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Commonly asked questions
What causes spider veins, reticular veins, or varicose veins?
As we age, the veins of our leg no longer have the rigidity that
they used to. This causes blood to pool in these veins and they
dilate. Depending on the size of the vessels they will form either a
spider vein, reticular vein, or a varicose vein.
Can these veins be prevented?
Wearing support hose can add rigidity to these superficial vessels
and force blood back to the deep veins and eventually back to the
heart. Exercise can also propel blood back to the heart to prevent
pooling. Keeping within your ideal body weight is also ideal.
What treatments are available?
Depending on the extent of disease, there are several treatment
options. For saphenous vein reflux, laser ablation or radiofrequency
ablation can be performed. Alternatively, surgical vein stripping is
available as well. For varicose veins, these may be treated by
endovenous laser, sclerotherapy, or phlebectomy. The small, red
spider veins can be treated with sclerotherapy, or cutaneous laser
treatments. Only a consultation and physical evaluation with the
physician will determine which treatment(s) will best fit your
needs.
Do I need an ultrasound?
Ultrasound is an invaluable tool in diagnosing reflux in the
saphenous veins and also mapping out a treatment course. In some
instances, it may be necessary prior to your treatment. The reason
for this is that, you must first treat the highest point of reflux
first before you can treat the abnormal superficial veins. If this
is not done, then you can expect a high recurrence rate. The analogy
of a leaking faucet works best here. The best way to treat a leaking
faucet is to turn off the main water pipe (treatment of the
refluxing vein). Of course you can wipe the water from the floor but
the water will just reaccumulate. Both methods do the job but
turning off the water main will alleviate having to wipe up the
floor over and over again.
How successful is sclerotherapy/laser?
In most circumstances you can expect a 50-70% improvement in the way
that your veins will look. It is important to remember that things
will get worse before they get better. It usually takes about 4-6
weeks for all the bruising to disappear. In general, it takes about
3-6 sessions to reach your desired result. Therefore it is a process
which takes months.
Will these veins recur?
New veins will recur in time. As you age, the rigidity of those vein
walls start to decline. However, depending on the treatment you may
have months to years before new treatment is necessary.
Does insurance cover the cost of treatment?
For purely cosmetic vein treatment, the answer is no. In those
instances, where you have large varicose veins with reflux, the cost
of insurance may be covered. It is best to consult the physician and
they will make a determination of medical necessity. It still may
require photographs, laboratory studies, ultrasound, and other forms
to get coverage.
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