An estimated 40-60 million Americans are believed to be suffering from varicose veins. It is estimated that nearly 30-50% of women will have some degree of varicose veins after the age of 20. These varicose veins are more visible near the thigh area and sometimes occur just behind the knee. Even though not all individuals have symptoms from varicose veins, almost all of them complain about their unattractiveness.
California boasts of more Veins Clinic and Physicians who deal with varicose veins then any other State in the country. And most of these cosmetic physicians offer the latest in varicose vein treatment.
Why should varicose veins be treated?
Many individuals who have varicose veins have no symptoms. But there are also a fair number of individuals who do have symptoms. In most cases if the varicose veins are left untreated, symptoms will occur. The typical signs and symptoms of varicose veins include:
Cosmetic: Many individuals will complain that the varicose veins are ugly and unattractive. Many individuals also feel a sense of embarrassment at having unsightly varicose veins. The longer the veins are left untreated, the worse is the cosmesis.
Pain: Another very common complaint is pain and aches in the leg. The pain is all over the leg and is worse at the end of the day. Others will describe a feeling of a heavy leg or a sense of constant fatigue. Many individuals will describe other sensations such as a burning, throbbing, itching and cramping all over the leg.
Discoloration: If varicose veins are left untreated, a dark pigmentation around the ankles is a very common finding. This darkening is also associated with changes in skin texture and dryness. This does not reverse even after the varicose vein is removed.
Ulcers: Long standing varicose veins are notorious for causing ulcers which are painful. These ulcers tend to seep fluid constantly and are almost impossible to heal.
Phlebitis: When blood clot formation occurs in the varicose veins, it causes irritation of the vein. The irritation of the vein can lead to pain and tenderness along the entire leg. Some individuals may also develop a fever and have difficulty walking. The condition usually resolves in 2-4 weeks.
Swelling: Swelling of the leg especially around the foot and ankle is common; the swelling is worse after standing for prolonged periods. It usually resolves after elevating the leg.
What is the problem with varicose vein treatment?
Despite many years of experience, there are still many reports of varicose vein recurrences. This has been suggested to be due to inadequate investigations before treatment. In addition, we still do not have a cure for varicose veins.
How is diagnosis of varicose veins made?
The majority of Physicians in California use ultrasound to confirm the diagnosis of varicose veins. The test allows one to asses the valves in the veins and also for the presence of any blood clots
What options are available for treating varicose veins in California?
There are numerous options available for the treatment of varicose veins. The treatment is dependent on the presence of symptoms, the degree of varicose veins, available facilities and experience of the physician. The available treatments include:
Vein stripping: Vein stripping is one of the oldest procedures to treat varicose veins. Vein stripping is done under general anesthesia and requires 2-3 small incisions to remove the entire vein. After the procedure, a compression bandage is worn for a few days. The procedure is mildly painful and requires at least 5-7 days off work. The procedure is best for individuals with large varicose veins which are prominent and extend all the way from the groin to the ankle. When done well, the chance of recurrence is very low.
Ambulatory phlebectomy: Phlebectomy involves the removal of moderate to large varicose veins underneath the skin. The procedure does require anesthesia and numerous skin incisions. Specialized hooks help remove the varicose veins. A compression bandage is worn after the procedure. The procedure does leave numerous skin scars.
EVLT: This newer procedure called endovenous laser treatment (EVLT) is now widely used all over California. The procedure is fasting being accepted as an alternative to surgical stripping of the vein. A small laser probe is passed into the vein and the heat generated destroys the vein. The vein eventually collapses and shrinks. The procedure is done in a clinic setting and takes about 20-30 minutes. After the procedure, a compression bandage is worn for a few days; Short term results indicate that it is an effective procedure with good results.
Closure procedure: This is essential the same as EVLT but uses radiofrequency thermal heating to treat the varicose vein. The radiofrequency probe heats the inner lumen of the vein with subsequent scarring and closure of the treated vein. The procedure is performed in a clinic/office setting and does not require general anesthesia. The procedure usually takes 20-30 minutes. Possible side effects of the procedure include pain, redness or skin burns. The majority of these mild side effects resolve over a few weeks.
Trivex procedure: In this procedure, veins are visualized underneath the skin with a camera and removed with specialized instruments. The procedure does require anesthesia and multiple incisions. The potential advantages of the TriVex System over other methods have not been proven.
Compression stockings: In individuals who have no symptoms and are unsure about surgery, compression stockings may be the ideal treatment. The stockings come in various colors and sizes are effective in prevention of symptoms. However, the stockings must be worn daily to be effective.
Is there a role for herbs and nutrients in treating varicose veins?
Varicose veins are not affected by any specific diet or herbs. However, eating healthy is good for the entire body.
How can one prevent varicose veins?
Since there is no cure for varicose veins, most cosmetic physicians in California recommend preventive measures to help prevent worsening of the varicosities. The essential preventive measures include:
- Compression stocking
- Leg elevation is recommended whenever one is resting.
- One should avoid standing for prolonged periods
- Exercise regularly
- Control one's weight
Does insurance cover surgery for varicose veins?
The majority of insurance carriers only cover varicose veins if one has symptoms and have failed a trial of compression stockings. In those individuals with no symptoms, surgery is not covered as it is believed to be a cosmetic deformity. The cost of varicose vein surgery is dependent on the procedure and ranges anywhere from $200-500.
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