Jawdat Abboud, MD

5 Minute Medical Chat: Varicose Veins are Easier to Treat with Today's Options

Quick Facts
- 60% of all men and women suffer from some kind of disorder in the vein
- about 25% of those are men
- Duplex ultrasound allows you to get a better look at the circulatory system in the leg
- Newer techniques like duplex ultrasound allow doctors to get a better picture of what's going on instead of just listening to blood flow in the leg

Varicose Veins

There are 2 venous systems in the leg: the deep system, and the superficial system. The deep system is the main system to bring the blood back to the heart. The superficial system, which is closer to the surface, carries about 10% of your blood back to the heart. 

Various techniques can help solve problems with the superficial (surface) venous system and allow the deeper vein systems to take control of blood flow. 

In most cases, problems in the superficial system are the main cause of varicose veins. The word varicose means swollen.

Spider Veins and Varicose veins come about when the valves that normally keep blood from running backward fail, or become loose. This can result in "backwash", where veins become stretched and swelling results.


In addition to a "purple snake" appearance, varicose veins can cramp and hurt at night. The legs can feel heavy. There can be an itchy rash if circulation is reduced to the skin.

Cause

The exact cause is unknown, but there can be an influence from genes, or hormones. Pregnancy, menopause, birth control pills and other influences can weaken vein valves. Lifestyle, and job type can also influence varicose veins (ex: such as jobs where there are long periods standing or sitting.)

Diagnosis and Treatment

Newer techniques like duplex ultrasound allow doctors to get a better picture of what's going on instead of just listening to blood flow in the leg.

In the past you might have a metal rod inserted near the groin and actually passed through a vein, with a cap on the end, to pull out the vein entirely. This "stripping" is hardly ever done these days. Stripping is a significant surgery, done under general anesthesia, and has long period of recovery time.

Lasers can also be used now to send concentrated light into the vein to collapse it. There can be slight discomfort, but the skin is quickly cooled off.

There is also a new technique called "foam sclerotherapy". The foam is injected into a vein, gradually causing the walls to swell and stick, blocking the vein

Some techniques like foam are especially suited to spider veins, others are general.

Prevention 1-2-3

1) Don't sit with your legs crossed; it puts pressure on the veins
2) When resting, elevate your legs
3) When sitting anywhere, in a plane or at a desk, get up and walk about every hour.

In addition, engage in regular exercise that involves your legs to help prevent varicose veins.

Tamoxifen is well-known in increasing risk for deep venous thrombosis(DVT) , although sclerotherapy therapy has very slim chance of DVT but the combination may increase the risk, so you have to consult with your oncologist before you do it. 

This is a common issue in the white population, it could be an isolated problem, or in conjunction with roscea.

Couple of sessions of IPL or laser treatments should take care of this issue. 

Thanks for this question. We always recommend to conservative regarding facial spider veins, I prefer to treatment them with multiple sessions of laser. As far as the dark circles, there are couple of different options, fillers, laser, or PRP. 

Thanks for this important question. Usually moles should be avoided on skin laser treatments, but if the mole is suspicious, large or any changes occur to the mole, it should be removed.