Q & A
By Vein Specialities
November 16, 2016
Category: Dermatology
Tags: spider veins  

How long do the results of varicose vien treatment last?
QUESTION: I'm in my early 30's. My doctor said that my varicose vein will be a lifelong problem because it is inherited and genetic. If I get treated, how long can I expect the results to last? How often would I have to go in to get EVLT treatments?

ANSWER: Your doctor is correct that this is an inherited condition. There are really only 4 main veins (long and short saphenous veins in each leg) which are affected although there are some branches which can also be a problem. If you have symptomatic varicose veins caused by the reflux (pain, heaviness, aching, cramping, swelling, RLS etc) and have failed conservative therapy such as compression hose, anti-inflammatory pain meds, elevating, exercise, weight loss etc. you are a candidate for laser ablation. Not everyone has all of the veins causing problems and only veins leading to the symptoms should be treated. We often see people for second opinions who have been told they need to have 7 or 8 ablations and multiple injection treatments. It is very rare that a person has all of these veins fail and those that do are severely affected by them. if you have one saphenous vein causing your varicose veins directly, that would be the vein Dr. Bein would ablate first. You can always be evaluated later if symptoms start again in another area.

How can you tell if spider veings are a sign of venous reflux/insufficiency?
QUESTION: Aside from an ultrasound exam, are there any telltale signs that they could be something deeper? I have several spider veins on the outside of both thighs, and 3-4 on the back of my right knee. My mom has had spider veins since she was in high school, but I only noticed mine a couple months ago. I'm 28. I currently have no symptoms, but am terrified that it could be a sign of something more serious. I've read that they can also occur without venous reflux?

ANSWER: The spider veins on the outside of the thighs are very common in women.  These are in the line of the lateral subdermic system and are easily treated with sclerotherapy (injections).  It is rare to find them related to anything serious and are considered cosmetic.  The few you have behind the knees are most likely from the same system.  We evaluate all patients with spider veins to rule out deeper problems which will allay your anxiety.  We use transillumination to see the "feeder" veins below the surface and treat these.

I have spider veins in my leg, but they are not painful, shoud I be concerned?

ANSWER: Do not be concerned. Spider veins are not a serious problem and mostly cosmetic. These can be treated safely with injection sclerotherapy and/or laser. Several treatments are usually needed, but this varies from person to person. The reason most people come to our clinic is for self-esteem - they are too embarrassed to wear short skirts, pants or swimsuits.

Can I get compression stockings over the counter from a pharmacise if I've been measured?
QUESTION: I suffer from varicose veins in my lower legs and also thighs. One leg is more swollen than the other, with the veins being quite prominent and painful. Do I need to get a referral from my general practitioner to be measured for compression stockings, or can I go into my local pharmacy to get measured for them and purchase them? My GP has mentioned that I may find them beneficial.

ANSWER: Firstly, I would recommend you be evaluated by a vascular trained surgeon including ultrasound to see if you have an underlying venous reflux problem (back flow in veins).  He/she will be able to recommend the most appropriate strength and type of hose (thigh or calf length).  Many clinics will dispense a higher grade of hose than the local pharmacy and this is important for comfort.  We choose to carry Sigvaris.  If the hose are not correctly measured or comfortable you will not wear them.  Compression is important is establishing if the symptoms are alleviated somewhat prior to treating and for insurance coverage.  Also, if there is reflux it means blood is not flowing correctly and this can cause superficial blood clots which are painful.  Hose will keep the varicose veins compressed and improve the blood flow in the legs not to mention you will be more comfortable.

I have a large blue vein under my right eye that I'm finally ready to get rid of. I'm not sure if this requires a plastic surgeon or vascular surgeon.

ANSWER: Treatment of blue veins around the eyes is an advanced technique and should only be performed by experienced practitioners.  They can be injected (sclerotherapy), removed (phlebectomy) or treated with laser.  We mostly use a laser in our clinic with excellent results but in some cases use the other two modalities.  We have undergone advanced training to do so and use the Cutera 1064 Yag laser.

No compression hose after small microphlebectomy
QUESTION: I have 2 small reticular veins that are varicose. My doctor is going to do a Microphlebectomy. He said due to the size it won't even be necessary to wear compression hose after. He also stated there is no chance of DVT. Does this sound accurate?

ANSWER: I am sure you will have a dressing on the area after the treatment for several days.  If the areas is limited you may be ok without hose.  While there is little or no risk of DVT from such a small and limited area, you will find this on your consent form  which is routine for almost any procedure (including dental).

The veins in my legs hurt and swell so much during my menstrual cycle that it's hard to walk. What's going on?
QUESTION: I'm 26 and have 2 kids. The veins in my legs hurt and swell so much during my menstrual cycle that it's hard to walk. What's going on?

ANSWER: During menstrual cycles and pregnancy the veins dilate.  Since you have had 2 pregnancies, it is possible that you have venous reflux causing swelling and pain.  There are valves in the veins which carry the blood back to the heart for re-oxygenation and if they fail (usually an inherited condition made worse by pregnancy) the blood "pools" in the lower legs.  I would recommend an evaluation including an ultrasound to see if this is the case.  Either way, they can measure and fit you into a compression stocking (not your grandmother's stockings!!) to be worn a few days before and through your menstrual cycle.  Taking Ibuprofen 200- 400 mgs several times a day will help reduce the inflammation and pain.  Elevating your legs often will also help.  If you have venous reflux, the treatment options are all minimally invasive, little or no down time (important if you have small kids) and covered by most insurance plans.

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