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FAQs | Frequently Asked Questions about Vein Treatment

Varicose Vein FAQs

Below is a list of some frequently asked questions, but please feel free to call our office if you need additional information. We are always pleased to assist you. If you have any additional questions for Dr. Hyde please email by clicking here or calling our office at (925) 231-7590.

  • What is Elite Vein Specialists?

    Elite Vein Specialists is a full service diagnostic and treatment medical facility specializing in the evaluation and management of all types of vein disease. We treat large varicose veins, leg spider veins, hand and breast veins.

  • Where is Elite Vein Specialists located?

    Elite Vein Specialists has offices located in both San Francisco and Walnut Creek, California.

    Our Addresses are:

    490 Post St. Suite 700
    San Francisco, CA 94102
    (415) 614-4264

    675 Ygnacio Valley Road, suite B214
    Walnut Creek, CA 94596
    (925) 231-7590

  • How are appointments scheduled?

    All appointments are scheduled by calling (925) 231-7590. No referrals are needed for our initial, complimentary consultation. For driving directions or a map click on our Scheduling and Directions link.

  • What services are offered at Elite Vein Specialists?

    Dr. Nicholas H. Hyde, medical director of Elite Vein Specialists, is a phlebologist – a physician with a special interest and training in the diagnosis and management of all types of venous disease. At Elite Vein Specialists all types of varicose veins and spiders are treated – from cosmetically important spider veins and breast veins to large painful varicose veins.

    Specifically, we evaluate and treat:

    • Varicose veins – large and small
    • Leg spider veins
    • Facial veins
    • Breast Veins
    • Hand Veins

    *Taking advantage of Dr. Hyde’s vast experience with needles and injection techniques, EVS is delighted to offer botox injections for dimunition of fine wrinkles. Please ask Dr. Hyde and his staff if you are interested in these services.

  • How are diseased veins treated at Elite Vein Specialists?

    Elite Vein Specialists is a full service, state of the art medical facility offering advanced, outpatient treatment services for all types of varicose veins, leg spiders and facial veins. We perform the following procedures and services:

    • Ultrasound guided sclerotherapy – large varicose veins and wide spread spiders
    • ELVeS-cutting edge endovenous laser solution to large varicose veins originating high in the leg
    • Ambulatory Phlebectomy
    • Compression Therapy

  • I have large varicose veins. How should they be treated?

    Happily, the days of surgical stripping for large varicose veins are all but gone. Rarely now most patients endure hospitalization, undergo general anesthesia, experience considerable pain or miss extended time from work or play because of surgery for varicose veins.

    Now, because of advances in color-flow ultrasound imaging equipment and the development of newer and more complex sclerotherapy techniques as practiced at Elite Vein Specialists, physicians trained and skilled in performing a new procedure called “Ultrasound Guided Sclerotherapy” can successfully treat even very large varicose veins right in their offices without surgery, without anesthesia, and with virtually no post-operative down time.

    When seeking treatment for your vein problem, be sure to ask about “ultrasound guided sclerotherapy” if you have medium to large sized varicose veins or wide-spread spider vein disease.

    For patients with large varicose veins secondary to sapheno-femoral junction (groin area) reflux, Elite Vein Specialists offers ELVeS, an outpatient local alternative to vein stripping and ligation. This has a greater than 98% success rate after a single treatment session.

  • How are spider veins treated? I’ve been told nothing can be done for them.

    Virtually any type of spider vein can now be treated with sclerotherapy, ultrasound guided sclerotherapy and often times, a combination of techniques depending upon the type and severity of the problem that exists. When patients come in for their initial consultation, they are advised on the best type of treatments for their own particular problem.

  • What exactly is sclerotherapy? Is it painful?

    Developed over 40 years ago in Europe, sclerotherapy at Elite Vein Specialists utilizes only FDA approved drugs to close undesired veins. It is a simple, nearly painless, vessel injection technique that causes vein closure. Veins most commonly treated are leg spider veins, blue-green veins (that often are the blood supply to nests of spider veins) and varicose veins. Other successful areas for sclerotherapy include hands, breasts, and small spiders on shoulders or back. A treatment session typically lasts 30 minutes after which stockings are applied and walking for 20-30 minutes occurs to complete the session. Patients often benefit if they also are having leg fatigue or pain due to their vein disease.

  • What exactly is ultrasound guided sclerotherapy? Why is it so important?

    All diseased veins – from the largest of varicose veins to the tiniest of spiders – are caused by abnormal leakage of blood through faulty valves located inside veins deep beneath the surface of the skin. Over time, this abnormal leakage of blood, also called reflux causes veins visible on the skin surface to dilate and turn into diseased veins we call varicose veins and spiders. In order for sclerotherapy to be successful, the source of this venous reflux must be both identified by the treating doctor and injected or treated with sclerosing solution so the varicose vein caused by this leakage will disappear.

    Often the source of reflux causing varicose veins and even spiders is much deeper than can be reached by injecting from the skin surface, and since conventional sclerotherapy is done right on the surface of the skin, regular sclerotherapy will not be effective in treating veins caused by such a source of reflux.

    We also offer ultrasound guided sclerotherapy. Ultrasound can see below the surface of the skin!

    If abnormal veins deep under the skin can be visualized with the ultrasound machine, then Dr. Hyde can successfully guide a needle directly into the source of reflux and satisfactorily treat that source with the result of complete disappearance of the varicose vein originating from that source.

  • What is foam sclerotherapy?

    Foam sclerotherapy is an emulsion of the same drug that we use for conventional sclerotherapy. It appears to have much greater clinical effect on the inner wall of veins. It suffers less dilution from blood and perhaps displaces blood rather than simply mixing with it. The results are very positive probably due to greater drug-vessel wall surface contact. This procedure provides outstanding results with less concentrated drug requirements. This often leads to faster results with less treatment sessions. Foam sclerotherapy works extremely well on larger vessels in conjunction with ultrasound guided injections.

  • Is sclerotherapy expensive?

    Many people are surprised just how inexpensive sclerotherapy is, especially if they have had other cosmetic procedures performed. Your actual cost will depend upon the number of treatment sessions required and the extent of your disease. A highly accurate quote estimate will be supplied at the end of your initial consultation. We accept cash, personal checks, bank debit cards, and major credit cards.

  • How many sclerotherapy treatments are necessary?

    Regardless of the type of treatments needed, the number of treatment sessions varies depending upon the extent of vein disease, patient compliance with the post-treatment instructions and types of veins present. People usually have a mixture of diseased veins and each type of vein requires different treatment. Spider veins usually require three to five treatments, larger reticular veins more, and large varicose veins even more. Improvement will be noticed after every treatment and most people notice a fairly good degree of improvement after just three to four treatments.

  • What is the goal of sclerotherapy?

    As with all cosmetic procedures, we look for improvement… not perfection. With patience and good compliance, sclerotherapy and laser can effectively improve the appearance and health of your legs and leg circulation.

  • Can varicose and spider veins reappear?

    Once a varicosity or spider vein has been adequately treated, that vein is gone forever and will not reappear. You can, however, develop new varicosities and/or spider veins in other areas or even in areas that were previously treated.

  • Will getting rid of varicose veins and spider veins hurt my circulation?

    Removal of true varicosities actually improves venous circulation by helping to restore normal venous blood volumes and venous pressures. In general, the removal of spider veins has a minimal effect on overall circulation and may improve local venous circulation in the area treated.

  • Can I get a blood clot from injection therapy (sclerotherapy)?

    Blood clots do occur in the superficial varicosities being treated by injection therapy. They occur when the vein is shut down during injection therapy, but they do not impose any health risks and resolve as the injected vein is absorbed by the body. These superficial blood clots should not be confused with much more dangerous blood clots which can occur for other reasons in the deeper veins in the legs.

  • How long will it take before I see results?

    This varies based on the severity of the disease being treated. Some individuals see results within a few weeks, but we caution most people not to expect their best cosmetic results for two to three months. In rare instances, it may take up to six months before the best cosmetic result is achieved. Individuals who are being treated for symptomatic varicosities will notice improvement in their symptoms within the first week or two following treatment.

  • Where do these veins come from?

    Both varicosities and spider veins arise from previously normal veins that have become enlarged and dilated. The most common causes of vein enlargement are an inherited weakness in the vein wall and local injury.

  • When can I start exercising following treatment?

    In general, light exercise can be started approximately 72 hours following injection or light-based therapy treatment with resumption of normal or even aggressive activity at one week.

  • Does sclerotherapy cause discomfort during treatment?

    There is minimal discomfort during treatment employing either of these therapies. Sclerotherapy is performed with extremely small needles close to the diameter of a hair, and most individuals barely feel the injection at all. Many feel that this sensation is much less painful than having your legs waxed.

  • Will my insurance cover this?

    Insurance will reimburse a percentage of the treatment cost if there is a documented problem of venous insufficiency. If you have a medical problem and if you receive a positive result from a Doppler Duplex Ultrasound Scan, we can provide the diagnostic and procedure codes for pre-certification by your insurance company. It is important to note that each insurance company reimburses different amounts for these treatments. We will work with you to ensure you receive the most reimbursement possible. We also accept cash, personal checks, bank debit cards, and major credit cards.

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Walnut Creek – 925) 231-7590
San Francisco – (415) 614-4264


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S.B., Lafayette, CA

My large ugly varicose veins were gone with one treatment of foam sclerotherapy. I cried because I was so happy that my legs look normal again. I called Dr. Hyde because I was so excited with my results. He and his staff have been just lovely.

—S.B., Lafayette, CA