WHY DO I GET VARICOSE VEINS?
The most significant reason is inheriting them from family members. Anyone can get varicose veins however they occur more frequently in people who have a family history of them. They can affect both men and women of all ages, although women are more likely to get them due to hormonal differences and pregnancy. In addition to the genetic factors there are also 'lifestyle' factors which can effect the veins. Occupations that require prolonged periods of standing, obesity, lack of exercise or the number of pregnancies are all factors which can worsen your varicose your veins. It can be a combination of any or all of these factors that contribute to you varicose vein problem.
DON'T I NEED THE VEINS BEING TREATED?
Varicose veins and spider veins are not functioning normally and are of no use to you. They are flowing in the wrong direction due to damaged valves. Once veins become abnormal, our body finds alternative pathways with healthy veins to carry blood instead. Please remember that all the varicose veins you will have treated are superficial veins and part of the very minor system of veins. You can never run out of veins. Varicose veins are not missed by the circulatory system once removed, and in fact, the function of the leg will improve without these veins.
HOW LONG DOES IT TAKE TO SEE RESULTS?
Every individual case of varicose veins is different and as such, every patient will respond to treatment at different rates. With injection treatment, improvement is seen at two weeks but there is more improvement to come over the next month. Injections usually improve appearance by 60% or more. When the larger, bulging varicosities are removed, you’ll see the results immediately, although the bruising can take three to six weeks to settle.
Multiple vein treatments may be needed to achieve the results you want. A follow-up visit is usually scheduled for about a month after the procedure to check the success and to decide whether further sessions are needed. Generally, you need to wait about six weeks before undergoing another sclerotherapy session.
CAN VARICOSE VEINS COME BACK AFTER TREATMENT?
Yes they can. If you have a genetic disposition or family tendency to develop varicose veins or spider veins, all the veins in the legs have weak walls in them. No matter what form of treatment is used to treat your varicose veins initially, new veins will almost always develop at some point in your life and the chance of this increases over time. All patients who have had treatment for varicose veins should be on the look out for new veins arising. They need to have these veins treated earlier rather than later and hopefully this will involve some simple injection treatment, avoiding the need for any further surgery later down the track.
WHAT ARE THE POTENTIAL COMPLICATIONS OF SCLEROTHERAPY?
Injection treatment, or Sclerotherapy, often produces some temporary unwanted problems and on occasion produces a very unexpected problem. These can include:
Mild or severe allergy to the solution injected - this is very rare
Superficial Phlebitis – the target vein and the surrounding veins become lumpy and tender due to inflammation and some retained blood. This settles with regular massaging and anti-inflammatory cream
Clotting - Very rarely, patients can develop a deep vein thrombosis following injections. This is rare, however you can get some retained blood in the superficial veins that have been injected. To help prevent this, Dr Malouf encourages patients to apply compression to the leg and to walk for at least 20 minutes, 2-3 times a day to circulate the blood so it does not stagnate or clot
Pigmentation – the degree of pigmentation of the skin after injections varies from patient to patient. If there is a strong reaction to the solution injected, brown staining can occur on the skin due to the breakdown of red blood cells in the treated vein. This is minimised by good compression after injections. The body absorbs the staining after some weeks or months
Injection Ulceration – if the injected solution leaks out, it can cause damage to the surrounding tissue and even the skin, causing the skin to die and peel off. This then peels off, creating the ulcer. This is rare and the damage does heal but can be painful for a few weeks
New Vessel Formation – some patients form new small spider veins around a previously injected area. This is their body’s response to the inflammatory solution. For patients who form this problem, perhaps injection treatment should not be continued
WHAT ARE THE POTENTIAL COMPLICATIONS OF SURGERY?
The two rare but serious complications regarding thermal ablation or the removal of the large branching veins are:
Nerve Damage - When burning the saphenous veins closed, it possible to injure or irritate the sensory nerves lying next to the veins. This may lead to numb or tingly patches on the skin. This does not usually disable or prevent the patient from walking but can be annoying. In most cases this subsides after some months.
Deep Vein Thrombosis - This refers to a clot in the deep veins following varicose veins treatment. These are noticed by the patient in about 1% of cases and are treated with blood thinners. Early mobilisation of the operation is also very important.
Overall, varicose veins surgery is extremely safe, producing excellent results.
CAN I PREVENT GETTING VARICOSE VEINS?
You cannot change your genetics, nor the tendency to inherit varicose veins, however although there is no way to completely prevent varicose veins from occurring, improving your lifestyle may reduce your risk of developing varicose veins or getting additional ones.
Things like exercising regularly, watching your weight, elevating your legs, wearing compression garments and eating a good diet can make you healthier and may prevent new varicose veins from forming. You can also benefit from changing your sitting or standing position regularly to encourage blood flow through the legs, particularly in a standing occupation. It is important to note that elevation and compression of the legs do not prevent varicose veins from appearing, they can only help to alleviate the discomfort you may feel.
WHAT ARE THESE LUMPS ON MY LEG AFTER INJECTIONS?
After sclerotherapy, small, dark and tender lumps may develop along the injected vein site. These lumps can be quite hard and sore to touch. These can often be mistaken for “missed veins” however, they are simply areas of trapped blood under the skin. They are NOT dangerous clots. These lumps will disappear in time as the body reabsorbs the trapped blood back into the system however, you can help speed the process along by massaging the area and applying hirudoid or arnica ointment for bruising, or anti-inflammatory cream for local pain. If you are experiencing extreme discomfort, contact Dr Malouf’s rooms for an appointment where the trapped blood will be released.
CAN I HAVE TREATMENT IF I AM PREGNANT?
Pregnancy will increase the size and the pressure in your varicose veins. Usually the only treatment during pregnancy is to wear compression stockings or tights to counteract the high venous pressure. Dr Malouf will not inject or perform surgery on a pregnant patient. The veins will settle down significantly after having the baby and the situation can be reassessed with another visit to Dr Malouf.
CAN I TRAVEL FOLLOWING MY TREATMENT?
Yes, you can travel following varicose veins treatment, whether that treatment is just injections or more extensive. Short car trips and even short haul flights are safe within the week following treatment, but it is safer to wait at least a couple of weeks before long haul flights are taken. If you are travelling by car for long periods of time, it is recommended to stop for regular walks every 1-2 hours. If you have had a lot of work done on big veins, the leg will be sore and bruised for the first week and you need to wear support stockings and walk regularly. As such, your travel during this time will have to be modified or delayed