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What are Spider Veins?
Spider veins technically known as telangiectasias, are tiny 1-2 mm dilated capillary veins that can be red, blue or purplish in color and sometimes give a spidery appearance. Commonly patients will be asked if they have bruised their legs. Spider veins can occur anywhere on the legs but commonly occur along the lateral thigh and medial knee. Risk factors for spider veins include genetics, obesity, pregnancy, increased age, sitting or standing for long periods of time, prior blood clots and just being female.Spider veins can initially start as just a cosmetic problem with a worrisome appearance. Spider veins can be associated with varicose veins and most patients with varicose veins will also have spider veins. Spider veins will not disappear without treatment and will normally progress and worsen over years. If you have spider veins and also have leg symptoms including pain, aching, heaviness, tiredness, fatigue, cramping, throbbing, itching, burning, warmth, restless or swelling, you will likely need a diagnostic ultrasound to evaluate for vein disease. Our veins have tiny valves that keep the blood flowing in one direction up towards our heart. These valves may become damaged over time. Diagnostic ultrasound can evaluate these valves and the direction of flow in our veins. As these valves become damaged you will start to notice visible increase in spider and varicose veins.
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How are Spider Veins Treated?
Spider veins can be treated with sclerotherapy or laser treatment. Sclerotherapy is a treatment that is performed by injecting a sclerosant into the veins. The sclerosant will cause the vein to collapse and eventually the body will resorb the vein and it will disappear over the following weeks. The needle used for injection is tiny and thus there is minimal discomfort during the injections. New sclerosants are very safe and have minimal side effects. There will usually be some mild bruising after treatment which resolves over the following week. It's important to inform Dr. Madan if you are on blood thinners, which would increase your risk of bruising. Hyperpigmentation at the sites of injection may also occur. This is darkening of the skin overlying the treated veins. Hyperpigmentation more commonly occurs over larger varicose veins and is less of a concern over spider veins. Hyperpigmentation is more frequent in darker skin tone patients and slowly resolves over the following weeks and months. Some patients may notice itching or a small rash over the area of treatment but severe allergic reactions are very rare.
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What are varicose veins?
Varicose veins are abnormally enlarged veins that result from damaged or poorly functioning valves.
Your veins have these valves to keep blood flowing in one direction, back toward your heart. If your valves become damaged, blood doesn't flow properly, trickling back the wrong way to form pools that distend the veins.
The valve damage has many different causes including family history, pregnancy, obesity, sedentary lifestyle and even standing jobs and increased age.
The result is unsightly varicose veins. They’re most common on the legs but can develop in other areas as well.
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Is Ultrasound Needed For Varicose Vein Treatment?
First, it's important to understand that most insurance companies require that patients undergo a diagnostic ultrasound before having a radiofrequency ablation (RFA), endovenous laser ablation (EVLA), or other varicose vein procedures. If you fail to get an ultrasound, your insurance company might deny the claim.
However, that's just one of the reasons that you need to get an ultrasound. Your provider will also require it so he or she can take a closer look at your veins to check for damaged valves and blood flow issues. Plus, the ultrasound helps the doctor map out your veins and create a personalized treatment plan. This is a critical component of a successful procedure.
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How are Varicose Veins Treated?
​Dr. Madan starts your varicose vein treatment by addressing correctable causes like obesity and inactivity. For example, losing weight and getting more exercise usually improve some of the symptoms of varicose veins.
For patients whose jobs require prolonged standing, Dr. Madan recommends you wear graduated compression stockings when you're at work to slow the progression of the underlying vein disease.
If you continue to have problems with your varicose veins after following a conservative treatment program, Dr. Madan can perform a variety of minimally invasive procedures including:
⋆ Radiofrequency ablation
⋆ Endovenous laser ablation
⋆ Adhesive vein closure
⋆ Injectable Foam Sclerotherapy
These treatments all cause the varicose veins to collapse, preventing blood from flowing. With blood safely diverted along other veins, the treated veins break down over time and vanish.
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Varicose Vein Treatments
⋆ Radiofrequency ablation
⋆ Endovenous laser ablation
⋆ Adhesive vein closure
⋆ Injectable Foam Sclerotherapy
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Radiofrequency Ablation
​Dr. Madan and his team at Center for Varicose Veins use radiofrequency ablation (RFA) as a treatment for venous problems and varicose veins.
Ablation is a safe way of using a heat source to create precision damage to tissues in your body. With varicose veins, ablation causes the collagen in the walls of your veins to contract, collapse, and close up.
Blood can't travel along the treated vein, which breaks down over time and disappears. RFA causes the treated veins to contract and collapse using heat generated by radiofrequency energy.
To ensure accuracy and safety in every radiofrequency ablation procedure, Dr. Madan uses ultrasound guidance, which provides him with a live view of your veins.
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Endovenous Laser Ablation
Endovenous laser ablation (ELA) is a procedure Dr. Madan performs at Center for Varicose Veins to resolve venous problems like varicose veins.
Ablation means using a heat source to safely and precisely damage specific tissues in your body. When used on varicose veins, ablation causes the vein walls to contract, collapse, and close. Blood can't travel along the ablated vein, so over time, it breaks down and disappears.
Endovenous laser ablation causes treated veins to collapse just as they do with radiofrequency ablation — another treatment available at Center for Varicose Veins. The difference is that instead of radio wave energy, ELA uses laser light energy to create heat.
Endovenous laser ablation is a treatment of varicose veins which uses light energy to generate heat. The heat generated from the laser results in damage to the inside lining of the vein. This causes the vein to close and get resorbed by the body over the following weeks and months. Patients start to notice improvement in their symptoms soon after the treatment. The blood flow returning to the heart is rerouted from the abnormal veins into the normal healthy veins.
To ensure endovenous laser ablation is accurate and safe, Dr. Madan performs the procedure using ultrasound guidance, which provides him with live images of your veins.
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Foam Sclerotherapy
​Sclerotherapy is an injectable method of treating varicose veins, spider veins, and venous malformations. Dr. Madan uses ultrasound imaging to see the underlying veins so he can deliver and monitor the injection.
Your veins have these valves to keep blood flowing in one direction, back toward your heart. If your valves become damaged, blood doesn't flow properly, trickling back the wrong way to form pools that distend the veins.
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Venasealâ„¢
​The VenaSeal Closure System is a method of treating problem veins using a medical adhesive that closes off the diseased blood vessels. More than 100,000 patients worldwide have experienced the benefits of VenaSeal treatment.
VenaSeal is one of a range of options available at Center for Varicose Veins. Other options include sclerotherapy, radiofrequency ablation, and endovenous laser ablation.
The Center for Varicose Veins team delivers VenaSeal as an outpatient procedure.
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Cosmetic Vein Treatments
​There are many different locations on the body where veins can look cosmetically unpleasing. They can involve any part of the body including the legs, hands, face and body. These veins are usually normal veins but are prominent for varying reasons including genetics, weight loss, increased age and even trauma.
Depending on their location, these veins are usually treatable with sclerotherapy. The needles used for these treatments are tiny and can be done with minimal discomfort. Bruising is to be expected and is usually minimal and resolves over the following couple of weeks.
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Facial Veins
​Facial veins are very common and can be prominent along the forehead and temporal areas of the face. Some facial veins can become very enlarged due to loss of weight or collagen from the face. These veins may be green or blue in color and are affected by the overlying skin texture, color and elasticity.
Facial veins can be treated with caution and require an expert to perform properly. Facial veins larger than 2-3mm usually require sclerotherapy to adequately treat. The treated veins take time to resorb and often take a couple of treatments to get desired results.
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Chest Veins
​Usually visible chest veins are completely normal. They can vary in appearance due to size, skin tone, amount of subcutaneous fat and location. Genetics mostly decides the appearance of our chest veins. Chest veins can definitely become more prominent for varying reasons. Age alone, with loss of collagen can cause our veins to become more visible. Significant weight loss results in loss of our subcutaneous fat. This brings the veins closer to the skin surface making them look more prominent.
Women who have had breast augmentation, both reduction and implants, often complain of their chest veins becoming more visible. Implants will commonly thin the overlying skin causing the chest veins to become more visible.
There are other, much less common causes of prominent chest veins including cancer, vein clotting or thrombosis and prior vein surgeries like dialysis catheters, fistulas or grafts.
The easiest way to treat chest veins is with sclerotherapy. Sclerotherapy is the process of injecting a solution into the vein with a tiny needle. The solution or sclerosant causes the vein to vasospasm. The vein shrinks and the body starts to resorb the vein. Over the following weeks and months, the vein starts to disappear.
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Hand Veins
​ Unsightly hand veins are a common problem, especially as you get older. They usually protrude above the levels of your skin, sometimes bulging out. Hand veins may also be more noticeably blue or purple.
As you age, the skin on your hands gets thinner and less elastic. Your veins look more prominent and are easier to see through the more delicate skin. Most often, bulging or unsightly hand veins aren't anything to worry about, other than being a cosmetic issue. However, in a few cases, bulging hand veins might indicate you have a more serious condition, like a blood clot in the deep veins of your arm that might require clot-busting therapy.
Treating prominent hand veins typically involves using sclerotherapy, a similar method that Dr. Madan uses to treat varicose veins in your legs. With sclerotherapy, Dr. Madan injects a solution called a sclerosant into the vein to close it off.
After your hand vein treatment, the veins gradually disappear, absorbed back into your body. Blood that would have used these veins simply takes another route, so there's no adverse effect on your circulation.
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1064 Nd:YAG Laser Treatment
1064 Nd:YAG laser treatment is a non-invasive treatment that uses laser energy to heat and close spider veins. The hemoglobin within our red cells absorb the laser energy causing the spider vein to shrink and eventually disappear. This treatment is highly effective and non-invasive, resulting in minimal discomfort and short recovery times. 1064 Nd:YAG laser treatment offers a number of benefits for patients with spider veins. These include:
Non-invasive: Unlike traditional spider vein treatments, 1064 Nd:YAG laser treatment is a non-invasive procedure that requires no incisions and is performed with only minimal discomfort.
Safe: 1064 Nd:YAG laser treatment is a safe and effective treatment option for spider veins, with a minimal risk of complications.
Fast recovery time: Most patients can return to their normal activities on the same day of treatment.
Improved appearance: 1064 Nd:YAG laser treatment can significantly improve the appearance of spider veins, resulting in smoother, clearer skin.
We use the latest technology in 1064 Nd:YAG laser treatment to provide safe and effective treatment options for our patients. Our state-of-the-art facility is equipped with the latest equipment and technology to ensure that our patients receive the best possible care.
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About Dr. Vinay Madan, MD, DABVLM
​Vinay Madan, MD, is a Board-Certified Vascular and Interventional Radiologist at Center for Varicose Veins in Wilton, Connecticut. With two decades of experience treating vein disease, he has performed over 5,000 foam sclerotherapy cases, 3,000 endovenous laser ablation cases, and 2,000 radiofrequency ablation cases.
Dr. Madan received his Doctor of Medicine from the State University of New York (SUNY) Downstate Medical Center in New York City​. He then completed his internship in internal medicine at NYU Winthrop Hospital in Mineola, New York, before completing his radiology residency at the Albert Einstein College of Medicine at Long Island Jewish Medical Center, where he served as chief resident. Afterward, he completed his fellowship in vascular and interventional radiology at the Albert Einstein College of Medicine at Long Island Jewish Medical Center in New Hyde Park, Long Island.
Board certified by the American Board of Radiology, Dr. Madan holds a certificate of added qualification by the American Board of Radiology and is a diplomate of the American Board of Lymphatic and Venous Medicine. He has been recognized several times throughout his career, having received the Vital’s Patient’s Choice Award and On-Time Doctors Award in 2016. He has also been on the Healthgrades Honor Roll and is an honored member of Trademark Who's Who Top Doctors.
Dedicated to staying up-to-date on the latest advancements in his field, Dr. Madan is a member of the American College of Radiology, Society of Interventional Radiology, American Board of Venous and Lymphatic Medicine, American Medical Association, and Radiological Society of North America.
Dr. Madan has been married for 23 years and has two children. In his spare time, he enjoys hiking, playing squash and tennis, swimming, and listening to music.
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5 star reviews
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I had the best experience with Dr. Madan!!!. I was referred to him through a family member. I first went for a consultation to learn more. He immediately made me feel so comfortable. He is so knowledgeable and personable that we performed treatment the same day! I highly recommend this practice to everyone!
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The best word to describe Dr. Madan's Center for Varicose Veins is impeccable. Over the past few months, I have been going to the Wilton office for varicose vein treatments where I have been treated with genuine kindness and respect at every visit. I am most impressed with their high level of commitment, dedication, friendliness, and professionalism. Dr. Madan is extremely knowledgeable and very pleasant as are all of his assistants.
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I had a leg issue and wanted a professional team to look at it. Wow! The facility is very clean. I was very impressed by the whole staff right down to the front desk. The team at Center for Varicose Veins makes you feel special, heard, and appreciated. Dr. Madan still believes in the lost art of bedside manner. He explains everything in a way that makes sense and gives you honesty. I would highly recommend you book an appt if you need help.
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Dr. Madan was very kind and knowledgeable during my consultation. He provided me with all the information I needed and options for treatment. I highly recommend him. He is a very good doctor!
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5 star reviews
Dr. Madan and staff are exceptional. They are very thorough and tell you everything you need to know. They are friendly and helpful. The technicians that assist the Doctor are really outstanding. They have a strong command of their jobs, are extremely personable and professional. He is personable, patient, and takes the time to explain things step by step, patient-focused and thorough. It is a pleasure dealing with him and the staff.
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Not only is Dr. Madan an expert in his field, but he is professional, careful and caring. I felt very comfortable with him and his great support staff throughout my treatments.
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Dr. Madan is very respectful, listens carefully to my medical complaints, fully answers all of my questions, is honest and knowledgeable about vein problems. I highly recommend Dr. Madan and his staff for their professionalism and sincere concern for patients.
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Dr. Madan was very kind and knowledgeable during my consultation. He provided me with all the information I needed and options for treatment. I highly recommend him. He is a very good doctor!
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