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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 more information.

How can varicose vein disease be treated?

For information regarding treatment, please see: Varicose Veins, Spider Veins, Prevention, Sclerotherapy, Laser/Light Therapy, Endovenous Techniques, Ultrasound-Guided Sclerotherapy, Endovenous Laser Treatment, Radiofrequency Occlusion, Surgical Methods, Ambulatory Phlebectomy, Ligation, Stripping and Other Methods.

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:

• Burning/stinging/itching 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 cases.
• "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 or bandages.
• 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.