Frequently Asked Questions (FAQ)

What are varicose veins?
What causes varicose veins?
How common are varicose veins?
Is it necessary to seek treatment for my vein problems?
How do I know if I have vein disease?
What are the different types of vein disease?
Can vein disease be prevented?
What can happen if varicose veins aren't treated?
How successful is endovenous laser therapy?
Who should not be treated?
If the vein is closed by the treatment, where does the blood go?
Is the loss of the vein a problem?
What are the complications of vein treatment?
What should I do after the procedure?
What should I expect after the procedure?

What are varicose veins?

Varicose veins are the large, "rope-like" veins which are often one-quarter inch or larger in diameter.

Vein disease of the legs is one of the most common medical conditions. Approximately half of the population has some form of vein disease. Varicose veins affect between 15-25% of all adults, and approximately 50% of all people over age 50. Women have a higher incidence of vein disease than men.

The single most important cause of vein disease is heredity. Approximately 70% of all patients with varicose veins have parents with the same condition. Pregnancy, especially multiple pregnancies, is a contributing cause of vein disease. Other factors influencing vein disease are age, obesity and jobs that require long periods of standing.

Veins are the blood vessels that return blood to the heart from the body. To overcome the force of gravity, inside the veins are one-way valves which open to allow blood flow to the heart and close to prevent "reflux" of blood back to the body. When these valves fail to function, or if the vein is damaged so the valves do not completely close, blood can begin to pool in the vein and cause a variety of vein complications.

What causes varicose veins?

Varicose veins occur when veins do not properly return blood from the lower leg to the heart. All veins have valves that open, to allow the flow of blood to the heart, and close to prevent back flow (otherwise know as "reflux") of blood to the foot. When valves fail to function properly, blood leaks through and flows down the leg in the wrong direction. The blood overfills and distends the superficial veins under the skin, resulting in the bulging that you see in varicose veins.

The walls and valves of veins are thin and elastic, and can stretch due to a variety of conditions including pregnancy, heredity and age. When varicose veins become severe, it is referred to as chronic venous insufficiency. Symptoms of chronic venous insufficiency include aching pain, easy leg fatigue and leg heaviness, all of which worsen as time progresses. Left untreated, chronic venous insufficiency can cause ulcerations, which can be very difficult to treat. 

How common are varicose veins?

Approximately half of the population has some form of venous disease, while varicose veins affect about one out of two people age 50 and older, and 15-25% of all adults. 

Is it necessary to seek treatment for my vein problems?

The answer is yes. Most of our patients come to us because they find their spider veins and varicose veins to be unsightly and uncomfortable. However, it is important to seek treatment for vein problems regardless, as they can be signs of more serious vein disease issues and can lead to serious medical complications, including ulcers, bleeding, infection and blood clots.

Here are some other physical symptoms of varicose veins that make them easier to diagnose:

• Itchy or flaky skin around the affected vein sometimes accompanied by a burning sensation
• Feeling of heaviness in the lower legs after standing or sitting
• Aching in the lower leg area without relief
• Muscle cramps or pain in the lower legs
• Moderate or severe swelling around the ankles- the ankle area appears puffy and swollen and the ankle bone may not be visible

Not all of these symptoms are present in all cases. However, if your veins fit the above description and you have one or more of these symptoms, then it’s likely you have varicose veins. It is also very likely that these types of symptoms will, or already have, impacted your quality of life. It may be difficult for you to walk, sit or even stand for a long period of time.

The good news is that if you suffer from varicose veins, treatment has advanced rapidly in recent years. In other words, you don’t have to live with varicose veins!

You may have varicose veins, or are suffering from any level of venous insufficiency if you are experiencing one or any of the following symptoms:

• Varicose veins
• Spider veins
• Dull aching, heaviness, or cramping of the legs
• Itching and tingling
• Pain that gets worse when standing
• Pain that gets better when legs are raised
• Swelling of the legs
• Redness of the legs and ankles
• Skin color changes around the ankles
• Skin discoloration (bluing and browning of the skin)
• Thickening and hardening of the skin on the legs and ankles
• Ulcers on the legs and ankles
• Restless legs

All the above symptoms, as well as many others, can be caused by abnormal circulation in the veins of the lower extremities. This is a condition called “venous insufficiency”. 

How do I know if I have vein disease?

Fortunately, most vein disease can be seen by looking at the size and color of the vein at the skin’s surface. In some cases, however, the diseased vein may be deeper in the body and not visible through the skin. As a result, paying close attention to other symptoms is important in diagnosing vein disease. Many patients with vein disease experience cramping, aching, burning, itching, soreness and "tired" or "restless" legs, especially in the calf muscles. If you experience these symptoms, your physician can quickly and easily perform a test to determine if you have vein disease. 

What are the different types of vein disease?

Spider veins are the small, thread-like colored veins that are most often seen on the surface of the skin. While many people seek treatment for spider veins for cosmetic reasons, spider veins can also result in substantial discomfort requiring therapy.

Varicose veins are the large, "rope-like" veins which are often 1/4" or larger in diameter. Varicose veins generally grow in size over time and can result in substantial pain and complications if not treated.

Depending on the type and stage of vein disease, there are many different treatments. Your physician can explain all of the options. 

Can vein disease be prevented?

Generally no. If you have a family history of vein disease, there is nothing you can do to change your genes. Being overweight can accelerate the progression of vein disease, and long periods of standing can also contribute to the problem. Diet and footwear are generally believed to be irrelevant in the formation of vein disease. 

What can happen if varicose veins aren't treated?

Varicose veins generally worsen over time. Initially, slight pain and restlessness in the diseased leg will be felt. If untreated, this pain will increase and result in limitations in walking and cramps during sleeping. Eventually, varicose veins can lead to open sores on the foot, blood clots and tissue loss. 

How successful is endovenous laser therapy?

Clinical results have been published which document the success of endovenous laser treatment at 98%. Like any medical treatment, however, endovenous laser therapy has certain risks which your physician will explain, to you, as they apply to your individual case. More info>>

Who should not be treated?

Patients should wait at least three months after pregnancy or major surgery before being treated for vein disease. Patients who have suppressed immune systems, persons with deep vein thrombosis or incompetence and patients who cannot ambulate for other reasons are not good candidates for treatment. More info>>

If the vein is closed by the treatment, where does the blood go?

There are many veins in the leg - so the blood that would have flowed through the closed vein simply flows through other healthy veins after the procedure. The loss of the diseased vein is not a problem for the circulatory system. More info>>

Is the loss of the vein a problem?

No. Since there are many veins in the leg, the blood that would have flowed through the closed vein simply flows through other healthy veins after the laser therapy. More info>>

What are the complications of vein treatment?

Fortunately, sclerotherapy and endovenous laser therapies have rarely been associated with any serious complications when properly performed. Common minor complications of these procedures may include bruising, mild itching, and tenderness and tightness in the treated leg for up to two weeks after the treatment. More info>>

What should I do after the procedure?

After endovenous laser therapy, a gauze pad and tape will be placed over the puncture site and a compression stocking or compression bandage will be placed on your leg. You are encouraged to immediately walk, following the procedure, and resume normal activities. However, during the two weeks following your procedure you should avoid swimming, vigorous gym workouts, hot baths and  excessive sun. Following your endovenous laser therapy, your physician will provide customized instructions for you to observe including how long you will need to wear a compression stocking. If you have any questions, don’t hesitate to ask your physician. More info>>

What should I expect after the procedure?

You should expect to see some bruising along the treatment site as the vein disappears. This is normal and should gradually go away within a month. You also may feel some tenderness, tingling, itching or tightness in your treated leg during the two weeks following the procedure. If you experience significant pain, or have bleeding of the treated leg, contact your physician immediately. More info>>

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