ASK THE DOCTOR

Varicose Veins

+ How common are varicose veins?

The incidence of varicose veins increases with age. Varicose veins affect about 20% of all adults and 50% of people age 50 and older.

+ What causes varicose veins?

The two most important factors are heredity and hormones. Varicose veins run in families. Veins are affected by the female hormone estrogen, which explains why most patients with varicose veins are women. Standing for long periods of time is a factor also.

+ Do varicose veins affect both men and women?

Yes, but about 75% of all patients with varicose veins are women.

+ My legs ache, but I only have spider veins. Will treating them help?

Blood stagnates in clusters of spider veins and causes localized aching and itching. Sclerotherapy of the spider veins can relieve these symptoms as well as improving the appearance of the legs.

+ Are there several types of treatment for varicose veins?

With current technology, a variety of treatment options are available. Each patient receives an individualized treatment plan based on their particular problem at the time of the initial consultation. With current technology, treatment of even the largest bulging varicose veins can be done without traditional vein stripping surgery.

+ Does closing a varicose vein harm my circulation?

Quite the contrary, eliminating veins with abnormal blood flow improves and enhances the overall circulation of blood in your legs.

+ Might I need one of the varicose veins later for heart bypass surgery?

Only small normal veins can be used for heart bypass. Varicose veins are stretched out of shape and not acceptable for artery substitutes in heart bypass surgery.

+ What causes brown discoloration and clusters of spider veins on the inside of my ankles?

Venous reflux from varicose veins is the most common cause of the skin changes in the lower calf and ankle. Anyone with ankles like this should have evaluation of their venous system. Treatment of the underlying venous problem may improve these skin changes.

+ What can happen if my varicose veins are not treated?

Varicose veins progressively get worse, producing certain symptoms and complications such as swelling, phlebitis, bleeding, and venous ulcers. Appropriate treatment can stop this process.

+ Will L'eggs or Hanes support stockings help my legs?

Although they make your legs feel better, these stockings have very slight support. For therapy of varicose veins you need the extra support of a quality graduated compression stocking.

Spider Veins

+ How likely is it that I'll need more than one treatment? How many? And do you offer a discount on future/multiple treatments?

Most people will need more than one treatment. The average patient will need one to three initial treatments to get the spider veins under control. We do offer package pricing for multiple treatments needed over a 6-month period. Future treatments would be at the current rate at the time the treatment is done.

+ Should I be concerned about the treatment causing skin staining?

Temporary staining or discoloration can occur after sclerotherapy. If staining occurs it typically fades over a few months. Wearing the compression stockings as directed can minimize staining.

+ Are certain skin tones easier to treat or less susceptible to staining?

Staining is more common in someone who has darker features with fair skin, such as, dark hair with brown eyes. We are able to treat all skin types but we may recommend wearing the compression stockings for a longer period after a treatment and avoiding sun exposure in someone who is at a higher risk for staining.

+ Are all spider veins treated the same way?

Sclerotherapy is the “gold standard” for spider vein treatment and will give the best result in most people. There are a few occasions that a different type of treatment called ohmic thermolysis, or radiofrequency thermocoagulation may be used alone or in conjunction with sclerotherapy. In general laser has not been shown to give the best result.

+ Are certain parts of the body easier to treat?

The most common area that spider veins are treated are the legs, but spider veins can occur on the face, back and torso. These veins are treated in the same way as the legs.

+ Should I treat underlying varicose vein issues before treating spider veins?

It is better to treat larger veins prior to treating the smaller spider veins to see the best long-term result.

+ If I don't also treat my varicose veins, will my spider veins come back?

In general, varicose veins should be treated prior to cosmetic treatment, but spider veins can occur independent from varicose veins.

+ Will my spider veins come back?

The veins that are treated will not come back but you can form new areas over time. This varies from patient to patient. Most patients will need treatment periodically and return at 1 to 3 year intervals.

+ How long will I need to wear compression stockings after my spider vein treatment?

The minimum timeframe for stockings is 7-10 days. The treated areas will continue to show improvement over approximately 3-6 weeks.