FAQs - What is Vein Disease Treatment

Frequently Asked Questions

Q: What are varicose veins?
A: Varicose veins are raised, enlarged veins. Which usually appear on the skin surface and can cause the leg to swell, burn, fatigue, itch, or ache. In severe cases, they can bleed, lead to skin discoloration or cause ulcers. Normal vein valves close after blood travels up the vein, preventing blood from moving backwards (refluxing) down the vein. Varicose veins form when valves in the vein fail (become incompetent). Valves become incompetent for a variety of reasons, including heredity, trauma, and pregnancy. Once a valve becomes incompetent, the vein below the valve is exposed to higher pressure and becomes dilated. This causes other valves to fail and other veins to dilate.

Q: What are symptoms of varicose veins?
A: Leg pain, aching, or cramping
Burning or itching
Leg or ankle swelling
Heavy feeling in legs or fatigue
Skin Discolorations or texture changes
Open wounds or sores

Q: How are varicose veins diagnosed?
A: Along with your initial physical exam further testing is often required which includes duplex Doppler ultrasound exams of the legs. This non-invasive test uses sound waves to evaluate the function of the valves in the veins of the leg. This test is very important in diagnosis, and can improve the effectiveness of any treatment.

Q: What is vein disease treatment?
A: Both invasive and non-invasive methods are available to treat varicose veins. Non-invasive methods include wearing compression stockings, exercising, losing weight, elevating the legs, avoiding long periods of standing or sitting. Invasive treatments include endovenous therapy, ligation, and phlebectomy. Endovenous therapy is treatment from inside the vein using heat generated by lasers, or chemicals to irritate the vein walls and cause the vein to shrink and then be reabsorbed by the body.

Q: How does a Laser treat varicose veins?
A: A Laser is a highly concentrated beam of light. These lasers work by delivering
just the right wavelength of laser energy to the right tissue, causing the incompetent vein to close while your body automatically routes the blood to other healthy veins.

Q: What is the actual procedure like?
A: The procedure takes place right in our office with no general anesthesia required. The doctor will insert a thin laser fiber into the vein through a sheath and the laser light is emitted through the fiber. While you might feel some unfamiliar sensation it is not painful.

Q: What is the advantage of treating varicose veins by Laser?
A: There is no anesthesia, minimal pain, and one can return to normal activities the next day. There is minimal to no scarring, bruising, or swelling.

Q: How long does the procedure take?
A: The procedure takes 45-60 minutes, though patients might spend 2 hours @ our office due to normal pre and post treatment procedures.

Q: How effective is the laser treatment your office offers?
A: The success rate is greater than 95%.

Q: How soon can I return to work or normal activities?
A: Normal activities can typically be resumed within a day. For a few weeks following treatment the Doctor may recommend regular walking and refrain from very strenuous activity or prolonged standing for 2 weeks.

Q: What happens to the treated vein?
A: The vein becomes fibrous tissue after treatment. Overtime the vein will gradually be reabsorbed by the body.

Q: What are the risks and complications?
A: As with any medical procedure, there are potential risks and complications, which can occur. Dr. Whittle will review potential complications at your consultations, which can include vessel perforation, thrombosis, pulmonary embolism, phlebitis, hematoma, infection, paresthesia (numbness or tingling) and or skin burn.

Q: Does insurance cover these procedures?
A: 98% of all procedures are covered. Sclerotherapy (cosmetically) is not typically covered.

Q: What are venous stasis ulcers?
A: A skin ulcer, caused by a venous reflux disorder is called a venous stasis ulcer. It is an irregularly shaped wound with well-defined borders, surrounded by red or dark and thickened skin. Venous ulcers vary in size and location, but are usually found on the inside of the lower leg.

Q: How are venous stasis ulcers treated?
A: Patients with venous ulcers need compression treatment. Bandages, stockings and compression devices have been used for compression treatment. Bandaging is used short term to reduce swelling and stockings are used long term to keep swelling at a minimum. Compression devices are sometimes used as well. These are often worn at night. Compression leads to increased venous flow, which leads to decreased swelling. In order to achieve maximum benefit from compression the patient needs to walk. Walking increases the action of the calf muscle pump; this also decreases swelling and edema.

Q: What are medical grade compression stockings?
A: Compression stockings or socks, which are now available in a variety of styles and fashion colors, are recommended for early treatment of venous insufficiency. They compress the lower leg and decrease the swelling and the other symptoms of varicose veins. They come in various strengths and are fitted by a trained person. They are worn as treatment of varicose veins and after treatment to assist in the healing process, and maximize results of therapy, reduce risk of deep vein thrombosis.

Q: What are spider veins?
A: Spider veins are small red, blue or purple veins that appear on the surface of the thighs, calves and ankles. They may appear as a group of veins radiating outward from a central point, in a pattern that resembles branches on a tree or they may appear as thin separate lines. Spider veins may be isolated or associated with “feeder” veins. They can also be associated with larger underlying varicose veins. Certain factors contribute to the development of spider veins, including heredity, pregnancy, hormonal factors, weight gain, and occupations or activities that require prolonged sitting or standing, and trauma.

Q: How are spider veins treated?
A: People often seek treatment for spider veins because of cosmetic concerns. However, on occasion spider veins may cause symptoms, such as aching, heaviness, and itching and night cramps. A common form of treatment for spider veins is Sclerotherapy. This is an in-office procedure where veins are injected with a solution, using small needles, which causes them to collapse and fade from view. The procedure typically improves not only the cosmetic appearance but associated symptoms as well. Generally 2-4 sessions are required to obtain maximum benefit and patients are required to wear compression hose for two weeks after treatment.


Q: What is sclerotherapy?
A: Sclerotherapy is the injection of small amounts of dilute detergent solution into visible veins to cause inflammation in the vein wall. The patient then wears compression stockings for several days. The walls of the vein scar together and the vein is no longer visible. It may take 3-6 months for the veins to fade. Surface sclerotherapy treats only visible veins. It is usually not covered by medical insurance, as it is a cosmetic procedure.

Q: What type of results can I expect?
A: Most veins will lighten and/or disappear. Upon the first treatment 70%-75% will fade or disappear. Sclerotherapy DOES NOT yield perfect results. Improvement usually occurs, but perfection is rarely achieved. As long as you expect improvement and not perfection, you should be satisfied. Full results will not been seen for 8-12 weeks.

Q: Are results usually permanent?
A: The effect on the veins treated usually lasts in the majority of cases. However, new veins can develop over time. Sclerotherapy treats the problem at this time. It does not prevent new veins from showing up in other areas.

Q: What are the side effects of sclerotherapy?
A: Certain side effects may be experienced after sclerotherapy. Larger injected varicose veins may become lumpy and hard for several months before resolving. Raised red areas may appear at the injection sites and should disappear within a few days. Brown lines or a spot (hyper pigmentation) on the skin may be noted at the site of injection, possibly caused by a form of iron that escapes from the injected veins. In most cases, they disappear within 3-6 months, but can be permanent about 5 percent of the time. Bruising may occur around the injection site and can last several days or weeks. Your legs will look worse before they look better.

Q: How many treatments are needed?
A: We will give you an estimate of the number of sessions needed to obtain your goal. Occasionally areas may need additional re-treatment or “touch ups”.

Q: Do I have to elevate my legs after the procedure, and if so, for how long?
A: First, we encourage all patients to walk as much as possible after the procedure. However, while you are resting or if you plan to be stationary for an extended period of time, elevating your legs is important to help reduce swelling and prevent any remaining blood from pooling in the treated vein. If you are going to be sitting for a while, your legs should be elevated as much as possible for the first week after the procedure. You do not have to sleep with your legs elevated.

Q: How long do I have to wear compression stockings after the procedure?
A: Compression stockings are essential to a successful recovery and prevent adverse side effects after surgery. You must wear compression stockings for the first 24 hours after the procedure. After that time, you should continue to wear them for the next 14 days at all times, except when sleeping.

Q: Will my insurance cover sclerotherapy?
A: Typically treatment of spider veins and reticular veins (green veins) are considered a cosmetic treatment and therefore insurance companies WILL NOT cover the treatment. At the time of your consultation, The Doctor will determine if your vein treatment is cosmetic or medically necessary.


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