Monday, February 28, 2011

Is there a connection between hormones and spider veins?


Yes, another factor related to increased incidence of spider veins during pregnancy is the female sex hormone- estrogen. Estrogen is known to soften the vein wall and the valves which control blood flow. The stretching of the veins is believed to cause an increase in blood engorgement- which eventually leads to spider vein formation.

During the last trimester of pregnancy, the fetus may put pressure on the leg veins by compressing the lower pelvis. For this reason it is highly recommended that pregnant females lie down on their left side to prevent the fetus from lying on top of the leg veins. Multiple pregnancies are often associated with numerous spider veins which rarely resolve.

I noticed that during my pregnancy I developed spider veins. Is there a connection?


Spider veins are common during the latter stages of pregnancy. This is thought to be due to an increase in body weight and retention of fluids. The increased fluid retention leads to engorgement of veins and which causes pressure on the smaller branch veins. These small branch veins with thin walls become distended and frequently rupture.

During the last trimester of pregnancy, the fetus may put pressure on the leg veins by compressing the lower pelvis. For this reason it is highly recommended that pregnant females lie down on their left side to prevent the fetus from lying on top of the leg veins. Multiple pregnancies are often associated with numerous spider veins which rarely resolve.

My mother has spider veins. Does that mean I will develop them also?


There is a higher incidence of spider veins in siblings if any one of the parents or other siblings has spider veins. The pattern of inheritance is not exactly known or understood. Spider veins have not been associated with any known medical disorder. They are harmless but some women find them cosmetically unappealing.

I am only 33 and have many spider veins on my face. Is this related to aging?

Spider veins are rarely seen in children and teenagers. Most individuals develop spider veins after the 3rd decade of life. As people get older, the spider veins do increase. Elderly individuals have very friable skin and easily develop bruising and spider veins.

What exactly are spider veins?

Spider veins are small veins which are located just below the skin surface. They are called spider veins because on close observation they resemble a dark center with fine radiating lines in a circular fashion. Other names by which spider veins are often known as include “star” veins or telangiectasias. Spider veins are common and most individuals (especially females) have one or multiple spider veins somewhere on their body. Spider veins are generally more common on the legs, especially around the thigh and ankle area. Even though they occur in all ethnic populations, they are most obvious in fair skinned individuals. Because of their prominent bluish color, they are considered a cosmetic nuisance by most females.

Friday, February 25, 2011

Is Endovenous laser therapy for varicose veins treatment covered by insurance?


Despite what doctors’ claim, the majority of health plans do not cover this procedure. It is entirely cosmetic in nature. The rare patient who has documented symptoms may be offered coverage by the health plan. For those with no medical coverage, the average cost of EVLT ranges from $300-600 per leg.

IS Endovenous laser therapy used to treat spider veins?


No, spider veins are best treated with simple laser treatment or sclerotherapy

What are other minimally invasive options for treating varicose veins?


Instead of using a laser, one can also use radiofrequency ablation as a probe. The entire procedure is the same except that radiofrequency ablation utilizes electrical heat instead of thermal heat. The treatment with radiofrequency ablation is only slightly longer by a few minutes. The cost, complications and recovery time is the same for both procedures.

How do I know that my varicose vein has disappeared?


After 1-3 weeks, you will be seen by a doctor who will perform an ultrasound to confirm that the vein has closed off.

What happens if the Endovenous laser therapy does not close my vein?

If endovenous laser treatment does not close a vein, you will need a second treatment. In some cases vein surgery is recommended.

How effective is Endovenous laser therapy for varicose veins?

Most data indicate that EVLT is as good as surgery and most patients are satisfied with the results. There have been a few failures and these have mainly been due to inexperienced physicians and faulty technique.

What are the limitations of Endovenous laser therapy procedure?


In those individuals with tortuous and small thrombosed varicose veins, the physician may not be able to pass the catheter through it. The procedure is only used to treat large varicose veins above the knee. Varicosities below the knee are not treated with EVLT.

Is Endovenous laser therapy procedure suitable for everyone?


The EVLT procedure is only used to treat the large varicose veins. It is not suitable for spider veins. Normal veins should not be removed, because future open-heart surgery may require the use of these veins. EVLT is best for individuals with large varicose veins in the thigh area.

What are potential complications associated with Endovenous laser therapy?


Complications of EVLT include:

-   Vein perforation
-   Blood clot formation
-   Blood clot in lungs (pulmonary embolism)
-   Inflammation of the vein (phlebitis)
-   Blood collection (hematoma)
-   Infection
-   Paresthesia (numbness or tingling)
-   Skin burn.
-   Nerve damage
-   Extensive bruising of the skin
-   Pain
-   Failure of the procedure to work

Complications are quite common as there are many non trained health care workers doing the procedure

I am 24 years old and 32 weeks pregnant. Can Endovenous laser therapy be done during pregnancy?

No, it is best to wait until the pregnancy is over. In most cases, the varicose veins will subside after the baby is delivered

What are benefits of Endovenous laser therapy for varicose veins?

Compared to the conventional varicose vein surgery, EVLT offers a number of benefits which include:

-  It is relatively fast
-  It is relatively safe
-  Less extensive procedure
-  There is minimal pain after the procedure
-  There is less bruising
-  There is only one very small incision
-  There is little downtime, most individuals are able to return to work in 1-2 days
-  There is no use of general anesthesia

What are side effects of Endovenous laser therapy for varicose veins?

Side effects include:

- Skin discoloration
- Mild skin burns
- Burning pain
- Numbness
- Bruising
- Change in skin texture

The majority of these side effects disappear in 10-14 days. There are hundreds of doctor performing this therapy, most have learnt to the procedure after a weekend course and the majority of these people are technically incompetent. You always want to go to a doctor who is able to take care of the complications, when they occur. Most of the doctors who run vein clinics are able to tell the mouth from the a..e.

When will I see the results of Endovenous laser therapy for varicose veins?

The vein takes about 2 weeks to shrivel up. The final cosmetic result is not seen for about 2 months. If the doctor has goofed up, then your varicose vein will be there forever.

When does one resume normal activities after Endovenous laser therapy?


Most individuals return to work the following day. All individuals are encouraged to ambulate the first day. However, heavy exercise should be delayed for about a week.

Is Endovenous laser therapy for varicose veins painful?

There is mild pain during the procedure. However, prior to the procedure, the doctor will inject some local anesthetic to numb the area. If your skin is thin, then you will feel a burning sensation, which is often not tolerable. Once the procedure is over, there is minimal pain

How long does Endovenous laser therapy for varicose veins take?

The average time for the procedure is about 30-45 minutes. One can expect to be at the doctor’s office for about an hour. There are now hundreds of doctors running vein mills and most people are in and out in 20-30 minutes. Of course, there is no guarantee that the doctors know what they are doing but they can all count the money.

How is Endovenous laser therapy for varicose veins performed?


EVLT is done as an outpatient procedure and can even be done during a lunch break. Ultrasound is required to observe the vein during the entire procedure. Your leg will be exposed from the groin to the lower thigh. A small amount of local anesthetic will be injected in your thigh and the entire leg will be cleaned with a sterile solution. Following this a small needle will be inserted in the vein at the thigh and through the vein, a small laser probe will be inserted all the way to the origin of the vein in the groin. When the probe is in the correct place, the laser is fired. The energy generated from the probe slowly causes the vein to collapse. The catheter is then slowly withdrawn while heating the entire vein.  After the procedure, a small dressing is applied to the incision and a compression dressing is applied around the thigh.

Are there any preparations required for Endovenous laser therapy for varicose veins?


No, but you must have the cash up front .There are no special preparations required for EVLT. During the procedure, your eyes will be protected against the laser beam with special dark glasses. If you are taking Aspirin or any blood thinners, you will need to discuss this with your doctor. In most cases, blood thinners should be stopped at least 1 week prior to the procedure.

Can Endovenous laser treat varicose veins in the entire leg?

No, EVLT is only used to treat varicose veins in the upper thigh. For the lower leg, you will require surgery or sclerotherapy

Is endovenous laser a permanent cure for varicose veins?


The only thing permanent in life are herpes  and death. EVLT is not a permanent cure for varicose veins. Over time, anywhere from 5-15 percent of people will have recurrence of varicose veins, which are smaller. If the doctor makes an error and the vein is not properly heated, then you will have recurrence immediately.

How does Endovnous laser treatment for varicose veins work?

The laser probe is inserted into the vein and when the probe is activated it heats up the vein. The heat energy generated by the laser probe causes the vein to collapse. Once the vein is collapsed, it is replaced by a thin fibrous scar.

How long does endovenous laser for varicose veins treatment take?

The entire procedure is visualized by ultrasound. The laser probe takes a few minutes to burn the vein with minimal complications. The procedure is fast, effective and has little or no pain. In addition, this novel procedure is done as an outpatient, involves a small incision and results in rapid recovery. Patients can have the procedure done during lunch break.

I have varicose veins and my doctor says I should undergo endovenous laser treatment? Can you explain to me what this involves?

EVLT is a relatively new method developed to treat varicose veins. The procedure is done by inserting a thin laser fiber into the vein around the thigh. The laser fiber is then inserted all the way up the groin and turned on. The heat generated then destroys the vein. The laser fiber is gently pulled as it is pulled out and the entire thigh vein is destroyed.

Thursday, February 10, 2011

Can Spider veins be cured permanently?


No, spider veins cannot be cured. One can eliminate them for a few months but they do recur over time. Do not listen to health care professionals who tell you that laser can permanently cure spider veins. Only thing permanent in life are herpes and death

What are the available treatments for spider veins on the legs?


Spider veins can be treated with either:
-       compression stockings
-       sclerotherapy
-       laser
-       camouflage creams

Surgery is never used to treat spider veins. The best treatment for spider veins is compression stockings.

What conditions are known to cause spider veins?


The most common conditions that are associated with spider veins include the following:

-  female gender
 pregnancy or multiple pregnancies
- obesity or recent weight gain
- standing for prolonged periods
- trauma

If you are a female and have any of the above features, your chances of developing spider veins are high

I am 27 and have spider veins. Can spider veins cause leg pain or swelling?


No, spider veins cause no symptoms. They are generally 1-2 mm in size and not capable of causing any leg swelling or pain. If you have symptoms of leg pain or swelling, then the cause may be something else. Spider veins are harmless and usually disappear on their own.

I am a 27 year old female and have numerous spider veins on my legs. Are spider veins harmful?


No spider veins cause no ill health and are only a cosmetic concern to most females. If they do not bother you, they are best left alone. To prevent them from becoming obvious, wear compression stockings.

What causes spider veins in the legs?


Spider veins are associated with any condition that causes increased pressure in the tiny superficial veins. These small veins carry a small amount of blood and are very thinned walled. Anytime there is increased pressure in these veins, they will become engorged with blood and become prominent. Sometimes they rupture and present like a “star shaped” vein. Common conditions that increase pressure in veins include weight gain, pregnancy, sedentary life style and use of the birth control pill

What exactly is sclerotherapy?


Sclerotherapy is a procedure which requires the use of a chemical to destroy the spider veins. It involves injections of a special chemical (sclerosing agent) with a fine needle in each spider vein. The procedure is time consuming and a little painful. Because of the pain, most people can only tolerate injection of 10-15 spider veins in each session. After the procedure, compression stockings have to be worn for the first 2-7 days. The results after sclerotherapy suck. Sclerotherapy can only be utilized on the leg and not the face.

How effective are lasers for spider veins?


Laser is an excellent option for treatment of spider veins. It does not require the use of any injections and is a much faster procedure compared to sclerotherapy. However, most individuals require repeat sessions. The laser works by destroying the small veins so that blood can no longer collect in them. On the downside, laser is more expensive and has the potential to cause permanent skin complications.

Can Spider veins be cured permanently?


No, there is no treatment available today that can permanently cure spider veins. With any type of treatment, spider veins will recur sometime in the future. Even with laser treatment, spider veins will return within 3-6 months.

What causes spider veins?


Spider veins usually appear spontaneously. There is an association of spider veins with prolonged standing, obesity, pregnancy and minor trauma. Spider veins do run in families and are most commonly seen in females. Any condition that increases the pressure in the superficial veins will cause spider veins.

Can spider veins cause leg swelling or pain?


No, Spider veins are so minute and superficial that they do not cause any symptoms. In any individual with complaints of pain or muscle aches, another cause must be suspected.

What exactly are spider veins


Spider veins (also known as telangiectasias) are small “star” shaped bluish veins which are often found on the face and legs. Spider veins, unlike varicose veins, are very superficial and close to the skin surface. They are called spider because from the dark center of the vein are linear radiating smaller veins. Spider veins tend to be more prominent on the thigh, just below the knee and around the face

Spider veins are more often visible in light skinned people and appear to be more common in females. The smaller spider veins may resolve on their own but the majority persist and get darker. Spider veins never cause any symptoms and are of only a cosmetic concern.

Monday, January 17, 2011

What is sclerotherapy for spider veins?

Sclerotherapy is a very old treatment for spider veins. The procedure involves injection of an irritant chemical into the spider veins. The chemical destroys the vein over time. However, multiple injections (15-20 per session) are required and it is moderately painful. Unlike the laser, sclerotherapy takes a little longer to be effective. After the procedure, compression stocking have to be worn for 7 days. The results of sclerotherapy suck. Most women who have undergone one session, never go back again for another treatment.

What treatment do you recommend for spider veins on the legs?

Personal choice is a trial of compression stockings. For those women who have not made up their mind about other treatments, compression stockings may be the cheapest and most effective way of preventing more spider veins. These stockings unfortunately cannot remove the spider veins which are already present. A negative aspect for compression stockings in the South is the hot weather. The stockings are tight and can be uncomfortable to wear during hot weather.

How can I prevent spider veins on my legs?

For those who are not sure about laser or sclerotherapy, preventive measures may help future occurrence of spider veins. The preventive steps include:

- avoid prolonged sitting or standing
- wear compression stockings on a regular basis
- keep active and exercise regularly

Are there any vitamin based creams that can remove my spider veins?

There are many creams which are marketed with newly discovered vitamins (vitamins which no one else knows about -like vitamin P and Z). Claims are made that these new vitamin-based creams can make spider veins disappear. There is not a single spider vein cream on the market which has been shown to erase spider veins. The business of skincare & cosmetics has many individuals who prey on desperate people, giving false hopes and illusions of grandeur.

These expensive creams are at best moisturizing agents and with some fancy scent. Every single ad on cyberspace offers these products with gimmicks like buy one and get one for free. If these products did what they are claimed to do, why give away one for free? Why push people to buy 3 jars or buy a minimum of $100?

Best advice: Save your money and stop wasting money on products which only make you smell good and do nothing for your spider veins. If you are that concerned about your spider veins, go and see a reputable dermatologist or a cosmetic physician. In the end you will not only save money, but have the result you so desire.

Can vitamin K creams remove spider veins? I want something cheap

Many skincare manufacturers are making claims that vitamin K creams have the ability to penetrate skin and make spider veins disappear- continue dreaming because this is the most absurd thing ever. There is absolutely no vitamin, nutrient or herb which can be applied on skin and make any vein disappear. Vitamin K can only be absorbed from the gut or given as an injection. In medicine, vitamin K is never used to treat spider veins- because it just does not work. Millions of patients have been treated with vitamin K and they all continue to have spider veins. So save your hard earned money for something more important like food and rent. If you have the money and can’t live with your spider veins, go get laser- you will get short term relief.


Are there any creams that can help remove my spider veins?

All over the internet, there are new ads marketing spider vein vanishing creams and ointments. Claims of immediate results, painless therapy and excellent cosmesis are highly touted virtues of these so called spider-vein-creams. In reality most of them are only camouflage creams and the rest are moisturizers (most just contain Vaseline with some additive). In reality, there is no cream or ointment that can remove spider veins. If you got money, go for laser, and if you do not have money, learn to live with your spider veins- they are harmless

What is the best treatment for spider veins?

Spider veins are small bluish veins which resemble “stars” with radiating lines. They may appear anywhere on the body, but are common on the face and legs. On the face these veins have been linked to excess sun exposure and on the legs they have been associated with increased venous pressure. Over the past 4 decades, many treatments have come and gone for the treatment of these cosmetically unacceptable veins. Today, we have laser and sclerotherapy. Sclerotherapy is only used for the legs veins. Even though neither of these treatments is curative, they do erase spider veins for some time.

Tuesday, January 11, 2011

Do varicoceles cause complications?

For those who have had long standing varicoceles some complications have been associated with it. However, not all individuals with varicoceles develop these complications. The complications include:

- Small testes. In many men who have varicoceles, it is found that the testis on that side is slightly smaller compared to other side. Why the testicle shrinks is not known but most probably related to the pressure in the veins.

- Infertility. Varicoceles have been associated with infertility. However this is not a universal finding. About 40% of men who have varicoceles are infertile. However, reversal or treatment of the varicocele does not always result in return of infertility. It is thought that the high temperature from the increased blood affects sperm production and motility.

Final point- Keep in mind that surgeons in North America tend to hype up the seriousness of varicoceles so that they can operate more and make money. Thousands of men all over the globe have varicoceles, never see a surgeon and live a normal healthy life.

I have been told that I may have a varicocele. How is the actual diagnosis made?

Some men may not know they have a varicocele. In most cases the diagnosis is made by the doctor. The scrotum is gently palpated and if no varicocele is apparent, you may be asked to bear down (like pooping). This force will cause engorgement of the veins and the varicocele will become prominent. The “bag of worms” will be more prominent during this maneuver. Varicoceles are always more prominent when standing up than when lying down.

To confirm the presence of a varicocele, an ultrasound may be ordered. This non invasive painless test can reveal the presence of the varicocele, its size, and even the flow reversal. In addition, size of the testis can be determined.


How can varicoceles cause infertility?

It is believed that when the veins in the testes get engorged with blood and the temperature of the scrotum increases. When the temperature of the scrotum increases, the sperms are damaged and hence sterility results. In males who have varicoceles and sterility, both a decrease in number and structural defects of  sperm have been seen. However, sterility does not occur in all men who have varicoceles. Millions of men with varicoceles have gone on to have successful families.

How does one develop a varicocele?

The reasons why varicoceles occur are numerous but the most common reason is that the valves in the veins are defective. These valves usually close and prevent backflow of blood into the scrotal veins. When the valves are defective the veins get engorged with blood. In the elderly male, the reason why varicoceles occur is that they may be a blockage of the veins draining the scrotum. The blockage is usually due to a cancer or a mass.

In some males, there may be a history of trauma to the groin or scrotum and this may have disrupted the vein or the valves. The reason why varicoceles are most common on the left side is due to the anatomical differences in drainage of the veins from the scrotum.

How do I know if I have a varicocele?

Many men who have a varicocele do not always have symptoms. In most cases, the varicocele is identified as a coincidental finding or during the work up of sterility. Varicoceles are small and most are about 1 x 1 cm but  some may be larger. Once a varicocle occurs it generally tends to grow in size. For the male who likes to keep on fondling his “Kahounas”, the varicocele may feel like a “bag of worms”. Some may complain of heaviness in the groin which is usually worse at the end of the day. Others may complain of a drag-like sensation in the groin. However, the pain is generally mild in nature. In most cases, the varicoceles do tend to grow over time.

Is a varicocele linked to infertility?

Varicoceles have been linked to male infertility but the topic is by no means clear and the data are conflicting. Some men who do have varicoceles are sterile but many more men do have varicoceles and have no evidence of sterility. In most cases, the varicocele may exist without the individual knowing about it. Varicoceles are most common in males aged 15-35. In the majority of cases, a varicocele develops on the left side and very rarely, they are bilateral. In reality there is no association between a varicocele and infertility

My doctor says i have a varicocele. What is a varicocele?

Varicocele is a collection or engorgement of veins in the scrotum. These veins normally take the blood away from the testes into the abdomen. A varicocele is very similar to varicose veins which develop in the legs. It is estimated that at least 20% of men have varicoceles and the figure may even be higher because many men do not even known if they have it. In those men who are sterile, the incidence of varicoceles has been reported to be as high as 40%.