Varicose Vein Treatments
Benefits of varicose vein treatment
The benefit of treating varicose veins is to reduce symptoms and prevent the long term complications developing. The visible appearance will be greatly improved but with all forms of treatment, it is possible to develop new veins elsewhere later in life. The veins that you have treated are obliterated but it is possible to develop new veins elsewhere.
If veins are untreated, they gradually spread and symptoms increase. Long standing varicose veins can lead to damaged skin with eczema, permanent brown discolouration of the skin and eventually leg ulcers which are very difficult to heal.
When veins are treated, quality of life is improved. Symptoms of aching, cramps etc go away and patients are more confident in what clothes they can wear and the activities that they can take part in without embarrassment. Ablating these abnormal veins improves your circulation and forces the blood into the deep veins where it belongs. This reduces your risk of getting a DVT.
What treatments are available?
In order to choose the right treatment for you, your surgeon will need to scan the veins in your legs to determine where the valves have broken and how extensive the varicose veins are. The aim of treatment is to destroy or remove the damaged veins and force the blood to go away from the skin and into the calf where it belongs.
ClariVein ultrasound guided ablation
10 years ago we stopped using laser and this is now our recommended treatment. It is done under a small amount of local anaesthetic. A small catheter is passed into the damaged vein and it spins round inside the vein while a type of sealant is injected to seal the damaged vein and make the body reabsorb it. You walk in and then walk out with a bandage on but with very little restriction while you recover.
Laser (EVLT)
We have stopped using laser because the multiple injections of a large volume of local anaesthetic were painful. Bruising from perforated veins was not uncommon and some people got nerve damage due to burning. You need time off work.
Foam sclerotherapy
Foam sclerotherapy is suitable for smaller veins or recurrent veins which are very twisty and which a catheter will not go up. This is again a type of sealant which blocks the damaged vein and makes the body reabsorb it.
Surgery
Surgery under a general anaesthetic is needed for advanced or large veins. This is done as a day case and will involve a cut about one inch long either in the groin or behind the knee. In addition there will be very small incisions to remove the biggest bulging veins and this gives a good cosmetic result.
Micro-sclerotherapy
Micro-sclerotherapy is the treatment of choice for thread veins or spider veins on the legs. This involves a tiny needle being inserted into a thread vein and injecting a sclerosant which destroys the abnormal vein. The thread veins then get absorbed into the body over the next few weeks. For large areas it may require more than one session and these are at least 4 weeks apart so that we can see how much things have improved. This gives a huge improvement in the cosmetic appearance but you can never remove every visible vein.
Pam Pearson is our sclerotherapist who is also a qualified nurse. She has many years experience as a recognised therapist treating thread veins.
What is the best treatment for Varicose Veins?
Outcomes of different treatments for varicose veins
Treatment of varicose veins using ClariVein Ablation
Treatment of reticular veins using foam sclerotherapy
Example Varicose Vein Treatments
Frequently asked questions about Varicose Vein Treatment
How do you diagnose varicose veins?
Varicose veins can be unsightly blemishes on your legs which are often knobbly, blue lumps. They can cause pain and discomfort, aching and swelling as well as painful complications like phlebitis and leg ulcers. However, they also may affect your self-confidence on the beach, in the gym and how you dress. In addition, you may have thread veins. Major veins must be treated first if treatment of thread veins is to be successful. Therefore, the starting point is to have a consultation with a free Colour Duplex Ultrasound Scan which will diagnose exactly what the problem is and enable us to give you personal advice as to what the best options for you are.
What happens if I don’t have them treated?
The natural history is that slowly varicose veins get worse. This can take many years but how quickly they deteriorate is difficult to predict. Once complications such as skin changes happen, it may be too late to fully reverse the changes and then we can only stop things getting progressively worse.
If you develop a break in the skin at the ankle, this is called an ulcer, this normally takes 3-12 months to heal and unless the underlying varicose veins are treated, recurrent ulceration will happen much quicker.
Older patients often don’t consider treatment because they associate treatment, with out of date procedures such as surgical stripping of varicose veins. Modern treatments are particularly good in this situation.
Is treatment available on the NHS?
The NHS does not offer varicose vein treatment for cosmetic reasons, however if you have complications such as phlebitis, skin colour changes, itchy eczema or ulceration, treatment is available in some locations.
What treatments are available?
We can help you improve the appearance of your legs and also offer relief from pain, discomfort or complications such as phlebitis, eczema or leg ulcers.
We offer both surgical and non-surgical treatments, but we will discuss what option is best for you at your initial appointment. Treatment choices depend on the type of varicose veins you have as shown by your scan. In addition we need to know about your general health and what you would like to achieve.
Providing the results that you want is at the centre of what we offer you. Once your major veins have been dealt with we can discuss your cosmetic requirements. This may involve cosmetic creams, micro-injections or tiny amounts of laser to thread veins. We will therefore explain your choices to you, every step of the way.
Do I need to do anything before treatment?
You will have a formal consultation with a healthcare professional. During this time, you will be able to explain your medical history, symptoms and raise any concerns that you might have. For local anaesthetic procedures there is no other preparation. For surgery, hair removal may be required from the affected area.
Who will do it?
Mr Stephen Blair is an internationally recognised venous surgeon and will personally carry out all procedures. These are mostly done as outpatient procedures in a new treatment room in Rodney Street, it takes about 45 minutes. However, if the veins are very advanced, surgery may be necessary in about 2% of patients. This will be carried out as a daycase at Murrayfield Hospital.
What happens after treatment?
For all treatments you will need to have compression applied to the veins to keep them squashed flat and empty of blood. This involves having a bandage on for one week. However, this is applied so that you can fully bend your knee, to be able to drive and continue normal activities. You will be given a waterproof protection bag so that you can shower without getting the bandage wet.
For non-surgical treatments you can walk in and walk out before returning to normal activities. Detailed instructions will be given to you before you have your procedure so that you know what to expect.
How long is it before I can return to the gym, driving and full activities?
The DVLA says that you cannot drive after a procedure unless you are safe to do an emergency stop. Therefore, you should make sure that you can do this without pain.
As a general rule, if you are pain free, you can do whatever you like. The more minor the procedure, the sooner you can get on with life. For ClariVein ablation most people can drive home, walk around freely and return to the gym after 1-2 weeks.
When can I fly abroad?
There is no medical reason why you can’t fly short haul after a procedure. However, the more extensive the procedure, the more uncomfortable you will be in getting to the airport, carrying bags and being worried about being hit where you have had your treatment. Everyone should wear flight socks on long haul flights.
What follow-up arrangements are there?
You will be given a phone number where you can contact us after your procedure. All patients will be invited to have a free follow up appointment about 1 month after the procedure. If further treatments are needed, they will be arranged then and fees quoted. If you are willing, we will inform your GP of what we have done so that they can also support you.
Do "Alternative" treatments work?
The simple answer is no. Varicose veins are a mechanical problem due to broken valves. No dietary change, exercise, vitamins or anything else can restore the broken valve. Fake tans. lotions etc can hide the veins temporarily