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Varicose Veins and Spider Veins (cont'd)
How can
I prevent varicose and spider veins?
Should I see a doctor
about varicose veins?
How are varicose
and spider veins treated?
Can varicose and
spider veins return even after treatment?
How
can I prevent varicose and spider veins?
There are several easy things you can do to help prevent
varicose and spider veins and to relieve discomfort from
the ones you have:
- Protect your skin from the sun
by wearing sunscreen to limit spider veins on the face.
- Exercise regularly to improve your
leg strength, circulation, and vein strength. Focus on
exercises that work your legs, such as walking or running.
- Control your weight to avoid placing
too much pressure on your legs.
- Do not cross your legs when sitting.
However, try to elevate your legs when resting.
- Do not stand for long periods of
time. If you have to stand for long periods of time, shift
your weight from one leg to the other every few minutes.
If you have to sit for long periods of time, stand up
and move around or take a short walk approximately every
30 minutes.
- Wear elastic support stockings,
but avoid clothing that is too tight or that will constrict
your waist, groin, or legs. Make sure to include high-fiber
foods in your diet since constipation can contribute to
varicose veins. High fiber foods include fresh fruits
and vegetables and whole grains, like bran. Control your
salt-intake. Salt, or sodium, can cause you to retain
water or swell.
Should
I see a doctor about varicose veins?
Remember these important questions when deciding whether
to see your doctor:
Has the varicose
vein become swollen, red, or very tender or warm to the
touch?
If yes, see your doctor.
If no, are there sores or a rash on the leg or
near the ankle with the varicose vein, or are there circulation
problems in your feet?
If yes, see your doctor.
If no, continue to follow the self-care tips above.
How
are varicose and spider veins treated?
Besides a physical examination, your doctor can take x-rays
or ultrasound pictures of the vein to assess the cause and
severity of the problem. You may want to speak with a doctor
who specializes in vein diseases (phlebology). You should
discuss which treatment options are best for your condition
and lifestyle. It is important to remember that not all
cases of varicose veins are the same. Doctors may differ
in the ways they treat you. Some available treatments or
surgeries include:
Sclerotherapy - Of
all available treatments, this one is most commonly used
for both spider veins and varicose veins. It involves injecting
a solution into the vein that causes the lining of the vein
walls to swell, stick together, and eventually seal shut.
The flow of blood is stopped and the vein turns into scar
tissue. In a few weeks, the vein should fade. Although the
same vein may need to be injected with the solution more
than once, sclerotherapy is very effective if done correctly.
The American Academy of Dermatology states that most patients
can expect a 50% to 90% improvement. Also, a new and improved
type of sclerotherapy called microsclerotherapy uses improved
solutions and injection techniques that increase the success
rate for removal of spider veins. Sclerotherapy does not
require anesthesia, and can be done in the doctor's office.
Some side effects may only occur at the site of the injection,
such as stinging or painful cramps; red raised patches of
skin, small skin ulcers, and bruises. Spots, brown lines,
or groups of fine red blood vessels could appear around
the vein being treated. These usually disappear. The treated
vein could become inflamed or develop lumps of coagulated
or congested blood. These are not dangerous. Applying heat
and taking aspirin or antibiotics can relieve inflammation.
Lumps of coagulated blood can be drained. Health insurance
coverage varies. If the treatment is done for cosmetic reasons
only, it may not be covered.
Electrodesiccation
- This treatment is similar to sclerotherapy except the
veins are sealed off with an electrical current instead
of the injection of solution. This treatment may leave scars.
Laser surgery – Until recently, laser treatments
mostly were used for treating spider veins on the face.
Varicose veins in the legs did not respond consistently
to this treatment, and some doctors doubted whether laser
treatment actually worked, and it was not covered by most
health insurance plans. Now, however, new technology in
laser treatments can effectively treat varicose veins in
the legs.
Laser surgery works by sending very strong bursts of light
onto the vein that makes the vein slowly fade and disappear.
Lasers are very direct and accurate, and only damage the
area being treated. All skin types and colors can be safely
treated with lasers. The American Academy of Dermatology
believes that the new laser technology is more effective
with fewer side effects. Laser surgery is more comfortable
for patients because there are no needles or incisions.
When the laser hits the skin, the patient only feels a small
pinch, and the skin is soothed by cooling both before and
after the laser is applied. There may be some redness or
swelling of the skin right after the treatment, but this
disappears within a few days. The skin also may be discolored,
but this will disappear within one to two weeks. Treatments
last 15 to 20 minutes, and depending on the severity of
the veins, two to five treatments are generally needed to
remove varicose veins in the legs. Patients can return to
normal activity right after treatment.
There are several types of lasers
that can be used to treat varicose veins and spider veins
on the legs and face. Although your doctor will decide which
type is best to treat your condition, some of the lasers
used to treat veins include yellow light lasers, green light
lasers, and other intense pulsed light systems. Again, health
insurance coverage varies. If the treatment is done for
cosmetic reasons only, it may not be covered.
Closure Technique
– The U.S. Food and Drug Administration (FDA) in March
1999 approved this new procedure for use in the United States.
Although it is not as widely used as sclerotherapy, some
doctors feel it may become the standard for treating varicose
veins. It is not very invasive and can be done in a doctor’s
office. This method involves placing a special catheter
or a very small tube into the vein. Once inside, the catheter
sends radiofrequency energy to cause the vein wall to shrink
and seal shut. Healthier veins surrounding the closed vein
can then restore the normal flow of blood. As this happens,
symptoms from the varicose vein decrease. The only side
effect is slight bruising.
Surgery is used mostly to treat very large varicose veins.
Available surgical options include:
Surgical Ligation and Stripping
- With this treatment, the veins are tied shut and completely
removed from the leg. Removing the veins will not affect
the circulation of blood in the leg because veins deeper
in the leg take care of the larger volumes of blood. The
varicose veins mostly removed through surgery are superficial
or surface veins, and collect blood only from the skin.
This surgery requires either local or general anesthesia
and must be done in an operating room on an outpatient basis.
Serious side effects or complications with this surgery
are uncommon. However, with general anesthesia, there always
is a risk of cardiac and respiratory complications. Similar
to the risks of sclerotherapy, bleeding and congestion of
blood can be a problem, but the collected blood usually
settles on its own and does not require any further treating.
Wound infection, inflammation, swelling and redness also
can occur. This surgery also can leave permanent scars.
A very common complication is the damage of nerve tissue
around the treated vein. Small sensory nerve branches are
difficult to avoid when veins are removed. This damage can
cause numbness in small areas of skin, burning, or a change
in sensation around the surgical scar. The most serious,
but rare, complication of surgery is the creation of a deep
vein blood clot that may travel to the lungs and heart.
To be safe, many surgeons give injections of heparin, a
drug that reduces blood coagulation, for one to two days
before the surgery. However, heparin also can increase the
normal amount of bleeding and bruising after the operation.
Ambulatory Phlebectomy
- With this surgery, a special light source marks the location
of the vein. Tiny incisions are made in the vein, and then
with surgical hooks, the vein is pulled out of the leg.
This surgery requires local or regional anesthesia. The
vein usually is removed in one treatment. Side effects and
complications are similar to those of ligation and stripping.
The most common side effect is slight bruising. Compared
to traditional surgery, ambulatory phlebectomy allows the
removal of very large varicose veins while leaving only
very small scars. Patients can return to normal activity
the day after treatment.
Can
varicose and spider veins return even after treatment?
Current treatments for varicose veins and spider veins have
very high success rates. Although it is uncommon, these
veins can return after treatment. One reason may be hidden
areas in the body where there is a lot of pressure on the
veins. This pressure may cause new spider veins. Doctors
can diagnose this with ultrasound. Another cause may be
new re-growth of vein branches. Doctors have found that
tiny vein branches can grow through scar tissue to connect
to both deep and superficial veins even after surgery.
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For More Information...
National Heart Lung and Blood Institute (NHLBI)
http://www.nhlbi.nih.gov
American Academy of Dermatology
http://www.aad.org
American Society for Dermatologic Surgery
http://www.asds-net.org/
The American College of Phlebology
http://www.phlebology.org/
For more expert information please visit
The National Health Information Center at http://www.4woman.gov/.
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