Dr. Aleman Conditions Treatments Visit Schedule Call
No. 03  ·  Conditions

The conditions we actually treat.

Most of what we see has been dismissed somewhere else as "just aging." It usually isn't. Below: the full library, with honest notes on what each one is — and how an ultrasound diagnosis settles the question.

01Varicose Veins
Graduated compression stocking for varicose vein care.

Varicose Veins

Twisted, rope-like veins — typically in the legs.

Caused by failing one-way valves inside the vein, which let blood pool. Often runs in families. Beyond cosmetic concern, varicose veins can cause aching, heaviness, swelling, and skin changes if left untreated. Treatment is minimally invasive and most often medically necessary — which means insurance commonly covers it.

Common symptoms

  • Visible bulging veins
  • Aching or heaviness
  • Night-time leg cramps
  • Swelling at the ankles
  • Itching over the vein

How we evaluate

  • Free screening visit
  • Diagnostic ultrasound (the actual diagnosis)
  • Written plan with insurance estimate
A diagnostic ultrasound is the only way to confirm reflux. Visual inspection alone isn't enough.
02Spider Veins
Visually guided injection of spider veins.

Spider Veins

Fine, web-like surface vessels.

Small dilated capillaries close to the skin's surface — usually red, purple, or blue. Often cosmetic, but in some patients they signal deeper venous insufficiency. We evaluate every patient for underlying reflux before treating surface vessels — otherwise, the spider veins return.

Where they appear

  • Thighs and calves
  • Behind the knees
  • Around the ankles
  • Occasionally on the face

How we treat

  • Visually guided sclerotherapy
  • Treat underlying reflux first if present
03Leg & Ankle Swelling
Leg and ankle swelling from venous pressure.

Leg & Ankle Swelling

Persistent heaviness and end-of-day edema.

When the veins can't move blood back to the heart efficiently, pressure builds and fluid collects in the lower legs and ankles. It's often worse by evening and after long periods of standing or sitting. Swelling that's clearly one-sided, or paired with skin changes, is worth an ultrasound.

Tell-tale signs

  • Socks leaving deep marks
  • Worse by the end of the day
  • Heaviness and fatigue in the legs
  • Improves overnight or with elevation

What we look for

  • Underlying venous reflux on ultrasound
  • Whether it's venous, lymphatic, or mixed
04Restless Leg Syndrome
Restless leg syndrome — often traced to vein reflux.

Restless Leg Syndrome

The urge to move at rest — frequently traced to vein reflux.

Many cases of restless legs have a venous component. When valves are leaking, the pooled blood and inflammatory mediators can produce that classic creeping, crawling urge — especially at night. A vein evaluation is worth pursuing before adding medication.

Tell-tale signs

  • Urge to move legs when still
  • Worse at night, better with motion
  • Sleep disruption
  • Relief when walking

What we look for

  • Underlying venous reflux on ultrasound
  • Symptom-pattern correlation
05Leg Discoloration

Leg Discoloration

Skin browning or darkening, usually near the ankle.

Long-standing venous pressure causes red blood cells to break down in the skin, leaving a brown, rust, or reddish stain — most often around the inner ankle. It's an early visible warning of chronic venous insufficiency, and it tends to worsen quietly if the underlying reflux isn't addressed.

Signs it's venous

  • Brown or rusty staining at the ankle
  • Skin feels firmer or tighter over time
  • Paired with swelling or aching

Why act early

  • Discoloration can precede an ulcer
  • Treating reflux halts the progression
Skin changes are a signal to evaluate sooner rather than later.
06Venous Leg Ulcers

Venous Leg Ulcers

Slow-healing wounds caused by long-standing vein pressure.

Sores that open just above the ankle and refuse to close are usually caused by underlying venous reflux. Treating the reflux is what allows them to heal — and stay healed. Surface wound care alone, without addressing the vein, tends to fail.

Signs it's venous

  • Wound near the inside ankle
  • Surrounding skin is brown or hardened
  • Wound returns after each healing attempt

How we treat

  • Identify and close the refluxing vein
  • Compression as part of healing
  • Coordinated wound care
07Chronic Venous Insufficiency

Chronic Venous Insufficiency

The umbrella diagnosis behind most adult leg-vein symptoms.

When the venous system can no longer move blood back to the heart efficiently, pressure builds in the legs. The result: heaviness, swelling, skin discoloration, and eventually ulceration. It ties together nearly everything else on this page — and it is very treatable, though often missed.

Symptoms

  • Persistent leg swelling
  • End-of-day heaviness
  • Skin browning around the ankles
  • Slow-healing wounds near the ankle

What helps

  • Closing the refluxing veins
  • Graduated compression
  • Activity & weight management
Often misattributed to age. Don't accept it without an ultrasound.

Not sure if what you're feeling is "a vein thing"?

That's exactly what the free screening is for. We tell you honestly whether further workup is warranted — or whether your symptoms have a different source.

Schedule a Free Screening → Call (404) 777-1728