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Dr Bryan Proskiw about Varicose Veins
2005-11-02
Dear Dr. Bryan Proskiw: Just like my mother, the veins in my legs have become unsightly and painful. What kind of treatments are available to help with this painful and unattractive condition?
Answer: The condition you describe, commonly known as varicose veins, is an ailment suffered by up to 40% of women and 20% of men. The symptoms of this condition, unsightly blue veins, fatigue, pain and swelling poses both medical and cosmetic problems.
Question: What causes varicose veins?
Answer: Heredity is the number one contributing factor causing varicose veins and spider veins. In women, hormonal factors such as pregnancy, menopause and the use of birth control pills, estrogen, and progestorone affect the disease. It is also very common for pregnant women to develop varicose veins in their first trimester. Although varicose veins due to pregnancy often improve within 3 months of delivery, successive pregnancies may lead to a permanent condition. Other predisposing factors include aging, standing occupations, obesity and leg injury.
Question: How do I know if my veins need treatment and which treatment is best?
Answer: Veins that are cosmetically unappealing or cause pain or other symptoms are prime candidates for treatment. Until 1999, this condition was usually treated by surgically striping the diseased vein from the body. Vein stripping was an invasive, painful surgical procedure. Now there are several minimally invasive alternatives to that traditional surgical procedure. Conservative measures such as compression stockings are an option and corrective methods such as sclerotherapy and light source/laser treatments offer another approach. Sometimes a combination of laser and light treatment methods works best.
Question: Can you explain how the corrective methods are performed?
Sclerotherapy treatment involves injecting a solution directly inito the vein, causing it to close or collapse and then be absorbed into the body. It is performed on an outpatient basis and requires one to three treatments spaced one to three weeks apart.
Ultrasound-guided sclerotherapy is performed while the doctor visually monitors the vein on an ultrasound screen. This enables the treatment of veins that can't be seen because they are below the surface of the skin and would otherwise require surgical removal.
Endovenous laser treatment is also a treatment alternative to surgical stripping and is highly effective in treating large, painful varicose veins. The procedure involves inserting a small laser fiber into the damaged vein using the guidance of ultrasound. Once in place pulses of laser light are delivered inside the vein causing the vein to collapse and seal shut. The procedure is done in-office and under local anesthsia. Following the procedure a compression stocking is placed on the treated leg for one week.
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