Vein Treatments & Symptoms

Varicose veins

Varicose Veins are usually caused by an incompetent valve system allowing blood to return from the deep veins into the superficial veins just beneath the skin. The increasing pressure in the thin walled skin veins can then lead to an increase in size of these veins and further failure of valves.
 This can result in rapid progression to visible and palpable varicose veins.

Retrograde flow of blood leads to mixing of oxygen-deprived blood with oxygen-rich blood resulting in low levels of O2 and reduced nutrients in the skin. This can lead to the
following symptoms:

Varicose vein symptoms

• Discomfort and pain (usually worse as the day progresses and into the evening).
• Itchiness associated with dry skin.
• A burning sensation.
• Restless legs at night.
• Swelling of the ankles.
• Changes in skin quality.
• Brown-black skin discolouration (severe cases).
• Varicose eczema around the ankles and ulceration (severe cases).
  
   

Treatment

The traditional options of surgical “stripping”, tying or avulsion have been refined over recent years but still require a general anaesthetic. The Skin Institute's vascular surgeons can perform this procedure for you in one of our purpose built day-stay facilities. Recovery time is between 1 and 2 weeks with only minimal bedrest in the first 12-24 hours. No follow up treatments are usually required.

Another option has been refined over the last 10 years - Endovenous Laser Ablation (EVLA). This treatment involves the passage of a laser fibre into the affected vein under local anaesthetic and subsequent internal cautery and closure of the vessel. The remains of the treated vein immediately scar shut and will be absorbed by the body within 3-6 months.

Usually this treatment needs to be augmented by Ultrasound Guided Sclerotherapy (UGS) to the lower legs and/or smaller tributary veins in the thighs. Recovery time is rapid with the ability to return to work on the following day with only minimal discomfort. Compression stockings need to be worn for 3 weeks. 
Follow up treatments are usually scheduled for 1 week, 3, 6 and 12 months.

In isolation Ultrasound Guided Sclerotherapy (UGS) treatment can provide good success rates but is not comparable to surgery or EVLA. However, tortuous veins or small calibre veins that are too small to admit a laser fibre leave only this option. It is particularly effective for recurrent varicose veins. We have achieved good results with closure rates close to 90% at one year but recommend the combination of EVLA and UGS as the most reliable non-surgical treatment option.

The choice of which of the three treatments is most suitable for a patient is based on a duplex ultrasound mapping of the veins. Patients with varicose veins should always have an
ultrasound map before any intervention or treatment. Insurance companies usually cover
the cost of this.

Spider veins, venous lakes and blue veins

Spider veins are a cosmetic complaint usually associated with fair skin colour making superficial veins more visible. Pregnancy can worsen the appearance of spider veins.

Treatment

There are easy and very successful treatments for spider veins available, usually through injection of a sclerosant substance (Sclerotherapy) that collapses the vein essentially closing it from further blood supply. Stockings need to be worn for about 2 weeks after this treatment.

Immediately following treatment, the veins may become swollen and bruised, the area treated will have a raised appearance at the injection site and you may experience some temporary discomfort or
itchy sensation.

Venous lakes and blue veins sometimes require small operative procedures under local anaesthetic. It is important to have your complaint assessed by a specialist nurse or doctor to exclude more serious underlying disease.

Click the Book a Vein Consultation button below to arrange your assessment. Treatments may be covered by medical insurance where medical necessity criteria apply.