FAQ about varicose veins

What are varicose veins?

This is the expansion and tortuosity of altered veins, the skin above which can be either normal in color or dark purple or blue, they can protrude above the skin, forming nodes.

Why do varicose veins appear in the lower extremities?

The cause of their appearance may be weakness of the walls or destruction of the valves of the veins as a result of inflammatory processes. The heart pumps blood rich in oxygen and nutrients to all organs and tissues through the arteries. The veins carry this blood back to the heart. When moving, the muscles push blood through the veins against gravity, while the valves of the veins normally pass blood in one direction from the lower extremities to the heart. When the valve flaps weaken, the blood can go in the opposite direction and stagnate, leading to a gradual expansion of the veins. Compared to other veins, the veins of the lower extremities do the hardest work of returning blood to the heart. They experience the highest pressure. And sometimes the valves of the veins cannot withstand this pressure.

Who usually suffers from varicose veins?

This disease is largely hereditary, both men and women suffer; in women, it manifests itself at an earlier age. The cause of varicose veins is not prolonged standing or sitting, although they contribute to the development of the disease. Often, veins dilate during pregnancy, both on the legs and sometimes in the perineum. They disappear completely or partially after childbirth. Varicose veins appear more often during the second pregnancy, although sometimes during the first. If varicose veins were present before pregnancy, then the likelihood of their deterioration is very high with each subsequent pregnancy. Spider veins (telangiectasias) are similar to varicose veins, but much smaller in diameter. They are located more superficially, look like tree branches or like a red or blue web, can appear on the lower limbs or on the face, covering small or large areas. Approximately 50-55% of women and 40-45% of men suffer from varicose veins to some degree.

Is varicose veins hereditary?

Not always. But there is a risk, and it increases if both parents suffer from varicose veins.

What are the symptoms of varicose veins?

• Dilated veins of the lower extremities and spider veins.
• A feeling of heaviness, fatigue and pain in the lower extremities after prolonged exertion, or after sitting for a long time (by the end of the working day), and sometimes after minor exertion.
• Swelling of the lower extremities by the end of the day.
• Cramping conditions in the lower extremities, most often at night.
• Itching and/or rashes on the skin of the lower extremities. With the slightest wounds of the shins, bleeding lasts a long time, and healing is protracted.
• Trophic changes in the skin of the shins (darkening of the skin, hyperpigmentation, sometimes its shine) and ulcers. These changes may be the only manifestation of varicose disease.

How does walking affect varicose veins?

Walking is useful for varicose veins. When walking, the muscles of the lower extremities contract, squeezing the veins, pushing blood to the heart. But if walking causes you pain or discomfort, then you need to see a doctor to find out the reasons.

What happens if some veins are turned off from the bloodstream?

Varicose veins lead to stagnation and disruption of microcirculation. Elimination of these changes is possible only by eliminating stagnation, i.e. by shutting off varicose veins from the bloodstream, which not only does not harm you, but on the contrary improves microcirculation and protects your healthy veins from deterioration and reduces the likelihood of complications to a minimum.

How to prevent the development of varicose veins?

It is not always possible to prevent varicose veins or spider veins, but some measures can reduce the likelihood of progression and the appearance of new varicose veins and spider veins. These measures in themselves help to reduce the severity of the symptoms of existing problems. Do exercises that train the leg muscles, improve blood circulation and vein function. Walk and run. Bend and unbend your feet when you stand or sit for a long time, without the ability to move. Control your weight, thereby reducing the load on your legs. Eat low-salt foods rich in fiber Do not cross your legs when sitting. Raise your legs as often as possible during the day. Try not to sit or stand for long periods of time. If this is not possible, then move and work your legs as often as possible. Stand up periodically. Wear compression hosiery and avoid tight clothing that squeezes your waist, groin, or legs. Change the height of your heels during the day. Save high-heeled shoes for special occasions.

When should you seek medical help for varicose veins?

Seeking medical help for this disease is often late and sometimes after complications have appeared. Varicose veins are an incurable disease. But seeking help at an early stage makes it possible to conduct the necessary tests, make a correct early diagnosis, conduct appropriate treatment, and also receive recommendations for prevention. It is known that correct diagnosis and treatment significantly reduce the likelihood of rapid progression of the disease and the occurrence of complications. As soon as you notice one or more of the above symptoms, you need to see a specialist. This is especially true for pregnant women and those who have close relatives who suffer from varicose veins.

What is a duplex scan of veins?

If you suspect a venous pathology, you need to undergo a duplex scan to determine the nature of the changes and their extent. This is an ultrasound examination of the veins using a device equipped with a sensor that allows you to study the structure of the veins, their elasticity, the presence of blood clots in them and the direction of blood flow. Today, duplex scanning is an integral part of the study of both superficial and deep veins of the lower extremities.

What is the most common reason for duplex scanning of veins?

The most common reason for duplex scanning of veins of the lower extremities is to exclude deep vein thrombosis and determine the presence or absence of venous insufficiency (i.e. determine the functioning of the valves).

What treatment is right for you?

After a full clinical examination, with duplex scanning of the veins of the lower extremities, allowing you to assess their condition, and after consultation with a specialist, you will be familiar with this pathology and the degree of damage to your veins. After this, your doctor will offer the treatment that suits you. I would like to draw your attention to the fact that surgical treatment is more often offered, not because it suits you better, but because not all specialists are proficient in the foam sclerotherapy method and have no experience in its use. There may be references to the fact that foam sclerotherapy is not suitable for you, and if you are treated with foam sclerotherapy, you will definitely end up under the knife sooner or later and it will be more difficult to operate on you. All this has nothing to do with reality. Foam sclerotherapy in experienced hands is a very valuable method with excellent therapeutic and cosmetic results. After surgical and laser treatment, you will still be offered to get rid of small varicose veins and spider veins with sclerotherapy, which ultimately makes the treatment more expensive and longer than foam sclerotherapy.

What happens if you do not treat varicose veins?

As varicose veins progress over time, symptoms increase, complications such as:

• thrombophlebitis
• deep vein thrombosis
• chronic venous insufficiency
• long-term swelling, skin irritation and itching end in dermatitis, eczema and trophic ulcers that are difficult to treat

What is varicose vein treatment?

Most patients think that varicose vein treatment means correcting the valves and returning the veins to normal. Unfortunately, this is impossible, so treatment means turning off varicose veins from the bloodstream. This is achieved by surgery, endovascular laser treatment, radio wave treatment, or foam sclerotherapy. As a result, congestion is eliminated, which leads to a delay or slowdown in the progression of the disease and a decrease in the likelihood of complications.

What is sclerotherapy and foam sclerotherapy?

Injections using sclerosing agents to close varicose veins have been used for over 60 years. We now know that if you mix the sclerosing liquid with gas, you get foam, which is more effective for the sclerotherapy process. This technique is virtually painless, inexpensive and well tolerated by patients.

What is ultrasound-guided foam sclerotherapy?

This is the latest in sclerotherapy. The principle of sclerotherapy itself is the same as with conventional foam sclerotherapy. Foam sclerosant is more effective. With foam sclerotherapy, the foam is traced in the lumen of the vein using ultrasound, which increases accuracy, improves efficiency and reduces the likelihood of complications to a minimum.

What are the alternative treatments?

Traditional surgery, intravenous laser treatment, radio wave treatment are also effective methods for treating varicose veins. They are more invasive than foam sclerotherapy. But after them, you will still be offered to treat small varicose veins and spider veins with sclerotherapy and foam sclerotherapy, which makes the treatment more troublesome, lengthy and expensive.

Where else can varicose veins appear?

We treat not only varicose veins of the lower extremities, but also of the upper extremities, trunk, chest and perineum. We also successfully treat varicose veins on the face (including around the eyes).

How effective is surgical treatment?

Relapse after surgical treatment occurs in 25-43% of cases within 1-5 years. Removal of varicose veins does not mean a cure, as with appendectomy - one-stage treatment - and that's it. Varicose veins are a chronic progressive disease that requires constant monitoring and correction, and repeated surgeries are usually unacceptable for the patient.

How effective is foam sclerotherapy?

Successful foam sclerotherapy will help you get rid of most (if not all) of the symptoms of the disease, and the cosmetic effect exceeds all expectations. Obviously, ultrasound-guided foam sclerotherapy is effective in the treatment of varicose veins. Studies by various authors on patient observation show that treatment is successful in 69-94% of patients over a period of 3 months to 10 years.

I had surgery for varicose veins of the lower extremities, but the varicose veins have returned. Which treatment method is best for me?

Foam sclerotherapy is the best choice in most cases. The author of this site has extensive experience in sclerotherapy and foam sclerotherapy, and believes that most patients with varicose veins of the lower extremities and venous ulcers of the legs can be successfully treated with sclerotherapy and foam sclerotherapy.

When is the best time to treat varicose veins?

We know that varicose veins are a progressive disease, and over time they affect more and more veins, thereby leading to increased symptoms and complications. Therefore, early treatment will save veins that are still functioning normally, and will save you from unnecessary suffering and complications. Expressed symptoms, trophic changes in the skin and trophic ulcers are an indication for immediate treatment.

What are the advantages of foam sclerotherapy?

Can I limit myself to treating spider veins?

We often hear from patients who have limited themselves to treating superficial veins that they are not satisfied with the results or that the situation with the veins has become worse.

Limiting myself to treating spider veins is not enough; all varicose veins must be treated, including those that caused them to appear (i.e. that feed them). In this way, you can achieve a good and lasting therapeutic and cosmetic effect, minimizing the likelihood of relapse.

Is foam sclerotherapy possible during pregnancy?

If there are no serious indications for sclerotherapy, it is better to wait until after childbirth and breastfeeding. We recommend that all pregnant women wear compression hosiery.

How long does the sclerotherapy procedure last?

The first session lasts from 15-45 minutes, often another procedure is needed to supplement the sclerotherapy and achieve the desired result.

Who can I call if I have any questions or problems?

You can call your doctor at any time of the day or night if necessary.

Call your doctor after sclerotherapy if:

• You are concerned about the injection site;
• A wound or lump appears at the site of the sclerosing agent;
• Swelling of the foot or ankle joint;
• Sudden pain and swelling appear shins;
• Any symptoms that cause you concern will appear.

Is foam sclerotherapy a safe method?

Yes, foam sclerotherapy is a safe method. The sclerosing agent has been used for many years. Allergic reactions have been described by the authors extremely rarely.

What side effects are possible?

Side effects are rare when the treatment is carried out by an experienced specialist. They can be in the form of a bruise or mild inflammation of the skin at the injection site or in the form of many small capillaries along the sclerosed vein, these phenomena disappear within 3 months.

In very rare cases, the following side effects occur, all of them pass without consequences within 05-30 minutes:

• visual disturbances in the form of the appearance of "flies" before the eyes;
• migraine attacks (in those suffering from migraines);
• tightness in the chest or dry cough.

What are the possible complications of sclerotherapy and foam sclerotherapy?

Foam sclerotherapy is a safe treatment method, complications are extremely rare and often go away without treatment, and sometimes require conservative treatment.

Over the next few weeks, discomfort or compaction may appear at the injection sites of the sclerosing agent, they disappear gradually and on their own. Severe redness, compaction or soreness requires immediate contact with the attending physician. Along the course of sclerosed large-diameter varicose veins, spherical elastic foci may form, slightly painful when pressed. They are a cluster of blood clots, your attending physician will remove them with a syringe, the density and soreness will disappear immediately.

Is hospitalization and a certificate of incapacity for work necessary after foam sclerotherapy?

Treatment is carried out on an outpatient basis. You don't need a sick leave, you can return to normal life immediately after the procedure.

Will I be able to drive a car after foam sclerotherapy?

Yes, you can!

Are there any restrictions after the procedure?

No, there are no restrictions!

When will I be able to see the results of sclerotherapy?

The time frame varies depending on the diameter of the varicose veins, their duration and intensity, from several weeks to two or three months.

Is foam sclerotherapy considered an expensive method?

Many people are surprised by the cheapness of foam sclerotherapy, especially those who are familiar with cosmetic procedures and their cost. The cost depends on the type of varicose veins, their intensity and area and is determined after a thorough examination and after duplex scanning.

Will varicose veins return after treatment?

Relapses occur in 20% of cases after surgical, laser treatment and foam sclerotherapy. In any case, repeating foam sclerotherapy in case of relapse is easy and inexpensive.

When can I do fitness?

Immediately after the sclerotherapy session!

Should compression hosiery be appropriate and the right size?

You should not buy compression hosiery anywhere, the hosiery should be the right size. You should buy it in specialized stores.

How often should I be monitored for varicose veins of the lower extremities?

Monitoring is necessary because varicose veins progress. The frequency of visits to a specialist will depend on the severity of varicose veins and the presence or absence of complications.

Recovery

The minimal invasiveness of foam sclerotherapy and its implementation on an outpatient basis allows the patient to continue his usual life, so the concept of rehabilitation in its classical sense is absent.

How long should I wear compression hosiery after foam sclerotherapy?

The patient wears compression hosiery around the clock from 1 to 4 weeks, depending on the diameter of the varicose veins. After the course of treatment, the patient wears preventive compression hosiery during prolonged standing or sitting to prevent venous congestion.

What are the possible complications of varicose veins?

As varicose veins progress over time, symptoms increase, complications such as:

• thrombophlebitis;
• deep vein thrombosis;
• chronic venous insufficiency;
• long-term swelling, skin irritation and itching end in dermatitis and eczema;
• trophic changes in the skin of the shins with the appearance of trophic.

Can varicose veins return after treatment?

Despite great success in the treatment of varicose veins and spider veins, other veins can dilate after several years. Therefore, the most important thing in this case is to carry out constant prevention, which helps to slow down and limit the progression of the disease.

How long has foam sclerotherapy been around?

The first attempts to sclerotherapy dilated veins of the lower extremities by injecting a sclerosing agent into them appeared several decades ago. Compression sclerotherapy, which is widely used all over the world, was proposed and developed by Irish scientist George Fegan in the fifties of the last century.

Foam sclerotherapy as an improved modification of sclerotherapy appeared 11 years ago.

What can be treated with foam sclerotherapy?

• Varicose veins of the lower extremities;
• Varicose veins of the perineum and buttocks;
• Cupirosis of the face;
• Varicose veins of the upper extremities;
• Varicose veins and spider veins of various localizations;
• Hemangiomas of various localizations.

Where is foam sclerotherapy performed?

Foam sclerotherapy is performed on an outpatient basis. At the end of the sclerotherapy session, the patient lies down with the lower limbs elevated for 30 minutes, after which it is recommended to walk 3-5 km.

How many sclerotherapy sessions are required?

The course consists of 2-4 sessions.

How long does each session last?

The first session lasts 30-40 minutes, the following 20-30 minutes.

What sensations can be expected during and after the procedure?

Since thin needles are used to inject the sclerosing agent, the sensations are minimal (mosquito bite).

What side effects can be expected after foam sclerotherapy?

In very rare cases, the following side effects occur, all of which pass without consequences within 05-30 minutes:

• visual disturbances in the form of "flies" appearing before the eyes;
• migraine attacks (in those suffering from migraines);
• chest tightness or dry cough.

What are the complications of sclerotherapy?

Complications after sclerotherapy are rare, and after foam sclerotherapy even rarer.

• Thrombophlebitis, as a rule, develops when the regimen is violated - when the compression is removed prematurely or when it is weakened. It is treated conservatively.
• Deep vein thrombosis - is extremely rare. It is treated conservatively.
• Seals at the injection site and hyperpigmentation over the sclerosed vein. They disappear gradually over a period of several weeks to several months.
• Appearance of spherical and oval elastic formations along the sclerosed vein with hyperpigmentation of the skin above them or without pigmentation 2-4 weeks after sclerotherapy. Aspiration of a blood clot from these formations leads to their disappearance and to the disappearance of hyperpigmentation of the skin above the vein.
• Ulcers at the injection site of the sclerosing drug appear extremely rarely.

How long should compression hosiery be worn?

From several days to four weeks. The period depends on the diameter of the vein.

When can I expect the results of sclerotherapy?

The final results can be expected, depending on the diameter of the sclerosed veins, within 1-3 months.

Is sclerotherapy an expensive method?

Despite the fact that sclerotherapy provides not only an excellent therapeutic effect, but also a remarkable cosmetic effect, it is considered a relatively inexpensive method of treatment. It is this combination that gives foam sclerotherapy its superiority over other methods.

Does microcirculation suffer after sclerotherapy?

Sclerotherapy of varicose veins not only does not harm microcirculation, but improves it, reduces the likelihood of thrombophlebitis and slows down the progression of the disease.

How long should I wait to see the results of treatment?

Depending on the severity of the disease, the result can be expected within a few weeks, although in some cases with intense varicose veins, the result appears slowly over 2-3 months. In any case, the improvement in the condition is noted before the cosmetic improvement.