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What is the best treatment for bulging ankle veins?

I have bulging blue veins in my achilles heel area around my ankle and foot, it makes my ankle and feet sore on hot days. Is foam sclerotherapy good to treat this? Will it solve this problem once and for all?


Doctors Answers (11)

Sclerotherapy liquid or foam is the best treatment for bulging ankle veins. Once the vein is treated, it should be gone for good.

The best thing is to get to the source as to why those veins are there. I would recommend having an ultrasound first to see what is feeding your ankle veins. Once you fix the underlying problem with an ablation or sclerotherapy than the ankle veins should improve. I usually treat ankle veins with micro phlebectomy after the source has been treated. This gives the best results. The probability with sclerotherapy at the ankle is that you are left with very tender brown lumps that will rub against your shoe.

An answer to your question requires a clinical exam and a venous color duplex ultrasound exam to evaluate the many veins which may contribute to causing the findings you describe. Foam sclerotherapy may be all or part of the treatment necessary in some cases. Others may best be treated with endovenous thermal ablation of a saphenous vein or microphlebectomy or combinations of the three treatments.

Firstly you should be evaluated by an experienced surgeon specializing in the treatment of vein disease. This will include an ultrasound examination to rule out any underlying valve insufficiency in the deep or saphenous veins. If there is, this should be treated by endovenous laser ablation. If there is no problem, these veins can be treated with microphlebectomy (minimally invasive tiny incisions through which sections of vein are removed). This is most effective for larger veins and should be performed by an experienced surgeon. Cosmetically it is a nice result and a one step procedure. For smaller veins sclerotherapy works well but usually involves multiple treatments.

You should see a vein specialist and have them determine if you have venous insufficiency causing this. If you do, you should treat the source. We usually remove these veins. Depending on the size, sclerotherapy is not the best choice as the vein will become hard and tender for a while and may rub against your socks and shoes and cause discomfort.

Foam may work. A complete ultrasound evaluation of your venous system will give us the answer to your question. Your health insurance will pay for the treatment of symptomatic varicose veins.

The first step in treating varicose veins around the lower calf and heel is to get a detailed venous duplex ultrasound evaluation of the veins of the lower legs. The ultrasound is usually done in the office to evaluate the anatomy and measures venous blood flow. This is done to identify the underlying source of the problem such as a perforating vein leading to venous hypertension (reflux) and resulting in varicose veins over the heel and to determine if the saphenous veins are involved. It is important to not only treat the obvious problems seen at the surface but also to follow the problem vein to its source. Then treatment options can be discussed which may include foam sclerotherapy, venous ablation, phlebectomy or yet another technique. In this way, the problem is properly treated and the results should be clearance of the varicose vein(s) and its symptoms. The risk of developing any new varicose veins in the future can also we discussed with the physician doing or evaluating the ultrasound results.

Foam sclerotherapy is good but it is not currently approved in the U.S. by the FDA. The alternatives are regular sclerotherapy or phlebectomy (surgical removal of the veins).

Actually ablation of the saphenous vein is more effective and lasting than sclerotherapy.

Yes, foam sclerotherapy is a good option for veins around the anckle.

Provided that one does not have venous reflux disease of the great saphenous or small saphenous vein, which should be treated first, foamed sclerotherapy of varicose veins about the ankles is a good choice.

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