- 1What is sclerotherapy and does it hurt?
Sclerotherapy involves the use of a very small needle to inject a solution into the diseased veins. The solutions work by causing the veins to shrink, close off, and gradually disappear. The needles used are very small and feel like a mosquito bite. Most people find this relatively painless.
- 2Will these spider veins come back?
The veins treated with sclerotherapy are destroyed and will be reabsorbed by the body so they can’t come back. However, nothing can be done to prevent your body from forming new spider veins. But new spider veins can be treated just as effectively as the previous ones with sclerotherapy.
- 3How long will my treatment take?
Sclerotherapy treatment sessions usually last 25-30 minutes. Every patient is different, and the number of sessions needed varies depending on the severity of your condition. Most cases require three to six treatments, however, this is only a guideline and your individual case may be different. Your legs may begin to show improvement in as little as a few weeks, but the best results are usually seen after several treatment sessions. After healing has occurred, spider vein “road maps” and bulging varicose veins will be gone, leaving you with healthy, great-looking legs.
- 4Are there any restrictions to my activity?
There are usually no restrictions on physical activity after sclerotherapy and in fact exercise is encouraged. We do discourage direct sun exposure to treated areas for a couple weeks after each treatment (sunscreens are adequate protection during this time).
- 5Will my insurance pay for treatments?
Insurance will only pay for the treatment if it is deemed medically indicated. Presence of symptoms like pain, cramps and swollen legs can make a good case for coverage. Complicated veins with history of phlebitis, bleeding and presence of skin ulceration will most likely be covered. For suitable cases, the clinic will provide you with a supporting letter to your Insurance Provider to seek reimbursement or to obtain letter of Guarantee.
- 6What causes varicose veins?
Varicose veins were once part of the superficial venous system which normally returns only 5-10% of the blood flow from the legs back to the heart. Varicose veins begin when tiny one-way valves inside veins wear out over time. When these valves fail, blood falls down the veins with gravity causing excessive pressure to build up inside the veins. The veins swell and become tortuous. Once a vein is damaged by this process it can never again function as a healthy vein.
- 7Why do I need an ultrasound since I don’t see any varicose veins on my legs?
In many cases spider veins appearing in certain areas of the legs are an indication that deeper problems exist. Twenty five percent of patients who are seen for ‘cosmetic’ reasons turn out to have more serious vein problems. If a large vein underneath the skin is diseased and is causing spider veins to appear on the surface, the spider veins will not respond to any form of treatment and in fact will get worse until the large ‘feeding’ vein underneath is treated first. Your doctor will determine whether deeper problems are likely during your consultation.
- 8Don’t I need these veins for my circulation?
These damaged veins are actually a burden to your circulation. When varicose veins are eliminated, the legs feel lighter and more vibrant because the venous circulation is improved. This is because the body has re-routed the blood flow into stronger, healthier, deeper veins.
- 9Do varicose veins come back?
Our micro-surgical procedures remove bulging varicose veins permanently. Sclerotherapy destroys veins so they will not return. Endovenous catheter procedures also permanently destroy the treated vein segments. None of these procedures, however, will prevent new veins from forming.
- 10I had vein surgery. Can you take out more veins?
In a word…yes! The venous system is a vast network of interconnected veins with much built-in redundancy. The superficial veins (the only ones we operate on) are of very minor importance even when they are normal, and the veins we treat are already abnormal. We do not treat healthy, functioning veins, and you will not ‘run out’ of those!
- 11I was told that if you take out my vein, then I will not have any for a heart bypass?
This is only partially true. Bulging varicose veins are useless to a heart surgeon. He needs a normal-sized, straight and healthy vein to bypass an obstructed coronary artery. Any internal veins that we treat are already diseased, and as such, cannot be used for coronary bypass. If your leg veins are so diseased that they cannot be used, there are plenty of other options available to the heart surgeon.
- 12I’ve told my doctor about my veins many times, but he told me not to worry about them, that they were just ‘Cosmetic.‘ What do you think?
Large bulging varicose veins cause symptoms in the vast majority of people who have them. In most cases, these veins are not just ‘cosmetic’ but are considered to be a serious medical problem that can lead to significant complications if not treated. In years past when the surgery to remove varicose veins was so barbaric and disfiguring (e.g., vein stripping), many physicians discouraged their patients from having anything done. The new surgical and non surgical techniques are so much easier and less painful; there is no reason to live with varicose veins anymore. Unfortunately, your physician may not be aware of all the newest techniques available for varicose vein treatment. (But YOU are!)
- 13What will happen if my varicose veins are not treated?
Over time varicose veins always enlarge and become more symptomatic, forcing many people to alter their daily activities to try to decrease the pain. In severe cases, varicose veins can cause skin damage, ulcerations, and blood clots. These complications can be prevented by treating the varicose veins early.
- 14I’ve had vein stripping before and the veins came back. How is your treatment different?
The key to modern, effective treatment of varicose veins is using duplex ultrasound, done in the standing position, to completely map out the size and location of all diseased veins, many of which are underneath the skin and not visible. By utilizing ultrasound to ‘see’ these hidden diseased veins, we can eliminate the root cause of most recurrences. Unless you had a complete vein mapping ultrasound in the standing position prior to your surgery, chances are the surgeon left behind some diseased veins, and that is why your problem came back. In addition, vein strippings were done in the hospital under general anesthesia and required prolonged and painful recovery times away from work. Our microsurgical procedures are done under local anesthesia right in our office. You are up and around immediately after the procedure, and most patients can return to work the very next day. And because our incisions are so small, there are no scars!
- 15What can I do to prevent varicose veins?
Regular exercise helps to pump blood up the legs and back to the heart against gravity. Getting enough rest, eating a healthy diet, and keeping your weight down help your overall health including your veins. Support stockings and herbal supplements have been shown to improve pain and swelling from varicose veins but have never been proven to heal bad veins or prevent healthy ones from deteriorating. Unfortunately, time and gravity cause veins in susceptible people to wear out over time. Once a vein has become varicose it will never function properly and should be eliminated.