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There are a number of ways to treat enlarged leg veins. The method(s) used for a particular person depends in part on the size of the veins. Very large (i.e., varicose) veins are managed in part by wearing support hose and keeping the legs elevated when possible. Surgical methods (e.g. ligation & stripping) have been used for years to remove varicose veins. A newer technique (endovenous/transvenous laser or radiofrequency treatment) that heats a portion of a large vessel in the thigh can produce dramatic effects and requires much less recovery time compared to the older methods.

For smaller vessels sclerotherapy has been used for years. This method involves injecting a substance that irritates the inside of the veins so that they collapse down. Once collapsed no blood can travel through so the red or blue blood color goes away. People who smoke, are on birth control pills/hormone replacement therapy, or have a personal or family history of blood clots may be at greater risk of having more serious side effects from sclerotherapy. Several treatment sessions are usually required for best results.

Light-based systems (intense pulsed light (IPL) & lasers) are beneficial for treating small vessels that are difficult to treat by sclerotherapy. For light-based treatments an intense light is moved over the veins. The light energy is converted to heat and this heat causes the veins to collapse down so blood can no longer flow through them. The color of the vessels then fades away. Several treatment sessions are usually required for best results. Below are before and after photos of leg veins treated by IPL.

Some patients can benefit from a combination of treatments (i.e., sclerotherapy plus intense pulsed light) to achieve the best cosmetic results. Health insurance companies sometimes will help pay for treatment of large varicose veins that are causing discomfort to the patient. Most health insurance companies consider the treatment of the smaller leg veins as cosmetic and don’t cover this service.

Temporary bruise-like discoloration can occur after any leg vein treatment. The winter season is therefore an ideal time for treatment as any discoloration will have time to clear before the bathing suit and shorts-wearing summer season.

Dr. McCauliffe offers both sclerotherapy and intense pulsed light treatment of leg veins at the Rutland Skin Center. The cost per session for sclerotherapy and intense pulsed light is $195 and $259, respectively. If you like to learn more and determine if you are a candidate for either of these services, call 773-3553 for an appointment.

Get medium to high strength panty hose type support hose. There is evidence that direct compression of leg veins after treatment can improve the outcome of this therapy. Dr. McCauliffe therefore advises his patients to obtain compression stockings and bring them to the treatment sessions to be put on afterward. You can get fit for the appropriate size compression stockings at most local pharmacies. This support hose is costly, so you may want to check on the cost to see if it is economically feasible for you to purchase them, and determine whether your insurance company will help cover the cost.
Bring a comfortable pair of shorts to wear during the treatment session.

Put your support hose on and wear them throughout the entire day for the next three weeks, or longer as advised.
Avoid vigorous activities such as exercise for three days after the treatment.


Leg veins before IPL treatment	Same leg after only one IPL treatment