Below are some common questions we hear. If you have other questions that aren't on this list, call or email us!  We'll be happy to help you learn as much as you can about vein disease and its proper treatment.

What is sclerotherapy? Isn't it painful?
Sclerotherapy involves using a very small needle to inject special medications into diseased veins that cause the veins to shrink and gradually disappear. The needles used are very small and feel like a mosquito bite. Most people find this treatment relatively painless. Sedation and local anesthesia are not required. The solutions we use for these treatments are painless, as opposed to the old-fashioned saline treatments which were not.

Do spider veins come back?
The spider veins treated with sclerotherapy are permanently destroyed and will be reabsorbed by the body, so they can't come back. However, nothing can be done to prevent your body from forming new spider veins. Excessive standing, crossing the legs, or being overweight does not cause them. It is mostly hereditary. But new spider veins can be treated just as effectively as the previous ones with additional sclerotherapy.

How do I begin treatment for my vein problem?
During your initial consultation, the physician will evaluate your symptoms and examine your legs. A portable ultrasound may be used to check for diseased internal veins. Any questions you may have will be answered. You may also discuss your expectations and anticipated results. The doctor will give you an estimate of the number and type of treatments you may need and the affiliated costs, which will vary depending upon the size and extent of your problem. In some cases, a more detailed ultrasound test may be needed to assess the extent of your vein problem. After final treatment recommendations have been made by the physician, you should then be able to schedule an appointment for treatment.

How long will my treatment take?
Sclerotherapy treatment sessions are usually 30 minutes each. Every patient is different, and the number of sessions needed varies depending on the severity of your condition. Most cases require three to six treatments; however, this is only a guideline. Your individual case may be different. Your legs may begin to show improvement in as little as a few weeks, but the best results are usually seen after several treatment sessions. After healing has occurred, spider veins and bulging varicose veins will be gone, leaving you with healthy, great-looking legs. Contrary to reports in the media, there is no such thing as a miracle 'one treatment' cure for spider veins.

Are there any restrictions to my physical activity after spider vein treatment?
There are usually no restrictions on physical activity after sclerotherapy. In fact, exercise is encouraged. We do discourage direct sun exposure to treated areas for a couple weeks after each treatment (sunscreens are adequate protection during this time).

Will my insurance pay for treatments?
The initial consultation (office visit) is usually covered, although we ask that you pay for your consultation at the time of your visit. An itemized bill showing appropriate insurance codes shall be provided for your records. If treatment of your condition is considered medically necessary by your physician, we will make every reasonable effort to seek reimbursement from your insurance company. Unfortunately, we cannot guarantee that they will provide payment. Treatment of spider veins, regardless of symptoms, is always considered cosmetic by insurance companies and is not covered.

What causes varicose veins?
Contrary to popular belief, crossing the legs has absolutely nothing to do with the appearance of varicose or spider veins. In most persons, the tendency to develop these abnormal veins is largely hereditary. Vein problems are aggravated by pregnancy and estrogen levels, so they are usually worse in women, but men are not immune! It can affect people of all ages, from teenagers to patients in their 90's.

What about herbal remedies and vein creams?
When it comes to over-the-counter remedies, save your money. Creams, pills, vitamins, herbs, salves, special wraps, and even prescription compression stockings do not treat or prevent varicose or spider veins. Exercise does not make them worse, either. So stay active! It's best to eat a high fiber, balanced diet, keep your weight down, and get plenty of rest and regular exercise.

I don't see any varicose veins on my legs...only spider veins. Why do I need an ultrasound?
In many cases, spider veins appearing in certain areas of the leg are an indication that deeper and more serious vein problems exist. Twenty five percent of patients who are seen for 'cosmetic' reasons turn out to have more serious vein problems. A large diseased vein underneath the skin can cause spider veins to appear on the surface. In this case, the spider veins will not respond to any form of treatment and may actually get worse until the large 'feeding' vein underneath is treated first. During your consultation, your doctor will determine whether deeper problems are likely.

Don't I need these veins for my circulation?
Spider and varicose veins are actually a burden to your circulation. When varicose veins are eliminated, the legs feel lighter and more energetic because the venous circulation is improved, and the body has re-routed the blood flow into stronger, healthier, deeper veins.

Do varicose veins come back?
Our micro-surgical procedures remove bulging varicose veins permanently. Sclerotherapy destroys veins so they will not return. Endovenous catheter procedures also permanently destroy the treated vein segments. None of these procedures, however, can prevent new veins from forming in the future. Remember, the tendency for good veins to wear out is hereditary. If you notice new varicose veins forming, see your doctor right away so additional treatment can be given. The earlier bad veins are found, the easier they are to treat.

I had vein surgery. Can you take out more veins?
In a word...yes! The venous system is a vast network of interconnected veins with much built-in redundancy. The superficial veins (the only ones we operate on) are of minor importance even when they are normal. The only veins we treat are already abnormal. We do not treat healthy, functioning veins, and you will not 'run out' of those!

I was told that if you take out my vein, then I would not have any for a heart bypass.
This is not true. Bulging varicose veins are useless to a heart surgeon. He needs a normal-sized, straight, and healthy vein to bypass an obstructed coronary artery. Likewise, any internal veins that we treat are already diseased, and as such, cannot be used for coronary bypass. If your leg veins are so diseased that they cannot be used, there are plenty of other options available to the heart surgeon.

I've told my doctor about my veins many times, but he told me not to worry about them, that they were just 'cosmetic.' What do you think?
Large bulging varicose veins cause symptoms in the vast majority of people who have them. In most cases, these veins are not just cosmetic but are considered to be a serious medical problem that can lead to significant complications if not treated. In years past, when the surgery to remove varicose veins was so barbaric and disfiguring (e.g., vein stripping), many physicians discouraged their patients from having anything done. The new surgical and non-surgical techniques are so much easier and less painful that there is no reason to live with varicose veins anymore. Unfortunately, your physician may not be aware of all the newest techniques available for varicose vein treatment (But YOU are!)

What will happen if my varicose veins are NOT treated?
Over time, varicose veins always enlarge and become more symptomatic, forcing many people to alter their daily activities to try to decrease the pain and swelling. In severe cases, varicose veins can cause skin damage, ulcerations, and blood clots. These complications can be prevented by treating the varicose veins early. No matter how severe the vein problem, and no matter how long it has gone on, effective treatment can be given in most cases.

I've had vein stripping before and the veins came back. How is your treatment different?
The key to modern, effective treatment of varicose veins is using duplex ultrasound, done in the standing position, to completely map out the size and location of all diseased veins, many of which are underneath the skin and not visible. By utilizing ultrasound to 'see' these hidden diseased veins, we can eliminate the root cause of most recurrences. Unless you had a complete 'vein mapping' ultrasound in the standing position prior to your surgery, chances are the surgeon left behind some diseased veins, and that is why your problem came back. In addition, vein strippings were done in the hospital under general anesthesia and required prolonged and painful recovery times away from work. Our microsurgical procedures are done under local anesthesia right in our office. You are up and around immediately after the procedure and can return to work the very next day. And because our incisions are so small, there are no scars!

What can I do to prevent varicose veins?
Regular exercise helps to pump blood up the legs and back to the heart against gravity. Getting enough rest, eating a healthy diet, and keeping your weight down help your overall health, including your veins. Support stockings and herbal supplements have been shown to improve pain and swelling from varicose veins but have never been proven to heal bad veins or prevent healthy ones from deteriorating. Unfortunately, time and gravity cause veins in susceptible people to wear out. Once a vein has become a varicose vein, it will never function properly and should be eliminated.