Treatment for vein disease will depend on a variety factors, including the underlying vein condition and history. Other factors Spectrum Vein Center considers include:
A variety treatment plans can be developed for a patient. The overall goal is to improve blood flow and that can be done with regular exercise, compression stocking, medications, and other conservative treatments. Other types of treatments are minimally invasive and use radiofrequency to resolve your vein condition, and for more complex cases a smaller surgery may be required. Here are a few types of treatment plans common to Spectrum Dermatology vein patients.
A variety of conservative treatment options exist including physical exercise, losing weight, therapeutic massage, dietary supplements, elevate legs, and more. One of the most significant changes you can make involves the use of compression stockings.
One of the easiest and most cost effective ways of treating venous insufficiency (varicose veins) is through the use of compression stockings. In fact, compression therapy is one of the mainstays in treating venous insufficiency in all of its forms. Compression stockings work by compressing the superficial veins, and pushing more blood into the deep venous system, ultimately decreasing venous pressures in the leg, and decreasing leg swelling. For some patients, symptoms of venous insufficiency go away completely with compression stockings, and no procedures are needed. Even if medical procedures (varicose vein removal surgery and radiofrequency ablation) are performed in order to eliminate varicose veins, compression therapy is often used prior to the procedure, and for a few weeks afterwards.
To fit correctly, the calf and ankle measurements must be taken, and the correct size of compression stockings must be ordered. Furthermore, the amount of compression needed to improve symptoms in patients with venous insufficiency is usually higher than what’s available in the drugstores, and requires a prescription. The stocking fitters will also be able to provide aids to help you wear stockings, and give you instructions for use. Usually stockings should be worn during the day and should be removed at night. Most patients find that compression therapy makes their legs feel much better!
You should wear the compression stockings during the day. You should put them on in the morning and take them off before bed. Compression stockings do not need to be worn at night. If only one leg hurts or is affected, then you only need to wear the compression stocking on that leg.
Generally, compression stockings are prescribed in two strengths. The weaker strength, 20-30 mmHg, is usually for people with mild spider veins or varicose veins. This strength is also used for people who have difficulty putting on the compression stockings. The tighter compression stockings, 30-40 mmHg, is the optimal strength for most people with documented venous insufficiency, especially if they have skin changes or ulcers.
Even if you have varicose veins as high as your thigh, knee high stockings will help a lot more than you would think. Most people are more comfortable wearing knee high compression stockings as opposed to thigh high. However, the most important thing is that you wear the stockings regularly.
Many medical supply stores supply rubber gloves, which will help you put on the stockings. There are also other application devices which help. Without these aids, putting on stockings can be quite time consuming. Ask the store about this, and have them give you a demonstration about how to put on stockings. Making it easier to put the stockings on will increase your chance of wearing them regularly.
Compression stockings can range from 65 to 120 Dollars for a pair from a medical store or medical supplier. Sigvaris and Jobst are the industry standard best, but most other brands are fine as well.
Sclerotherapy is considered the gold standard treatment for removing spider and most larger varicose leg veins. It is a very cost-effective in-office procedure that seldom leaves a scar or produces adverse effects. A concentrated saline or specially-developed chemical solution is injected with a very small needle into the spider or varicose vein.
The procedure is typically painless. The solution causes the vein to close up or collapse and become scar tissue that is eventually absorbed by the body. The work of carrying the blood is shifted to other healthy blood vessels nearby.
Each patient is evaluated during the initial consultation to determine the best treatment options, based on medical history, physical exam, and ultrasound. Spectrum Dermatology treats all sizes and types of veins.
Since this is a medication being injected into the bloodstream, sclerotherapy should only be performed by health professionals licensed to give medication injections.
Most patients report few, if any, minor side effects, which usually disappear in time. Temporary reactions can include slight itching, minor bruising, localized redness and minor tenderness over larger treated veins. Some patients experience pigmentation, or staining, of the skin where the blood vessel once was. This pigmentation is not usually permanent and fades with time.
Spider veins and varicose veins that are treated early and often actually improve the circulation. Sclerotherapy has few risks and is tolerated well with a skilled provider.
Compression hose and gloves must be worn after treatment to obtain optimal results. Compression hose are available in the office for purchase. All patients are encouraged to walk after treatment, but heavy cardiovascular or high impact workouts and weight training are discouraged for one week after treatment. Hot tub soaking and sun exposure should be avoided as well.
With sclerotherapy, most patients can expect a 60% improvement in the number of veins with each treatment. Individual results will vary based on patient compliance, individual healing process, and the experience of the provider.
Sclerotherapy generally requires approximately 2-3 treatment sessions spaced approximately 6-8 weeks apart. One to three injections are usually required to effectively treat any one vein. The same area should not be retreated for 6-8 weeks to allow for complete healing, although other areas may undergo treatment during this time. Veins sometimes start to fade immediately, but more often fade in the 6-8 weeks following treatment. Although sclerotherapy works for existing spider and varicose veins, it does not prevent new ones from developing, but may decrease this risk.
Radiofrequency ablation (VNUS Procedure) represents a minimally invasive means of curing varicose veins and venous insufficiency. It involves the use of radiofrequency energy, delivered through a catheter in a vein, to close the vein from the inside.
Radiofrequency ablation requires only a tiny incision in the leg to be performed. It is often done in the office using only local anesthesia and does not require a hospital stay.This procedure lasts one to two hours and is performed under local anesthesia. In fact, stitches are not necessary in most instances, and the micro punctures are nearly imperceptible. Most patients find that the procedure is nearly painless, and the vast majority of patients are back to their usual routine by the next day.
Radiofrequency ablation is remarkable, because it provides us with a means of treating varicose veins and venous insufficiency without vein removal surgery. In the not so distant past, surgeons would remove the poorly functioning vein with a procedure called vein stripping. This involved making two incisions in the leg, and literally “ripping out” the vein from the leg. Although this was effective, it caused pain, and sometimes required weeks for a full recovery. Another procedure we do not perform is Laser Ablation due to the bruising, pain, and discomfort compared to radiofrequency. Read more on the differences in the full article: Which Is Better: Radiofrequency Ablation VS Laser Ablation?
Now we can treat varicose veins without making an incision, and with minimal pain. Not only that, but the new treatments are more efficacious than vein stripping, with fewer complications. Radiofrequency ablation truly has revolutionized how varicose veins are treated, and we are pleased to offer it at our center.
Varicose vein removal is an option for patients with large ropy veins. This procedure is called “stab phlebectomy” or “ambulatory phlebectomy.” Stab phlebectomy is a minimally invasive out-patient procedure used to treat varicose veins that are too large to be effectively treated with sclerotherapy.
This is a surgical procedure, where tiny incisions are made directly over the large varicose veins, and the vein is removed in specific sections. Often, just a few incisions are required in order to really make a difference in the cosmetic appearance of the veins. These incisions are very small, usually less than half a centimeter, and are not associated with a lot of pain. This procedure is usually done in the operating room. Often it is performed in conjunction with a more definitive vein surgery (or procedure) for venous insufficiency, such as radiofrequency ablation.
Stab phlebectomy should not be confused with a traditional method of removing varicose veins called “vein stripping.” Vein stripping is a vein removal procedure that is not practiced as frequently as in the past. It involved removing the entire greater saphenous vein and was a painful surgical procedure that often left patients debilitated for weeks. In contrast, stab phlebectomies are minimally invasive and involve little pain. They target the varicose veins themselves, rather than the saphenous vein which is usually treated with radiofrequency ablation or endovenous laser therapy.
Stab phlebectomies are not always required, even for people with large varicose veins. If the underlying condition is treated (venous insufficiency), then the veins usually shrink considerably afterwards, because they are not subject to high venous pressures. In fact, many people choose to forgo this “vein removal” procedure, because their veins become so much smaller and less painful after radiofrequency ablation. Still others opt for less invasive sclerotherapy instead to treat residual varicose veins.
Now, we can treat varicose veins without making an incision, and with minimal pain. Not only that, but the new treatments are more efficacious than vein stripping, with fewer complications. Radiofrequency ablation truly has revolutionized how varicose veins are treated, and we are pleased to offer it at our center.
Spectrum Vein Center is happy to schedule a consultation to discuss types of vein disease, vein disease treatment, and diagnosing your vein condition. Learn more about vein conditions, treatment options, and additional educational resources. Our experience and reputation make Spectrum Dermatology one of the most sought-after dermatologists in the Scottsdale and Phoenix area. For more information or to set up an appointment please contact us at (480) 948-8400.