk of skin burns or nerve damage. VenaSeal usually does not require any post-treatment pain medication or uncomfortable compression stockings.’



Laser and Radiofrequency Vein Treatments

What is the difference between laser and radiofrequency procedures for varicose veins?

Both laser and radiofrequency ablation techniques are used as an alternative to surgery for the treatment of varicose veins and underlying venous insufficiency.  The concept behind both laser and radiofrequency treatments is that an energy source is used to heat the vein, causing it to collapse and seal shut. Over time, the treated veins will dissolve. This is offered as an alternative to surgical removal of the veins. The basic difference between the two, are the types of energy sources used.

Laser vein treatment, also known as laser ablation or endovenous laser ablation therapy (EVLT or EVLA) utilizes laser energy to heat the vein.

Radiofrequency vein treatment, also known as radiofrequency ablation (RFA), or the Venefit procedure (previously known as VNUS Closure) utilizes radiofrequency energy to heat the vein.

Both procedures are used to treat the small, great or anterior saphenous veins.

Either procedure involves making a tiny incision the size of a grain of rice on the skin, and a narrow catheter is inserted into the vein. The machine applies either laser or radiofrequency energy to the vein interior, an action that heats the vein and seals it closed.

Unlike traditional surgery, this new minimally invasive procedure takes about 30 minutes to perform and patients can walk out of the office afterward.

While both are effective options for vein treatment, we prefer radio-frequency ablation over laser because it has been proven to be more comfortable than laser yet equally effective. It is also our experience that there is less bruising,  pain and quicker recovery associated with radio-frequency closure of the veins.


Laser vein treatment, also known as laser ablation or endovenous laser ablation therapy (EVLT or EVLA) utilizes laser energy to heat the vein.
Radiofrequency vein treatment, also known as radiofrequency ablation (RFA), or the Venefit procedure (previously known as VNUS Closure) utilizes radiofrequency energy to heat the vein.


The radiofrequency catheter is inserted inside the vein. Radiofrequency energy then heats the vein causing it to collapse and seal shut. We prefer radiofrequency over laser vein treatment because we find that it is more comfortable for the patient with less bruising.

Remember, that more than one treatment type is often needed such as radiofrequency of the saphenous vein + sclerotherapy of superficial branches. Talk to your doctor to find our which is best for you or schedule a consultation at 858-550-0330.


How To Make Varicose Veins Vanish

How To Make Varicose Veins Vanish Without Surgery
Physicians have many options for treating varicose veins. The choice often depends on the severity and cause of the problem. It’s important that patients are carefully evaluated so treatment can be tailored to individual needs.

In some cases varicose veins may present a primarily cosmetic problem. In others they may be a symptom of a more severe underlying circulatory condition that should be addressed by a vascular specialist.

Compression hosiery can be used to provide support, and reduce symptoms such as the aching and tiredness associated with varicose veins but they cannot make varicose veins disappear.   There are no supplements or creams that can make varicose veins disappear. There are a variety of creams, lotions and ointments that are advertised in newspapers and magazines to make veins disappear. There is no scientific evidence that these creams or lotions can make varicose and spider veins disappear. Once veins are dysfunctional, it is a mechanical problem and the valves cannot be repaired. But, they can be removed. There are many ways to accomplish this.

Sclerotherapy is used for smaller varicose veins and for spider veins, also known as telangiectasia. A fine needle is used to inject a chemical solution into the veins. The chemical causes the vein to collapse and eventually disappear. The procedure can be done in a doctor’s office and doesn’t require an anesthetic. Patients feel only a slight burning when the chemical is injected. Often several sessions are needed to treat the veins.

Foam sclerotherapy, or ultrasound guided foam sclerotherapy is used to treat large varicose veins.

Ambulatory Phlebectomy is an alternative to foam sclerotherapy, and involves making a series of tiny incisions along the length of the vein and gently removing the vein in sections using a hook. The procedure can be done on an outpatient basis and can be used for both large and small veins.

Radiofrequency ablation,  is a minimally invasive procedure involves using a catheter to introduce an electrode into the saphenous vein (great, small or accessory saphenous veins). The energy from the electrode shrinks and seals off the vein. Nearby healthy veins take over the job of carrying blood from the legs.

Surgical ligation and stripping are rarely performed because the newer, minimally invasive procedures have replaced surgery for removing varicose veins.

For more information about treatment types and non-surgical methods to make varicose veins vanish, go to 

Before >> After

Before and After Pictures: Varicose Vein Treatment at La Jolla Vein Care. At La Jolla Vein Care, we utilize minimally invasive techniques to make varicose veins vanish- all without open surgery or general anasthesia.

History of Foam Sclerotherapy Treatment of Varicose Veins


Foamed sclerosant inside a vein: Once foam is introduced into the vein, it is hyperechogenic on ultrasound. In this picture, a La Jolla Vein Care doctor points to the foamed medication inside the vein. Notice it appears ‘white.’


Foamed sclerosant used for sclerotherapy has a ‘foam’ or frothy-like appearance.

In 1994 and 1950, E.J. Orbach introduced the concept of a macro bubble air-block technique to enhance the properties of sclerosant in performing macrosclerotherapy.  Apparently, few vascular surgeons were interested in the subject and the technique languished.  The work of Juan Cabrera and colleagues in Spain attracted attention of some vein specialists and interest in the use of foam technology in treating venous insufficiency was reawakened. Administration of foamed sclerosant was reintroduced in the early 1990s by Cabrerra, who summarized a broad experience in 1997. By the 1990’s, broad use of diagnostic ultrasound imaging made it possible to monitor foam distribution with ultrasound scanning. Some 40 years earlier, and before the development of ultrasound scanning, foam had been used in Germany to treat varicose veins.  At that time, foam was made by special syringes and its distribution was assessed by touch, instead of ultrasound scanning. Tessari , prior to the year 2000 developed an easy way of making liquid sclerosant into foam using two syringes and a three-way stop cock.   By 2000, Sica was able to report a three-year experience using foamed sclerosant in treating saphenous varices.  Since that time, foam has appeared increasingly in general use. Around 2000, Dr. John Bergan began describing the utility and success of foam treatment to physicians in the United States and can be attributed to bringing its awareness to North America. Over the past decade foam has gained world-wide popularity for the treatment of varicose vein tributaries in place of surgery. Varithena foam was recently FDA approved to treat the great saphenous vein with foam sclerotherapy.  Dr. Bergan predicted that microfoam sclerotherapy will eventually replace all other methods.  Presently, it is most commonly used as an adjunct to endovenous ablation of the great and small saphenous veins or as a sole treatment for surface varicose veins.

Can Varicose Veins Cause Leg Ulcers?


VENOUS LEG ULCER, BEFORE: This is a venous leg ulcer, caused by venous reflux or venous insufficiency. In this picture, you can see varicose veins above the wound.


VENOUS LEG ULCER, AFTER: Because this individual had reflux only in the superficial varicose veins, treatment consisted of foam sclerotherapy of the varicosities and compression with unna boot dressing. The wound healed rapidly and note that the varicose veins are gone.

A venous leg ulcer is an open wound on the leg, caused by long-standing vein problems. It is the most severe form of chronic venous insufficiency (CVI). Venous leg ulcers are common, accounting for over 70% of all leg wounds. It affects 1% of Americans and is the seventh leading cause for disability in the United States.

It is usually located around the ankle (on the inner or outer sides). It is caused by underlying venous insufficiency, or venous reflux.  The persistent venous reflux (back flow of blood through faulty valves) causes high pressure within the leg veins.  The high pressure, is then exerting outward on the skin, causing an inflammatory response, eventually causing the skin to break down.  Visible signs of venous disease are varicose veins, ankle swelling, skin discoloration around the ankle and usually precede the leg wound.  Underlying venous insufficiency can be detected by duplex ultrasound imaging (a non-painful study).

The treatment of venous leg ulcers is to correct the underlying problem: the faulty veins. Treatment of the underlying non-functional veins will reduce pressure from venous hypertension, allowing the wound to heal.  There are a number of non-surgical treatment options that can accomplish this including foam sclerotherapy and endovenous ablation, depending on the affected veins. To determine if your leg wound is related to a vein problem or for treatment options, call us for more information.

Boston Marathon Winner Finishes in Compression Socks

The first American man to win the Boston Marathon since 1983 crossed the finish line last week.  Meb Keflezighi, 38 , won the men’s division while wearing CEP compression, a line of Mediven medical compression stockings. Meb has been publicly wearing CEP compression socks for years, including as the US Olympic marathon runner.


CEP Compression

Due to the health benefits that come from compression socks, other athletes are also using compression socks to decrease muscle fatigue and improve performance and recovery. It seems as though every runner is wearing compression socks these days.  Compression is not just for athletes. Compression has been used for decades as the treatment for vein disorders. In the field of venous disease, they are the gold standard in conservative management for vein conditions such as varicose veins and venous insufficiency. For those who have jobs that require prolonged periods of standing or sitting, compression can help with occupational leg swelling and fatigue. They are also recommended during air travel to reduce the risk of deep venous thrombosis (DVT).

CEP Compression socks, like those worn by Meb Keflezighi in the Boston Marathon can be found at

Before and After Photos: Spider Vein Treatment

This patient recently asked us to post his ‘before and after’ photos of his spider veins on the inner ankle (medial malleolus) following treatment here at La Jolla Vein Care.  He is a 62 year-old gentleman whose wife found the appearance of these unsightly veins a nuisance and they also caused itching. As a result, he wanted them to ‘disappear’ before summer. Four weeks after his second treatment session,  (8 weeks total) most of these diseased blue and red dilated vessels had disappeared.  He was treated with two sessions of liquid sclerotherapy using Asclera pharmaceutical grade solution. He wore his compression stockings the entire 8 weeks.

vein pictures

Before and after spider vein photos at la jolla vein care.

Sclerotherapy is used to treat the small spider veins on the legs. Only a trained physician or RN/PA should administer sclerotherapy injections. Sclerotherapy usually requires more than one treatment session for best results and may take several weeks to see optimal results. The national average is 3-5 treatment sessions. A different type of sclerotherapy, called foam sclerotherapy is used to treat larger blue, reticular veins and varicose veins. This should be done under ultrasound guidance and is performed by a Medical Doctor. Read more about sclerotherapy and ultrasound-guided foam sclerotherapy at La Jolla Vein  or click here to see more La Jolla Vein Care’s before and after photos.