Before any treatment of leg telangectasia (spider veins) is considered, it is essential to have duplex ultrasonography, the test that has replaced Doppler ultrasound. The reason for this is that there is a clear association between leg telangectasia (spider veins) and underlying venous reflux.[9] Research has shown that 88-89% of women with telangectasia (spider veins) have refluxing reticular veins close,[10] and 15% have incompetent perforator veins nearby.[11] As such, it is essential to both find and treat underlying venous reflux before considering any treatment at all.