Varicose Veins in Los Angeles, CA

Are you experiencing pain, swelling, or unsightly veins in your legs? You might be dealing with varicose veins, a common condition affecting many individuals in Los Angeles and beyond. Varicose veins are enlarged, twisted veins that often appear blue or dark purple and can cause discomfort or lead to more serious health issues if left untreated.

At the Vein & Wound Center of LA, we specialize in the accurate diagnosis and treatment of varicose veins using advanced duplex ultrasound mapping and minimally invasive procedures. Many vein centers treat varicose veins the same way for every patient, but the reality is more complex: varicose veins can be both a cause and a result of saphenous vein reflux. That’s why correct diagnosis is the first step to long-lasting results.

What are Varicose Veins?

Varicose veins are enlarged, twisted veins that commonly appear on the legs and feet. They develop when the one-way valves inside your veins, which are responsible for keeping blood flowing toward the heart, become weakened or damaged. As a result, blood begins to flow backward and pool in the veins, causing them to stretch, bulge, and become visibly distorted.

While many people associate varicose veins with cosmetic concerns, the condition can lead to a range of physical symptoms. These may include aching, heaviness, burning, swelling, or cramping in the legs—especially after standing or sitting for extended periods. In more advanced cases, varicose veins can contribute to skin discoloration, irritation, or even open sores (venous ulcers) that require medical attention. Early diagnosis and treatment are important to prevent progression and improve comfort and circulation.

What Causes Varicose Veins?

Varicose veins develop due to increased pressure within the veins, often caused by a combination of lifestyle, genetic, and physiological factors. Some of the most common causes and risk factors include:

Genetic predisposition: A family history of varicose veins significantly raises your risk, as vein valve weakness can be inherited.
Prolonged standing or sitting: Occupations or daily routines that involve long periods of immobility can hinder proper blood circulation, increasing pressure in the leg veins.
Obesity: Carrying excess weight puts additional strain on leg veins, making it harder for blood to flow efficiently.
Pregnancy: Hormonal changes and increased blood volume during pregnancy, along with pressure from the growing uterus, can lead to vein dilation and valve dysfunction.
Age: As we age, vein walls and valves naturally lose elasticity and strength, making older adults more prone to varicose veins.
Prior blood clots or trauma: Blood clots can cause damage to venous valves, causing leak points and varicose veins to develop downstream.

Understanding these contributing factors can help you make informed decisions about prevention and when to seek treatment.

Symptoms and Risks

Identifying varicose veins early can prevent complications. Common symptoms include:

Aching or heavy feeling in the legs
Burning, throbbing, muscle cramping, and swelling
Worsened pain after sitting or standing for long periods
Itching around one or more of your veins
Skin discoloration around a varicose vein

If left untreated, varicose veins can lead to more severe issues such as ulcers, bleeding, or deep vein thrombosis (DVT).

Treatment Options at Vein and Wound Center of LA

Endovenous Laser Therapy (EVLT): A minimally invasive procedure that uses laser energy to seal off affected veins.
Sclerotherapy: An injection technique that collapses varicose veins, causing them to fade.
Radiofrequency Ablation (RFA): Uses radiofrequency energy to heat and close varicose veins.

Varicose Veins as a Symptom of a Leak Point

Visible varicose veins are rarely the whole story. They usually reflect a deeper “leak point” in the venous system, where faulty valves allow reflux to feed tributary veins. These leak points can be located in:

The great saphenous vein (GSV)
The small saphenous vein (SSV)
Perforator veins
Tributary (branch) veins
Pelvic veins

Treating only the visible varicose veins without identifying the source often leads to recurrence.

The Role of Duplex Ultrasound in Vein Mapping

Duplex ultrasound (DUS) is the gold standard for evaluating venous disease. It provides a real-time map of reflux, helping vein specialists determine:

The exact origin of venous leak points
Whether reflux begins in the GSV, SSV, or tributary veins
If reflux is ascending (from varicose tributaries upward) or descending (from the GSV downward)
Which veins should be treated for long-term success

At VWCLA, every treatment begins with a complete DUS performed by highly trained vascular technologists, ensuring accuracy before any intervention.

Learn more about Ultrasound Vein Mapping in Los Angeles..

Theories of Venous Reflux: Descending vs. Ascending

Traditionally, descending reflux was thought to be the dominant pattern: valve failure begins at the top of the GSV, and reflux extends downward into tributary veins.

Emerging evidence, however, supports the existence of ascending reflux: reflux may originate in tributaries, traveling upward into the saphenous trunk and eventually causing GSV failure.

Recent research has also highlighted the role of nonsaphenous sources of reflux, including perforator veins and pelvic escape points, as well as the contribution of vein wall stress and remodeling to progressive dilation. These factors suggest that varicose vein disease is not always a single-valve problem but a complex interplay of valve dysfunction, venous wall weakness, and hemodynamic forces.

Evidence from Clinical Studies

A key paper by Labropoulos N, Kim H. “Patterns of Saphenous Reflux and Treatment Plan” (Phlebology, 2006) emphasized that treatment must address not just the GSV, but also the tributaries feeding into it, since untreated tributaries can maintain reflux even after ablation.

Similarly, European work (e.g., Whiteley et al.) has described cases of descending versus ascending reflux, sparking debate in the field. While these theories are still under discussion and not universally adopted by societies such as the American Vein & Lymphatic Society (AVLS), they reinforce the principle that careful mapping and individualized planning are essential.

At VWCLA, we integrate this evidence-based perspective into our evaluations. By identifying reflux whether it arises from the GSV, tributaries, perforators, or nonsaphenous veins, we ensure that the true source of disease is addressed.

Learn more about Ultrasound Vein Mapping in Los Angeles

Why Ablation Isn’t Always the Answer

Endovenous ablation (closing the GSV with heat or glue) is one of the most effective and widely used treatments for venous reflux. However, ablation alone may not address every patient’s problem.

If reflux originates in tributary veins, ablating the GSV may not provide lasting relief.
Some patients benefit from targeted treatment of varicose tributaries first, or in addition to ablation.
Over-treating the saphenous vein unnecessarily can be avoided with proper mapping.

At VWCLA, we focus on targeted treatment guided by ultrasound — whether that means Endovenous Ablation, phlebectomy, sclerotherapy, or a combination — to achieve durable, minimally invasive results.

Why Choose Vein & Wound Center of LA for Spider Vein Treatment

Accurate Diagnosis
Successful spider vein treatment starts with understanding what’s feeding them. Our highly trained vascular ultrasound technologists identify whether your spider veins are being caused by deeper reticular or perforating veins. By mapping reflux patterns precisely, we ensure treatments are effective and long-lasting—not just surface-level.
Expert Experience
With thousands of vein procedures performed, we know how to recognize subtle patterns and choose the best approach for your spider veins. Our experience helps us treat both the cosmetic clusters you see on the surface and the underlying issues that often cause them to return.
Advanced Treatment Options
We offer minimally invasive treatments tailored to spider veins, including sclerotherapy and targeted laser therapy, with results that improve both appearance and comfort. Our goal is natural-looking results and durable improvements.
Convenience & Comfort
Treatments are performed in-office with no general anesthesia, no stitches, and minimal downtime—most patients return to normal activity the same day.
Patient-Focused Results
We take time to individualize every treatment plan. Whether you’re seeking cosmetic improvement, relief from discomfort, or both, we create a plan that addresses your unique needs.

Take the First Step Toward Healthier Veins in Los Angeles, CA

Don’t let varicose veins disrupt your life any longer. At the Vein and Wound Center of LA, we are committed to helping you regain comfort and confidence. Contact us today to schedule a consultation with Dr. Christopher Kim. Call us at (213) 654-8346, and take the first step towards healthier, pain-free legs.

Frequently Asked Questions (FAQ)

1. Are varicose veins dangerous?
They are not always dangerous but can worsen over time, leading to swelling, skin damage, or even ulcers if untreated.

2. Do varicose veins go away on their own?
No. Once valves are damaged, veins remain dilated. Only medical treatments can close or remove them.

3. Do varicose veins always mean I need a saphenous ablation?
Not always. Sometimes reflux begins in tributary veins and feeds the saphenous vein. In these cases, treating tributaries may be more effective.

5. What treatments are available?
Minimally invasive options include Endovenous Ablation, phlebectomy, and Sclerotherapy for Spider and Reticular Veins. All are done in-office with minimal downtime.

6. Who should get evaluated?
Anyone with visible varicose veins, leg discomfort, swelling, or skin changes should undergo duplex ultrasound mapping..

4. Can varicose veins cause reflux in the saphenous vein?
Yes. Although reflux often flows downward from the saphenous vein, it can also ascend from varicose tributaries into the GSV.

References

Eberhardt RT, Raffetto JD. Chronic Venous Insufficiency. Circulation. 2014;130(4):333-346.
Gloviczki P, Comerota AJ, Dalsing MC, et al. The care of patients with varicose veins and associated chronic venous diseases: Clinical practice guidelines. J Vasc Surg. 2011;53(5S):2S-48S.
Beebe-Dimmer JL, Pfeifer JR, Engle JS, Schottenfeld D. The epidemiology of chronic venous insufficiency and varicose veins. Ann Epidemiol. 2005;15(3):175-184.
Nicolaides AN, Allegra C, Bergan J, et al. Management of chronic venous disorders of the lower limbs: Guidelines according to scientific evidence. Int Angiol. 2008;27(1):1-59.
Labropoulos N, Kim H. Patterns of Saphenous Reflux and Treatment Plan. Phlebology. 2006;21(1):12–17.
Whiteley MS, Dos Santos SJ, Harrison CC, Holdstock JM. Descending venous reflux: when the great saphenous vein is refluxing because of varicose tributaries. Phlebology. 2014;29(10):706–713.
Holdstock JM, Dos Santos SJ, Harrison CC, Whiteley MS. Haemodynamics of varicose veins: effect of stripping the long saphenous vein. Br J Surg. 2014;101(6):709–716.