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Frequently Asked Questions (FAQ)
• What are varicose veins?
• What generally happens to varicose veins?
• What causes varicose veins?
• Who can get varicose veins?
• What are symptoms of varicose veins?
• How can varicose veins be diagnosed?
• What is treatment of varicose veins?
• Are varicose veins serious?
• Can one prevent them varicose veins?
• What problems can occur if left untreated?
• Is Varicose Vein Surgery covered by insurance?
• Who is a candidate for laser therapy?
• What type of laser is used to treat varicose veins?
• How does the laser work?
• How do I know if I am a candidate for laser vein treatment?
• What preparations must I take?
• What happens during the laser therapy?
• Is laser therapy painful?
• What is the role of Laser in the treatment of spider veins?
• What are advantages of laser over sclerotherapy?
• What are disadvantages of laser over sclerotherapy?
• Who is a candidate for laser therapy?
• What type of laser is used to treat Varicose Veins?
• How does the laser work?
• How do I know if I am a candidate for laser vein treatment?
• What preparations must I take?
• What happens during the laser therapy?
• Is laser therapy painful?
• How does one feel after the laser therapy?
• Are there any precautions after laser therapy?
• How often can one undertake laser therapy for varicose veins?
• What are side effects of laser therapy?
• How long does it take for the results to become evident?
Q: What are varicose veins?
A: Varicose veins are abnormally enlarged superficial veins usually seen in the thigh and leg. In the majority of cases, these large superficial veins are of a cosmetic nuisance. These veins connect with the deep veins of the leg and play a minor role in the transfer of blood to the heart. The veins become more prominent in the 3-4 decade of life and are more common in females.
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Q: What generally happens to varicose veins?
A: In the majority of cases, the varicose veins worsen with time. The varicose veins start to become more prominent and swell. With time, the veins are engorged with blood and can cause localized pain and itching. Once the veins become prominent, it is very unlikely that they will spontaneously resolve without any treatment.
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Q: What causes varicose veins?
A: The causes of varicose and spider veins are not entirely understood. In some instances, the absence or weakness of valves in the veins, which prevent the backward flow of blood away from the heart, may cause the poor circulation. In other cases, weaknesses in the vein walls may cause the pooling of the blood. Less commonly, varicose veins are caused by such diseases as phlebitis (inflammation of the veins) or congenital abnormalities of the veins. Venous disease is generally progressive and cannot be prevented entirely. However, in some cases, wearing support hosiery and maintaining normal weight and regular exercise may be beneficial.
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Q: Who can get varicose veins?
A: Conditions that can cause destruction of the veins are pregnancy, obesity, prolonged standing and trauma. Varicose veins are more common in females and this has been linked to the sex hormone, estrogen. Varicose and spider veins can also occur in men or women of any age, but most frequently affect women of childbearing years and older. Family history of the problem and aging increase one's tendency to develop varicose and spider veins.
Q: What are symptoms of varicose veins?
A: Aside from being unattractive, varicose veins may be responsible for leg aches, a feeling of heaviness or fatigue of the legs. The majority of individuals will complain of leg ache at the end of the day. Symptoms are often worse after prolonged standing and may include feelings of fatigue, heaviness, aching, burning, throbbing, itching, cramping, and restlessness of the legs.
With time, darkening or hyperpigmentation around the ankles is a classic feature of prolonged varicose veins. Hemorrhoids are analogous to varicose veins and involve engorgement of veins in the rectum. Varicose veins do not cause joint pains or a decrease in blood supply to the legs.
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Q: How can varicose veins be diagnosed?
A: Varicose veins can usually be diagnosed by a simple physical examination. However, the cause of the varicose vein requires the use of Doppler ultrasound. This painless test assesses the valve function in the groin and can also determine how much blood is flowing back into the legs. The test can also determine the presence of blood clots in the veins.
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Q: What is treatment of varicose veins?
A: There are many options in the treatment of varicose veins. If the saphenous vein is very “thick and rope like”, stripping may be the best option. This is a surgical procedure and the most invasive. If only the valve in the vein is defective, the vein can be tied off in the groin and the few superficial veins can be removed by small incisions. This also requires surgery and moderate amount of anesthesia. It preserves the vein for future use. The latest technology of varicose vein removal is using ultrasound with laser or radiofrequency ablation. In both techniques, the vein is burnt away. Both procedures are relatively painless and destroy the vein in the thigh.
Varicose veins are frequently treated by eliminating the "bad" veins. This forces the blood to flow through the remaining healthy veins. Various methods can be used to eliminate the problem veins, including, most commonly, surgery or sclerotherapy*. Spider veins cannot be removed through surgery. Sometimes, they disappear when the larger varicose veins feeding the spider veins are removed. Remaining spider veins also can be treated with sclerotherapy* and/or transcutaneous laser treatment.
The method you select for treating venous disease should be based on your physician's diagnosis, the size of the veins to be treated, your treatment history, your age, your history of allergies, and your ability to tolerate surgery and anesthesia, among other factors. As noted above, small spider veins cannot be surgically removed and can only be treated with sclerotherapy and/or transcutaneous laser treatment. On the other hand, larger varicose veins may, according to many studies, be better managed through surgery.
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Q: Are varicose veins serious?
A: In the majority of cases, varicose veins are of a cosmetic nuisance. Varicose veins generally tend to get worse without any treatment. Those who do not get them treated are more likely to develop:
• constant itching
• pigmentation around the ankles
• ulcers at the ankles
• mild swelling of the feet
• occasional blood clots in the veins
• infection of the vein
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Q.Can one prevent them varicose veins?
A: If one starts early in life, varicose veins can be prevented. The major preventive measure is to exercise and wear compression stockings.
- Elevation of the legs at all times is also recommended.
- During pregnancy, one should always lie on the left side with the legs elevated on a pillow. This prevents the fetus from pressing on the leg veins and decreases the chance of developing varicosities.
- One should avoid standing for prolonged periods.
- Don't cross your legs when sitting down.
- Wear elastic support stockings.
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Q: What problems can occur if left untreated?
A: Most people with varicose veins do not develop complications. It is impossible to predict who will develop complications. The size of the varicose vein is no related to complications but the duration of the varicose vein is. Complications that may occur include:
- Superficial thrombophlebitis – in this condition, the varicose vein is inflamed and tender. A clot is usually present in the vein.
- Bleeding – even with minor trauma, the varicose vein may be associated with bleeding. Because the vein is under high pressure, the bleeding can be quite profuse.
- Venous Eczema – the skin round the vein may become dry and very itchy.
- Venous Pigmentation - this is brown staining of the skin around the ankle. It is due to the leakage of small amount of blood from the veins into the skin.
- Venous Ulceration - ulcers at the ankle.
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Q: Who is a candidate for laser therapy?
A: There are no absolute reasons as to why one can not undergo laser therapy. However one should:
- be in good physical health
- be mentally and psychologically stable
- preferably does not smoke
- Wants to improve his/her appearance
- Is realistic about the procedure and results
- Has no disease of the blood vessels or problems with bleeding
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Q: What type of laser is used to treat spider veins?
A: The most advanced laser used to treat varicose veins is the Endovenous Laser.
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Q: How does the laser work?
A: The laser pierces the skin and penetrates the superficial blood vessel. The heat generated from the laser coagulates the blood inside the vessel causing it to collapse and seal. Over the next few weeks, the vessel will disappear and all the blood will be removed by the body's scavenging cells. The newer laser treatments allow the delivery of a precise dosage of energy to each blood vessel without injuring any nearby structures.
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Q: What preparations must I take?
A: There are no major preparations required before the laser treatment. A few common sense recommendations include avoiding sun exposure, aspirin, alcohol and not smoke for at least a week prior to the procedure.
On the day of the treatment one should avoid all creams, lotions and moisturizers on the area that is going to be treated. One should wear comfortable clothing that allows easy access to the body part(s).
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Q: What happens during the laser therapy?
A: The procedure is done in a doctor's office or clinic and usually takes less than 10-20 minutes. In most cases, only the very small superficial veins are treated with a laser. The majority of individuals do not require any type of anesthesia, but for those who are squeamish or anticipate pain, the physician may apply a topical anesthetic 20 minutes prior to the procedure. Most current day lasers also have a cooling system which prevents the tip of the laser from getting hot.
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Q: Is laser therapy painful?
A: During your treatment, you may feel a slight tingling sensation as the laser fires. If the individual feels any pain, a topical local anesthetic is applied 20 minutes before the procedure.
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Q: How does one feel after the laser therapy?
A: Soon after the procedure, you may feel a slight bump on the skin which will disappear in the next 2-4 hours. The area may also appear slightly redder and occasionally may be bruised.
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Q: Are there any precautions after laser therapy?
A: After laser therapy, it is strongly recommended that one keep away from the sun. Healing can be facilitated by wearing support hose. The pain is minimal and one may take any over the counter pain medications. After treatment, there is no down time. You can resume all of your normal activities immediately afterward.
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Q: How often can one undertake laser therapy for spider veins?
A: It is generally recommended that the treatments be spaced four to six weeks apart. If new veins appear, additional treatments are required for optimum results.
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Q: What are side effects of laser therapy?
A: The skin above the veins will have a reddish, cat-scratch appearance. This generally disappears over the next two days.
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Q: How long does it take for the results to become evident?
A: The results of laser treatment for spider veins are not immediate. After the laser therapy, the vessels underneath the skin will gradually change from a dark blue to light red color, then eventually disappearing in two to six weeks.
Most patients report a high degree of satisfaction with the procedure and relief at no longer having to hide unsightly veins. The treated areas are noticeably clearer and in most cases the skin continues to improve with each successive treatment.
The majority of spider veins will disappear within two to four weeks, and in some cases even longer.
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Q: What are potential complications of laser therapy?
A: The risks associated with laser vein therapy are minimal. Your eyes will be shielded during the treatments. Most facilities use state-of-the-art cooling systems, thus the treatments are low risk and relatively pain-free.
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Q: Is the Laser treatment for spider veins curative?
A: There is no cure for spider veins. Although treatment does not prevent the development of new spider veins, the removal of existing veins can dramatically improve the appearance of the affected area, providing a more youthful, healthy look and an even color pattern to the skin. Spider veins are recurrent and thus, more treatments will be required in the future.
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Q: What other conditions does the laser treat?
A: In addition to the leg spider veins, the laser can provide non-invasive skin treatments for the face. It is also used to remove unwanted hair even from patients who are not always good candidates for laser hair removal, such as those with darker or tanned skin.
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Q: How does the laser work?
A: The laser pierces the skin and penetrates the superficial blood vessel. The heat generated from the laser coagulates the blood inside the vessel causing it to collapse and seal. Over the next few weeks, the vessel will disappear and all the blood will be removed by the body's scavenging cells. The newer laser treatments allow the delivery of a precise dosage of energy to each blood vessel without injuring any nearby structures.
back to top
Q: How do I know if I am a candidate for laser vein treatment?
A: All individuals are evaluated prior to laser therapy. Spider veins do not cause symptoms and are of a cosmetic concern only. For those who have symptoms, further investigation is done to ensure that they do not have varicose veins. Laser therapy is most effective for the very small spider veins and not used to treat large varicose veins.
back to top
Q: What preparations must I take?
A: There are no major preparations required before the laser treatment. A few common sense recommendations include avoiding sun exposure, aspirin, alcohol and not smoke for at least a week prior to the procedure.
On the day of the treatment one should avoid all creams, lotions and moisturizers on the area that is going to be treated.
One should wear comfortable clothing that allows easy access to the body part(s).
back to top
Q: What happens during the laser therapy?
A: The procedure is done in a doctor's office or clinic and usually takes less than 10-20 minutes. In most cases, only the very small superficial veins are treated with a laser. The majority of individuals do not require any type of anesthesia, but for those who are squeamish or anticipate pain, the physician may apply a topical anesthetic 20 minutes prior to the procedure. Most current day lasers also have a cooling system which prevents the tip of the laser from getting hot.
back to top
Q: Is laser therapy painful?
A: During your treatment, you may feel a slight tingling sensation as the laser fires. If the individual feels any pain, a topical local anesthetic is applied 20 minutes before the procedure.
back to top
Q: How does one feel after the laser therapy?
A: Soon after the procedure, you may feel a slight bump on the skin which will disappear in the next 2-4 hours. The area may also appear slightly redder and occasionally may be bruised.
back to top
Q: Are there any precautions after laser therapy?
A: After laser therapy, it is strongly recommended that one keep away from the sun. Healing can be facilitated by wearing support hose. The pain is minimal and one may take any over the counter pain medications. After treatment, there is no down time. You can resume all of your normal activities immediately afterward.
back to top
Q: How often can one undertake laser therapy for spider veins?
A: It is generally recommended that the treatments be spaced four to six weeks apart. If new veins appear, additional treatments are required for optimum results.
back to top
Q: What are side effects of laser therapy?
A: The skin above the veins will have a reddish, cat-scratch appearance. This generally disappears over the next two days.
back to top
Q: How long does it take for the results to become evident?
A: The results of laser treatment for spider veins are not immediate. After the laser therapy, the vessels underneath the skin will gradually change from a dark blue to light red color, then eventually disappearing in two to six weeks.
Most patients report a high degree of satisfaction with the procedure and relief at no longer having to hide unsightly veins. The treated areas are noticeably clearer and in most cases the skin continues to improve with each successive treatment.
The majority of spider veins will disappear within two to four weeks, and in some cases even longer.
back to top
Q: What are potential complications of laser therapy?
A: The risks associated with laser vein therapy are minimal. Your eyes will be shielded during the treatments. Most facilities use state-of-the-art cooling systems, thus the treatments are low risk and relatively pain-free.
back to top
Q: Is the Laser treatment for spider veins curative?
A: There is no cure for spider veins. Although treatment does not prevent the development of new spider veins, the removal of existing veins can dramatically improve the appearance of the affected area, providing a more youthful, healthy look and an even color pattern to the skin. Spider veins are recurrent and thus, more treatments will be required in the future.
back to top
Q: What other conditions does the laser treat?
A: In addition to the leg spider veins, the laser can provide non-invasive skin treatments for the face. It is also used to remove unwanted hair even from patients who are not always good candidates for laser hair removal, such as those with darker or tanned skin.
back to top
Q: How does the laser work?
A: During laser therapy, light energy is delivered through a small laser hand piece to a targeted vein, in a series of brief pulses. The light energy is absorbed by the lining of the blood vessels and the blood within the blood vessels. The heat generated causes a coagulation (clotting) of the blood, which is subsequently absorbed by the body. The advanced laser treatments allow the delivery of a precise dosage of energy to each blood vessel.
back to top
Q: How do I know if I am a candidate for laser vein treatment?
A: All individuals are evaluated prior to laser therapy. Spider veins do not cause symptoms and are of a cosmetic concern only. For those who have symptoms, further investigation is done to ensure that they do not have varicose veins. Laser therapy is most effective for the very small spider veins and not used to treat large varicose veins.
back to top
Q: Do I require a preparation before laser therapy?
A: There is no prior preparation required before laser therapy. The procedure is done in a doctor’s office or clinic and usually takes less than 10-20 minutes.
back to top
Q: What happens during the laser therapy?
A: Only the very small superficial veins are treated with a laser. Generally no anesthetic is required for the procedure. The laser has a specialized chilled hand piece which acts to cool the surface of the skin while the beam from the laser penetrates the skin. Pulses of light energy are then administered in a sequential fashion.
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Q: Is laser therapy painful?
A: During your treatment, you will feel a slight tingling sensation as the laser fires. If the individual feels any pain, a topical local anesthetic is applied 20 minutes before the procedure.
back to top
Q: When do the spider veins disappear?
A: The majority of the treated spider veins will disappear within two to three treatments. The treatments can be spaced four to six weeks apart. If new veins appear, additional treatments are required for optimum results. The treatments may be spaced every three to four week intervals.
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Q: What are side effects of laser therapy?
A: The skin above the veins will have a reddish, cat-scratch appearance. This generally disappears over the next two days.
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Q: What happens after laser therapy?
A: Patients are encouraged to resume all normal activities immediately. Final results may not be apparent for several months. Most patients are satisfied by the results in a very short time.
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Q: Are there any other risks with laser therapy?
A: The risks associated with laser vein therapy are minimal. Your eyes will be shielded during the treatments. Most facilities use state-of-the-art cooling systems, thus the treatments are low risk and relatively pain-free.
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Q: How many treatments will I need?
A: Depending on the size and number of veins, two to six treatments will be needed. The treatments are usually done 4-6 weeks apart. Those with a tendency towards vascular problems will most likely require additional treatments.
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Q: When can I go back to work after laser therapy?
A: Patients are encouraged to resume all normal activities immediately. Final results may not be apparent for several months. Most patients are satisfied by the results in a very short time.
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Q: Is laser therapy covered by medical insurance?
A: No, spider veins are only of cosmetic nuisance and not covered by medical insurance or Medicare.
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