23, 5, 2020

How to Treat Leg Spider Veins


Spider veins and reticular veins of the legs are most commonly treated with sclerotherapy. 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 modern solutions such as Asclera, 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 the preferred  over laser in most cases of spider veins on the legs, because spider veins often have underlying ‘feeder veins’ that can easily be treated with sclerotherapy, but are not addressed by laser. Laser may be used for the fine thread like veins, most common on the face. 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.


How to Treat Leg Spider Veins2020-09-18T19:01:10-07:00

6, 5, 2016

Common Misconceptions… Do I have spider veins or varicose veins?


Common Misconceptions… Do I have spider veins or varicose veins?


photo of spider veins on back of thighs

spider veins on back of thighs


There is a common misconception of what varicose and spider veins really are. It may be embarrassing for some to admit that they have varicose veins or they simply just think that they have spider veins. Although spider veins can be fed from varicose veins, they are simply not the same. Let’s start with spider veins… What are they? Spider veins are typically purple web-like veins that appear either scattered all over the leg or in clusters. Although they can be symptomatic, they are usually painless and are considered cosmetic. They lie almost, if not, flat on the skin and are often described as “unsightly.” Varicose veins on the other hand are bulgy. People describe them as snake or rope like or even like a little brain. Varicose veins protrude from the skin and are not considered a cosmetic condition, but rather a medical condition. They can also be either symptomatic or asymptomatic. To properly diagnose patients with either spider veins or varicose veins, a thorough consultation should be done to examine the patient’s legs and areas of concern. Sometimes, certain patterns of spider veins indicate that there may be an underlying vein condition. An ultrasound examination can be done to properly diagnose varicose veins and underlying vein conditions.

Common Misconceptions… Do I have spider veins or varicose veins?2020-12-19T01:54:10-08:00

21, 7, 2014

Varicose Veins vs. Spider Veins


What is the difference between varicose veins and spider veins?  Are they the same thing? Spider veins and varicose veins both refer to dysfunctional, dilated leg veins but the main difference is the size of the veins. Spider veins are small, thread-like veins at the surface of the skin. They often appear in clusters or can have a ‘starburst’ or spider-like pattern. Varicose veins are larger veins that appear swollen, twisted cordlike veins that ‘bulge’ at the surface.

Both spider veins and varicose veins can cause pain and other symptoms like burning, aching, and throbbing. Both can be treated without surgery.

Slide 4_2

This image describes the difference between spider veins and varicose veins. Both are manifestations of unhealthy veins. Spider veins are essential, tiny varicose veins.

Varicose Veins vs. Spider Veins2021-11-05T13:08:51-07:00

5, 6, 2014

Why Didn’t My Spider Veins Go Away?


Before and After spider vein treatment at La Jolla Vein Care. This picture demonstrates that spider veins (reddish spider-like vessels) can stem from underlying feeder vessels (the blue vein). The feeder vein can be compared to the ‘root’ of a weed; If you clip the surface branches of a weed without pulling the root of the problem, the weed will never go away.


Veins in certain locations, like in the inner knee or inner thighs and inner ankles, often arise from underlying venous incompetence of a vein called the great saphenous vein that runs from the groin along the inner thigh to the ankle. If spider veins do not respond to treatment, it is important to have an ultrasound evaluation to determine if there is an underlying source of the problem.  Once the underlying problem is properly identified, it can be treated.

Spider veins can be the ‘tip of the iceberg’ and represent a bigger problem, that is not visible to the naked eye. For example, as seen in the first image, spider veins can arise from blue ‘feeder’ veins, which must be treated for best results.

Spider veins can also stem from an underlying problem such as venous reflux in larger veins, such as the great saphenous vein. As demonstrated in the second picture, spider veins in the inner knee, inner ankle and inner thighs can originate from this vein. This can only be determined by ultrasound examination. It is important to have your vein evaluated by a trained specialist. Effective treatment depends on an accurate and thorough diagnosis.

Why Didn’t My Spider Veins Go Away?2021-11-04T19:29:17-07:00

28, 1, 2014

Dr. Fronek teaches primary care doctors to care for patients with vein problems


Dr. Fronek was recently invited to discuss vein disorders with the Family Medicine Residency Program at Scripps Chula Vista.  The doctors-in-training were excited to learn about the variety of problems that patients have with their veins – including spider veins,  varicose veins,  blood clots, and leg ulcers.  Primary care doctors see patients with vein disorders every day, and yet very few medical schools or residency training programs include any information about these common problems.  Dr. Fronek and Dr. Bunke-Pacquette are committed to sharing their expertise with colleagues and are frequently asked to speak at medical meetings.  Primary care doctors, in particular, can often start patients with vein disorders on conservative treatment, including graduated compression stockings and regular exercise (walking is usually the best exercise for vein disorders), as well as certain supplements such as horse chestnut seed extract, that can alleviate the symptoms that many patients with vein disease suffer from.  Informed primary care doctors can also refer patients to a vein specialist when symptoms aren’t diminished with conservative treatment, if the varicose veins worsen while a patient is using compression and exercise, or if the patient suffers from a venous leg ulcer.

Dr. Fronek teaches primary care doctors to care for patients with vein problems2022-01-04T05:17:54-08:00

15, 4, 2011

Dr. Bunke Featured in San Diego Woman Magazine

Dr. Nisha Bunke featured in San diego Womans Magazine

Dr. Bunke In San Diego Woman Magazine

Dr. Bunke and her associate, Dr. Sardo were featured in the April issue of San Diego Woman Magazine.  The articles highlight their careers and their specialty practices in medicine. Dr. Bunke describes the evolution of varicose vein treatments from surgery to minimally invasive procedures.  She expresses that most varicose veins can be treated without surgery or anaesthesia. This is a huge advancement in the field of venous disease, considering only a decade ago vein stripping surgery was the gold standard for varicose vein treatment.


Dr. Sardo’s article describes her prominent career as a plastic surgeon, which has helped her help patients look better, feel better, and achieve greater health.

Dr. Sardo SD WomansMag April2011

Dr. Sardo

Dr. Bunke Featured in San Diego Woman Magazine2021-11-03T22:15:57-07:00

19, 8, 2010

Beyond Saline


If you’re looking to remove spider veins or varicose veins, you may find that saline injections are infrequently used. Why? They’re unnecessary. Today, more effective solutions are available for treating damaged veins. In short, saline injections cause stinging upon injection.  The saline solution mixes with the blood in larger veins, never making contact with the vein wall.  As a result, saline injections are only effective for tiny spider veins.  If sclerotherapy failed to remove your larger veins in the past, this is probably why. The good news? More effective and painless solutions are now available. Ask a board certified vein specialist (Phlebologist) which type of solution you should you use—and see if you’re ready to move beyond saline.


Executive Team

Beyond Saline2010-08-19T22:53:15-07:00

An Alternative to Surgery


Today, sclerotherapy is clearly the gold standard for removing spider and varicose veins. During this procedure, a specially trained physician injects a safe sclerosing agent directly into the blood vessel. The effectiveness of the procedure comes as a direct result of the training, experience, and judgment of the physician to make sure that the sclerosant’s volume, concentration, and exposure time are exactly right. What happens next? The solution displaces the blood in the vein, causing it to immediately appear lighter in color. The solution irritates the vein lining, causing it to collapse and blocking it from receiving more blood. Within a few weeks, the unused vein is absorbed by the body and disappears. With advancements in medicine, there’s no reason to go under the knife anymore—sclerotherapy is a safe, effective, and cost effective alternative to surgery.


Executive Team

An Alternative to Surgery2010-08-18T23:13:50-07:00

The Beauty of Expertise


Selecting the right vein specialist is important for receiving the most effective treatment available. Today, veins specialists are called phlebologists. Phlebology is a specialty field of medicine dedicated to diagnosing and treating vein-related conditions. As a result, it’s imperative that whoever is treating varicose or spider veins is board certified by the American Board of Phlebology. To confirm that your vein doctor is qualified, simply go to the American Board of Phlebology website. In the upper right-hand corner, you’ll see a tab that reads FIND AN ABPh CERTIFIED PHYSICIAN. By confirming your doctor is board-certified, you’ll get more than better treatment—you’ll get the peace of mind every patient deserves. It’s the beauty of expertise—and it’s the convenience of having valuable information at your fingertips.


Executive Team

The Beauty of Expertise2021-11-03T21:35:31-07:00
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