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What are "varicose veins"?
The term varicose veins refer
to abnormal and unwanted veins that vary in size from small spider
veins up to larger bulging "varicose" veins. Spider veins
commonly occur on the legs, face and other areas. Varicose veins occur
on the legs. Common symptoms include aching, leg fatigue and heaviness,
itching, throbbing, night cramps, restless legs and ankle swelling. Conservative
measures such as walking, compression hose and leg elevation typically
temporarily improve these symptoms.
Do these veins serve any useful purpose?
In the vast majority of cases, spider and varicose veins do not
serve any useful function. In fact, they are dysfunctional veins. Removal
of these veins may actually improve circulation. In extremely rare cases,
when the deep veins of legs are blocked, varicose veins of legs may carry
useful circulation and should not be removed.
What causes "varicose veins"?
The causes of varicose veins are unclear. However, some factors
have been identified that may contribute to the development of varicose
and spider veins: family history of varicose veins, female hormones (internally
produced or taken by prescription), pregnancy, trauma, age, obesity,
and prolonged standing. Extensive exposure to the sun may also cause
spider veins on the face. Please visit Prevention for
more information on the causes of “varicose veins”.
What can be done to prevent varicose veins?
Since the causes are still undetermined, prevention of varicose
veins is debatable. However, maintaining a normal weight, walking, limiting
the use of external female hormones, and wearing supportive stockings
may help limit the disease's progression. Please visit Prevention for
How can varicose vein disease be treated?
For information regarding treatment, please see: Varicose
Veins, Spider Veins, Prevention, Sclerotherapy, Laser/Light
Laser Treatment, Radiofrequency
Occlusion, Surgical Methods, Ambulatory
Phlebectomy, Ligation, Stripping and Other
How many treatments are necessary to remove such veins?
The severity and extent of each case will determine how many treatments
will be required. Please consult with the vein specialist from our Directory for
a more thorough evaluation of your specific needs and to determine the
best method of treatment for you.
How successful is sclerotherapy?
After several treatments, most patients notice a 50-90% improvement
in the appearance and symptoms. The full effect and benefit of treatment
usually takes several weeks. For this reason, many physicians recommend
waiting several weeks in between treatments.
Does insurance pay for the treatment of varicose vein disease?
Spider veins are considered cosmetic by most insurance
companies. Many insurance plans cover medically necessary vein treatment.
Consult with your vein specialist to find out more regarding your specific
case. Also, please visit our Health
Insurance Info page.
Are there any possible side effects to sclerotherapy?
Yes, they may include:
at the injection sites; and or muscle cramps, which usually
go away within 15-30 minutes. Swelling of the injection sites
or of the feet or ankles may occur. This generally resolves
in a few days.
- Areas of increased
pigmentation (brown staining) may occur as a treated vein dissolves.
This is usually due to iron depositing into the skin. Fortunately,
pigmentation usually fades over a period of several months. However,
this discoloration may remain permanent in a small percentage of
- "Matting" is
an overgrowth of fine caliber red veins near the areas of injection.
This may occur in up to 30% of patients, however, most go away with
time or with further sclerotherapy.
- Formation of small "burns" or
ulcers, usually due to leakage of the chemical solution into the
skin. These are more common when hyptertonic saline is used for the
injection. They heal in time, but often leave a scar.
- Bruising is common
and usually fades away within a week or two.
- Allergic reactions
(e.g. rashes). These are very uncommon and usually self-limited.
Rarely they can cause serious reactions.
- Inflamed vein
(phlebitis). This may be treated with non-steroidal anti-inflammatory
medication like Ibuprofen (Advil), walking and compression stockings
- Tender, firm bump(s)
- "trapped blood." These are areas of treated veins that
have closed like a "chain of pearls." Draining the contents
helps to seal the vein shut and may reduce the chance for brown discoloration.
What can happen to varicose vein disease if left untreated?
Phlebitis, thrombosis (blood clots), spontaneous bleeding and skin
ulcers are complications of varicose vein disease. Also, if varicose
veins are left untreated, smaller abnormal veins may increase in number
and are associated with worsening symptoms.
Is it likely to have the varicose veins reoccur?
Treatment is aimed at clearing the existing problem veins. As you
age, it is common for other veins to develop. Most often these are new
veins, although treated veins could re-open.
When is vein treatment not advisable?
As with any medical procedure there are those individuals who may
not be fit to undergo certain vein treatments. Before deciding
on any treatment options, make sure that you consult with your
vein specialist in order to make sure that all potential issues
have been raised. Patients should generally consider treatment
when the veins are bothering them enough because of cosmetic concern,
symptoms or complications due to the veins. There are contraindications
to treatment. These include, but are not limited to inability to
ambulate, increased risk of developing blood clots, pregnancy and
significant medical illness. Check with your doctor before hand
to make sure you are ready to undergo treatment.
What happens after treatment?
Recovery periods may differ from treatment to treatment. For example,
following sclerotherapy, support
stockings and/or bandages are worn on each treated leg. Your doctor
will determine how long you should wear the compression, generally
based on the type of veins and treatment you had. Most physicians
recommend that you walk a lot after treatment. Depending on your
treatment, other instructions may be given.