Varicose veins are common and usually aren’t a sign of a serious problem. But in some cases, varicose veins can be a sign of a blockage in the deeper veins called deep vein thrombosis. If you have this problem, you may need treatment for it.
Varicose Veins Diagnosis
Making the diagnosis of varicose veins is a relatively easy task. They are easy to identify just by their characteristic appearance on physical examination.
The health care professional most likely will take a thorough medical history and examination looking not only for the extent of the patient’s varicose veins, but also for potential risk factors.
- He or she may do any of several simple tourniquet tests to identify points of reverse blood flow. The simplest test uses only a blood pressure cuff.
- Another useful device aiding in localizing the extent of the problem is a Doppler ultrasound. This handheld device is skimmed over the surface of the leg to map out the veins and faulty valves. This device is similar to those used in pregnancy to identify the developing fetus.
- Duplex scanning, a similar but more detailed test, can also be done to rule out the presence of clots in the deeper veins.
- Magnetic resonance venography is another test performed when the Duplex scan test is unclear. This test can even look for blood clots in the deep veins.
- Blood (laboratory) tests are not helpful in making a diagnosis of varicose veins
Home treatment may be all you need to ease your symptoms and keep the varicose veins from getting worse.
- Wear compression stockings.
- Prop up (elevate) your legs.
- Avoid long periods of sitting or standing.
- Get plenty of exercise.
Alternatives to ELT and scierotherapy:
There are a number of different treatment options available for varicose and spider veins. While we feel our treatment combination of sclerotherapy and endovenous laser treatment (ELT) is the safer and more effective option, we feel it’s best to address the other options that are available and as well as their advantages and disadvantages.
Vein Surgery (stripping)
The documented failure rate for surgery is 25 percent to 43 percent in one to five years. This procedure has a longer and more painful recovery time than minimally invasive treatment options. It may also result in scarring. Removing a varicose vein surgically is not the same as removing an appendix – a one-time-only procedure – because varicose veins are a chronic problem plagued with new growth in many places in the leg. Repeated surgery is not an acceptable solution for a recurrent problem.
Compression stockings are designed to decrease tension on the veins in the legs. While they generally provide symptomatic relief, they do not correct the underlying problem or prevent vein disease from getting worse. Vein disease sufferers often have difficulty regularly wearing the stockings since they can be hot and uncomfortable.
Creams and herbal supplements
Topical treatment on its own cannot get rid of varicose veins; it simply attempts to reduce their appearance. If these creams could accomplish the same results as a medical procedure, they would be available by prescription instead of over-the-counter. Varicose and spider veins are progressive and will get worse over time if left untreated. Save your money on the creams and look into getting proper treatment before they become more noticeable.
Surface Laser or Intense Pulse Light (IPL)
Surface lasers treat the lighter, more delicate spider veins that appear close to the skin’s surface, but this procedure can be quite painful and runs the risk of damaging or burning the skin. Research has shown that this procedure is not as effective as ELT or sclerotherapy though.1
Ambulatory Phlebectomy: Removing veins through small incisions
During this procedure veins are removed through several tiny needle punctures in the skin. This procedure can only be used for veins that are close to the skin’s surface and requires local anesthesia. Swelling, hematomas or nerve damage can occur if proper technique is not observed.2
1 Goldman MP, Sadick NS, Weiss RA. Treatment of leg telangiectasias with lasers and high-intensity pulsed light. In: Fronek HL, ed. The Fundamentals of Phlebology: Venous Disease for Clinicians. 2nd ed. London, England: Royal Society of Medicine Press Ltd; 2008:47-52.
2 Morrison N, Olivencia JA. Ambulatory phlebectomy. In: Fronek HL, ed. The Fundamentals of Phlebology: Venous Disease for Clinicians. 2nd ed. London, England: Royal Society of Medicine Press Ltd; 2008:65-68.