Varicose and Spider Vein Removal

At one end of the spectrum, small spider veins are the smallest varicose veins. These are usually of most concern to women and can occur anywhere on the legs, but more often on the inside of the knee and outer thigh. Venulectasias are slightly larger veins that occur in groups – you’ll regularly see them with spider veins.

Just below the surface of your skin you may notice reticular veins – larger vessels that are dark blue in colour. These can sometimes appear to join together to form a stream or river travelling down the leg. It is important to treat these vessels, along with the spider veins, if long-term improvement in of spider veins is to be expected.

The next largest veins are what most people call varicose veins. These can be either blue in colour, if close to the skin, or may appear to be of normal colour. Large varicose veins are the bigger and more ropey ones that can be seen from a few metres away. They often extend from the groin to below the knee or behind the knee and can cause pressure problems on smaller veins. A solution to the abnormal flow must be found in order to make the leg look better as well as prevent the diseases that backpressure in veins can cause.

 

$100 Consultation fee (this has a Medicare Rebate available)

Each vein treatment (Item No. 32500) can attract a Medicare Rebate of approx $92 per treatment, up to a maximum of 6 treatments per year. If you have exceeded the Medicare Safety Net then you can claim a rebate of approx $190 per treatment. You are encouraged to discuss this directly with Medicare.

You will also be required to purchase a pair of medical compression stockings at the conclusion of your first vein treatment. These can be purchased from a local pharmacy (Jobst or Venosan brand –grade 2 stockings-pantyhose)

 

veins and venous disease

What are veins and why are they important?

There are two main types of blood vessels in the body and these are arteries and veins. Your arteries have thick walls and move blood away from your heart, while your veins have thinner walls and return the same blood to your heart, minus much of the oxygen and nutrients. To do their job, arteries are tough enough to cope with the pressure-generated by the heart to push the blood along, but veins can only withstand low pressure and, where possible, rely on gravity to return blood to the heart. In the legs, your veins need to work against gravity and so pressure can build up in those closest to the skin’s surface. This can cause the valves within the veins, which are there to help prevent the blood flowing backwards, to fail. This, in turn, leads to venous reflux and varicose veins.

Why do only some people get varicose veins?

  • Many women, and men, have a hereditary weakness in their vein walls. This is why you’ll often notice that members of the same family will suffer from varicose veins
  • Standing for long periods can be a factor, in both men and women, and is particularly an issue in those who stand every day to carry out their jobs
  • Pregnancy is a major factor for problem veins in many women. This can be due to a number of factors such as increased circulation, elevated pressure in the pelvic region late in pregnancy that creates pressure in leg veins, plus the hormone oestrogen, which can cause blood vessels to form as well as weaken the walls of blood vessels
  • Being overweight can cause varicose veins and also make them worse
  • Trauma or injury to the veins and blood vessels can lead to varicose veins

 

how we can help

Sclerotherapy (micro-injection) is a technique that can treat most varicose and spider veins. Tiny needles are used to inject a medication (sclerosing solution) directly into the unwanted vein. The solution acts on the inner lining of veins, causing it to collapse and shrink so that no more blood can flow through this unwanted vein. Within weeks, the unused vein is absorbed by the body and eventually becomes barely noticeable.

Compression stockings are often required after injection (from few days to 2 weeks depending on size of veins/treatment performed)

Different techniques of injection and sclerosants are employed to achieve a good outcome. Ultrasound guided sclerotherapy (UGS) is employed to treat leaking valves in leg vein (large veins usually).

 

frequently asked questions

What types of leg veins are there?

Dilated leg veins can be classified as:

  • Spider veins (red or purple fine veins)
  • Reticular veins (blue mid-sized veins often feeding into the spider veins)
  • Varicose veins (large blue ropey veins often traversing the leg)

All these veins can contribute to unsightly and cosmetically dissatisfying appearance of the legs, as well as medical complications such as aching, swelling, appearance of bruising, ulceration, eczema and/or pigmentation.

What is the mechanism by which veins develop?

Blood in leg veins normally travels upwards to the heart. Due to gravity blood tries to flow back down towards the feet. However, normal veins have valves, which close to prevent abnormal flow towards the feet. It is the breakdown of these valves that leads to abnormal flow, which in turn leads to increased pressure in the vein. The increased pressure eventually causes the vein wall to expand and bulge, producing a varicose vein. Varicose veins serve no useful function to the body's circulation. Our body has the ability to establish alternative pathways to bypass the abnormal varicose veins. When varicose veins are closed down, the circulatory system improves, as do many of the symptoms. It is important to understand that varicose veins can be a progressive condition and that totally new veins can develop with time. Maintenance treatment is likely for most patients.

Can you prevent unsightly veins?

Due to the causes, there is very little that can be done to halt the development of leg veins. Wearing compression stockings/ support hose only delays their progression. Maintaining a healthy weight can also reduce backward pressure on leg veins.

What is sclerotherapy?

There is a treatment available for these veins that does not require surgery or significant interference in one's lifestyle. The procedure is called sclerotherapy. A liquid solution called a sclerosing agent is injected directly into the veins, causing irritation and inflammation. This makes the vein stick together and scar thus preventing blood flow in the vein. This process takes 6 to 8 weeks to complete.

Larger varicose veins can also be treated with this solution but often require the assistance of an ultrasound to enable effective vein closure and thus adequate treatment. The procedure involves a series of tiny microinjections into the veins of each leg under direct vision. You may feel a slight stinging or throbbing sensation that is brief and relieved with walking after the procedure

Sclerotherapy is best for any areas in the lower legs, and can occasionally be used on the face although laser is a much more comfortable and preferred option here. Laser can be used on the lower legs also but has mixed success here.

What are the possible consequences if I DO NOT have treatment?

Symptoms commonly associated with varicose veins include leg tiredness, heaviness, aching, throbbing, restlessness, tingling, itching, numbness and swelling.

Complications such as phlebitis, blood clots, dermatitis and ulcers can occur if veins are left untreated.

What can you do after treatment?

Following treatment, which takes 30-45 minutes per leg, you are free to carry on normal activities just wearing a compression stocking. Exercise is encouraged at least 30 minutes per day (any form that gets the calf muscle working).

Is sclerotherapy successful?

Sclerotherapy by injection is a very effective method of treatment. You can expect 50-80% improvement with a single treatment and improved success after a course of between 2 to 5 treatments. The recurrence rate of dilated veins can be up to 30% over time. This can be improved with avoiding stiletto high heels and prolonged standing, maintaining adequate body weight and regular exercise.

 

the side effects

Immediate reactions include:

Red lumps like mosquito bites over the injected areas. These tend to last 6 to 24 hours.Some discomfort eased with walking and occasionally requiring simple analgesia. Rarely patients have reported generalized muscle aches and a cough immediately after the procedure but this is very transient. It is very rare and an uncommon situation that an allergic reaction may occur.

Temporary side effects include:

Bruising that can last 2 to 3 weeks, arnica or hiridoid cream can help (can get from pharmacy without a script), blood trapping, whereby blood gets caught when the vein closes down forming a brown tender lump along the vein. It can be cleared by putting a needle in the vein and squeezing the old blood out. Matting, is the formation of new very fine vessels related to opening of new smaller spider vein channels. 1/3 of cases of matting resolve themselves (but can take 6 months), 1/3 can be treated with further sclerotherapy and 1/3 is permanent. Brown pigmentation due to haemosiderin (iron) deposit from the leaky vein. This can take 3-6 months to fade but can be treated with laser if not resolved in 12 months.

Rare side effects include:

DVT, clot in the deep venous system seen in 1/7000 people. Ulceration seen in 1/200 people usually elderly, heavy smokers, diabetics and injections along the shin area. These heal with dressings and may lead to scarring. Thrombophlebitis, an inflamed and clotted superficial blood vessel usually responding to massage, anti-inflammatories and sometimes antibiotics. Numbness 
and/or swelling of the ankle.

 

 

 

Please call our friendly therapists to book your appointment with Ed, (03) 9598 3451.