Frequently asked questions, and their answers, you may have about vein disease, our practice, policies and procedures.

Varicose Veins

What causes varicose veins?

There are a number of factors that predispose to the development of varicose veins.

• AGE: Over time wear and tear can result in damage to the valves in the veins, leading to reflux in the veins and then to the development of varicosities.
• HEREDITY: If your parents or other family members have varicose veins, you have an increased risk of developing them as well. This probably relates to relative weakness of the vein walls, an inherited trait.
• SEX: Women have an increased risk of developing reflux and varicose veins. Female hormones relax vein walls, which can cause the valves in the veins to no longer work, again leading to reflux.
• PREGNANCY: In pregnancy, both the blood volume and hormone levels increase, both of which can lead to dilation of the veins and damage to the valves. In addition, later in pregnancy the fetus, together with the enlarged uterus, can compress the pelvic veins, resulting in restriction of blood flow back to the heart and further increasing the blood volume and venous pressures in the legs. Further dilation of the leg veins and damage to the valves can result.
• OBESITY: Being overweight increases the pressure in the veins as well.
• STANDING: People who are on their feet all day have increased pressure in their veins.
• PHLEBITIS/BLOOD CLOTS: If the veins have had clots in them in the past, this can cause damage to the valves and result in reflux (venous insufficiency) leading to the development of varicose veins.

About Treatment of Varicose Veins.

Will I have to return for more treatment?

Varicose veins and spider veins are chronic and recurrent conditions. The treatments available will not offer a cure, but rather control the condition. Surgically removed veins cannot recur; veins that are sclerosed will not return. However, your personal tendency toward developing new veins will not be relieved by this or any other form of treatment.

However, our goal is to provide the most effective and complete treatment available, and we hope that this will result in long term control of your venous disease.

How much will this treatment help my specific problem?

Successful treatment will result in relief of most, if not all, symptoms, and will result in significant improvement in the appearance of the legs. Some residual discoloration and lumpiness may persist.

How many treatments will it take?

Some patients will require only a single session, but all patients will be brought back for follow-up at the Vein Clinic in two to three days, and again in four to six weeks, to evaluate for potential complications and to judge the effectiveness of the therapy. Many patients, with extensive varicosities and/or persistent symptoms, may require additional therapy (typically sclerotherapy) to achieve a satisfactory result. If residual abnormal veins are left in place, they will tend to recruit more abnormal flow and this can lead to an early recurrence of the varicosities.

As many patients have said to us, it takes years to develop the problems, and one or more additional simple treatments are well worth the result.

Will insurance pay for the treatment?

Most insurance companies will cover treatment of venous insufficiency and varicose veins, based on medical necessity for symptom relief, if provided with adequate documentation (i.e. history and physical, ultrasound results). Many also require a trial of conservative care, typically with compression stockings. Our staff will explain the process to you.

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Will I have to return for more treatment?

Spider veins are chronic and potentially recurrent conditions. The treatments available will not offer a cure, but rather control the condition. However, your personal tendency toward developing new veins will not be relieved by this or any other form of treatment.

For a given patient presenting with spider veins, one or more treatments may be needed. Most patients will require only one or two treatment sessions, but occasionally patients with extensive spider veins will need several sessions.

Occasionally, the spider veins will be resistant to the initial treatment, but we have found that additional treatment will result in a good result.

How much will this treatment help my specific problem?

Successful treatment will result in significant improvement in the appearance of the legs. Some residual minimal discoloration may persist.

How much pain will there be after the treatment?

Immediately following the sclerotherapy session, there will be some redness and itchiness, but this usually resolves in 30 to 120 minutes. After this there are few symptoms, but it will take up to a month to see the full effect of the treatment. Patients are asked to wear compression stockings for the first 24 hours, and then to wear the stockings during the day for an additional 3 to 5 days.

Will insurance pay for the treatment?

Generally, no. Spider veins are felt to be a cosmetic problem by the insurance carriers, although they occasionally can be painful.

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