What causes varicose veins and spider veins?
Heredity is the number one factor causing varicose veins and spider veins. An inherited weakness of the vein wall and valves (genetic) and circulating hormones that relax the smooth muscle of the vein wall are the most common causes. Women are more likely to suffer from varicose veins, especially because of pregnancy and hormonal factors. Pregnancy causes increases in hormone levels and blood volume, which in turn causes veins to enlarge. The enlarged uterus can cause increased pressure on the veins. This is less important than the hormones, however, since vein problems often develop in the first trimester when the uterus is still quite small. Varicose veins due to pregnancy may improve within several months after delivery, but seldom go away completely. Other aggravating factors include occupations involving prolonged sitting or standing, obesity, trauma and intense weight-training exercise.

I am overweight. Did that cause my varicose veins and can I still be treated?
Being overweight probably did not cause your varicose veins. Your genetic makeup when you were born probably determined that you were going to have vein problems. The overweight condition aggravates the abnormal veins. You can still be treated and expect a good result, but you will have a higher chance of recurrence if the weight problem is not corrected.

How will the blood get back to my heart after the abnormal veins are removed or sealed off?
These damaged veins are actually a burden to your circulation. The backward flow of blood in the abnormal veins interferes with the normal venous return of blood. Removal of these veins improves circulation of blood in the treated limb. It is this improvement in limb circulation that causes relief of symptoms of tiredness and heaviness in the limb. This is because the body has re-routed the blood flow into stronger, healthier, deeper veins.

I was told that if you take out my vein, then I will not have any for a heart bypass.
Bulging varicose veins are useless to a heart surgeon. He needs a normal-sized, straight and healthy vein to bypass an obstructed coronary artery. The 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.

What 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.

What is a skin ulcer?
A skin ulcer is caused by a venous reflux disorder and is called a venous stasis ulcer. Early signs that a venous stasis ulcer may develop include a darkening of the skin in the area of the ankle. Gradually, the skin may become leathery or waxy in appearance. Without treatment of the venous disease, the skin may break down and bleeding may occur.

I've told my doctor about my varicose 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 painful 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 less invasive 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.

What about Post-Procedural care?
The majority of patients treated for varicose veins walk out of the office and return to normal daily activities including work within two days. While the amount of post treatment pain varies from one patient to another, most require only Tylenol or ibuprofen for any discomfort. Complete recovery, including resolution of bruising, takes from 4-6 weeks. Detailed written and verbal instructions will be provided to each patient before and after treatment.

What can I expect from my varicose vein treatments?
You can mainly expect improvement - improvement both in the relief of pain, fatigue, aching and heaviness that most varicose vein patients experience, and improvement in the appearance of those ugly, ropy veins. What you cannot expect is for the clock to be turned back to those flawless teenage legs. Our modern treatments are a vast improvement over the techniques of just a few years ago. Scars, if any, are a fraction of what they used to be. But the key word is improvement, not perfection.

What 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.

Who can be treated?
Nearly all patients with varicose veins, many patients with leg swelling and leg pain, many patients with spider veins, and most patients with more serious leg ulcers will have saphenous vein valve incompetence. These patients can be treated with the modern methods, and can expect excellent results.

Will my insurance pay for treatments?
Almost all major insurance companies and medicare now cover the diagnosis and treatment of varicose veins. This includes the modern endovenous ablation procedures and micro-incision phlebectomy of large veins. The initial consultation (office visit) is also usually covered. Treatment of spider veins, regardless of symptoms, is always considered cosmetic by insurance companies and is not covered.

What is a duplex ultrasound examination?
The venous duplex examination permits your doctor to see the anatomy and check the flow characteristics of the veins beneath your skin. Useful information is gathered that your physician can use to adequately diagnose your specific vein problem and to plan and guide treatment.

I don't see any varicose veins on my legs... only spider veins. Why do I need an ultrasound?
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.

What is ultrasound guided sclerotherapy?
Visual sclerotherapy refers to injection of surface veins that are visible to the naked eye. Some veins that need to be treated are below the surface of the skin and cannot be injected safely without the aid of ultrasound imaging assistance.

What is spider vein 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 it feels like plucking a hair. Most people find this relatively painless. The treatment sessions usually take 30 to 60 minutes depending on the extent of the condition. No anesthesia is necessary, and our patients may drive to and from the office on spider vein treatment day.

Are there any restrictions to my activity?
There are usually no restrictions on physical activity after spider vein sclerotherapy and, in fact, light 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).

What results can I expect from my spider vein treatments?
Realistic expectations are important when one undertakes any cosmetic procedure. That is why we never promise perfection or "beautiful legs" after treatment. (And, any clinic that does is being less than honest.) We set a goal of 80% improvement and can achieve that goal in most people. Every patient is different, and the number of sessions needed varies depending on the severity of your condition. Most cases require three to five 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.You will be the one to decide when your unsightly veins have cleared to the point that you are no longer self-conscious about your legs. You may want to come back for a touch-up treatment every year or two.

Is laser not the best treatment for spider veins?
Laser is the treatment of choice for spider veins of the FACE. The legs are a different story. In the legs, the spider veins are larger and under higher pressure. And the skin is thicker. Sclerotherapy is the most effective treatment. We use laser on the legs as adjunctive, or additional, treatment of spider veins. It is frequently very helpful in that role. There are no additional charges when laser is also used in the course of spider vein treatment at the Vein Center of Louisiana.

How do I begin treatment?
During the initial consultation, your legs will be examined, and any questions you may have will be answered. You may also discuss your expectations and anticipated results. At this point, an estimate of the number of treatments, affiliated costs, and payment will be covered which will vary depending upon the size and extent of your problem. You should then be able to schedule an appointment for treatment.