FAQs

What is venous insufficiency and how do I know if I have it?

Venous insufficiency occurs when the valves inside your leg veins fail to keep blood flowing toward the heart, allowing it to pool and flow backward. This increased pressure causes symptoms including varicose veins, ankle discoloration, leg swelling, heaviness, aching, and skin changes. A physical exam and ultrasound evaluation at our Los Angeles office or our Walnut office can confirm a diagnosis. Learn more on our Venous Insufficiency page.

What is the difference between varicose veins and spider veins?

Varicose veins are large, bulging, twisted veins visible beneath the skin — usually on the legs — caused by faulty valves and venous reflux. Spider veins (telangiectasia or venulectasia) are smaller clusters of red, purple, or blue vessels visible on the skin surface. Both can be cosmetic concerns, and either can signal underlying venous disease. Dr. Landau evaluates both conditions and recommends the most appropriate treatment.

Are vein treatments painful?

Most of our treatments cause minimal discomfort. Procedures like ClariVein™ and VenaSeal™ require only local anesthetic at the insertion site, while Direct Vision Sclerotherapy injections are often compared to a mosquito bite. The EVLA and RFA procedures use tumescent anesthesia to ensure comfort throughout. Most patients return to normal activity immediately after treatment.

How long does a vein treatment procedure take?

Most procedures are completed within one hour or less, right here in our office. Varithena™ typically takes under an hour, and ClariVein® is usually completed within 30 minutes. EVLA and RFA procedures can be performed in a single in-office visit without hospitalization. There is no need to arrange for lengthy time off work.

What is the recovery time after vein treatment?

Recovery varies by procedure, but most patients resume normal daily activity the same day. With VenaSeal™ and ClariVein™, there is virtually no downtime. After Varithena™, you should avoid heavy exercise for one week and keep bandages dry for 48 hours. Compression stockings may be recommended for some procedures. Dr. Landau will provide detailed post-treatment instructions tailored to your specific procedure.

Will my insurance cover vein treatment?

Coverage depends on whether your vein condition is medically necessary. Vein Care Medical Center participates in Medicare and accepts assignment on medically necessary and approved procedures. For other insurance carriers, we provide a walk-out receipt so you can submit claims directly. Cosmetic procedures are typically not covered. We encourage you to contact your insurance provider to understand your benefits, and our team is happy to assist with the process.

What payment options does Vein Care Medical Center offer?

We accept cash, check, Zelle, debit/ATM cards, Visa, Mastercard, and Discover/Novus. We also participate with CareCredit, which offers zero-interest payment options for a fixed period and competitive interest rate plans for longer-term financing. Payment is due at the time of service unless a payment plan has been arranged in advance.

How many treatment sessions will I need?

The number of sessions depends on the type, size, and number of veins being treated. Some patients achieve full results from a single session — particularly with procedures like Varithena™ or VenaSeal™. Others with extensive varicose veins or spider veins may benefit from multiple sclerotherapy sessions. Dr. Landau will provide an honest, realistic treatment plan at your initial consultation.

What is sclerotherapy and how does it work?

Sclerotherapy involves injecting an FDA-approved sclerosant solution (Sotradecol® or Asclera®) directly into the targeted vein. The solution damages the vein wall, causing it to harden and collapse — a process called sclerosis. The treated vein is then gradually absorbed by the body over the following weeks or months. Vein Care Medical Center uses foam sclerotherapy in most cases and never injects hypertonic saline.

What is the Excel V laser and what conditions can it treat?

The Cutera® Excel V™ is an advanced dual-wavelength laser system that targets vascular and pigmented skin conditions. At Vein Care Medical Center, we use it to treat rosacea, angiomas, port wine stains, freckles, age spots, skin tags, acne scars, wrinkles, warts, and a variety of vascular lesions. It is safe and effective for all six Fitzpatrick skin types with no downtime required.

Is VenaSeal™ safe, and what makes it different from other treatments?

VenaSeal™ is an FDA-approved, medical-grade cyanoacrylate adhesive that physically seals the diseased vein. Unlike thermal procedures such as EVLA and RFA, VenaSeal™ poses no risk of skin burns or nerve damage. It requires no tumescent anesthesia, no immediate post-treatment pain medication, and typically allows patients to return to all normal activities immediately. Only a small amount of adhesive is needed for effective, lasting results.

What is ankle discoloration and what causes it?

Ankle discoloration (corona phlebectatica) presents as clusters of purple or blue veins covering the ankle and foot area. It is caused by chronic venous pressure — the same pressure that produces varicose veins — which forces tiny capillaries to dilate and become visible. Think of venous insufficiency as the waterfall, and ankle discoloration as the spray at the bottom. Dr. Landau treats the underlying insufficiency to stop the progression and reduce discoloration.

Can leg swelling be caused by vein problems?

Yes. Leg swelling (edema) is a common symptom of venous insufficiency, where blood pools in the legs due to faulty vein valves. However, edema can also result from other conditions including lymphatic problems, heart or kidney disease, or medication side effects. Dr. Landau performs a thorough evaluation to identify the cause and recommend appropriate treatment — vein-related or otherwise.

What is musculoskeletal medicine and who is it for?

Vein Care Medical Center also offers musculoskeletal medicine for patients experiencing joint pain, soft tissue injuries, or orthopedic conditions. Treatments include Platelet Rich Plasma (PRP), Bone Marrow Cells, Adipose Tissue/Lipogems, Intraosseous injections, Alpha-2-Macroglobulin, Hyaluronic Acid, Perineural Therapy, and Prolotherapy. These regenerative approaches support healing without surgery and are appropriate for a wide range of patients.

How do I prepare for my first appointment at Vein Care Medical Center?

On the day of your consultation, please bring a pair of shorts, comfortable walking shoes, and comfortable loose-fitting pants. If you have insurance, bring your insurance card. You will be asked to read and sign our financial policy and patient information forms before seeing Dr. Landau. Appointments are available at our Los Angeles and Walnut offices — call (323) 934-9191 or visit our Patient Information page for complete details.

Can varicose veins come back after treatment?

While treated veins are permanently eliminated, new varicose veins can develop over time — particularly if the underlying risk factors (genetics, hormonal changes, prolonged standing, or obesity) are not addressed. Dr. Landau provides guidance on reducing recurrence risk and performs follow-up evaluations to monitor your vein health long-term. Regular check-ups and wearing compression stockings as recommended can help maintain your results.

How soon will I see results after vein treatment?

Results vary by procedure and patient. With thermal ablation procedures like EVLA and RFA, the treated vein closes immediately and is gradually absorbed over several weeks. Spider veins treated with sclerotherapy typically fade over four to eight weeks. Most patients notice significant improvement in symptoms like heaviness and aching within days of treatment.