Veins

What causes varicose veins?
Varicose veins are mainly caused by oestrogen, prolonged standing, obesity and inheritance. There is usually a source of high pressure from incompetent or damaged valves.

How are the damaged or incompetent valves located?
An ultrasound Doppler examination is performed to locate these high pressure points. Treatment proceeds from the largest veins to the smallest veins working from the groin towards the toes.

How are the veins treated and removed?
In the past veins were cut out (stripping) but advances in ultrasound guidance and foaming have made sclerotherapy (injections) so effective that surgery is not as common.

How does sclerotherapy work?
The solutions cause the inside of the veins to scar. Compression garments help the walls of the veins to scar together and keep out blood so reducing side effects. These are worn continuously for the first week, and during the day for the second week.

Will the veins go entirely?
Most veins will disappear completely. Some of the small reticular veins can be more difficult to treat and may not resolve. People who are on oestregen and who do not wear their stocking can develop telangiectatic matting. These are fine capillaries that look like a blush in the skin. For most people this resolves spontaneously over three to six months.

Does sclerotherapy hurt?
It can be uncomfortable but most people seem to tolerate it very well. Anaesthesia is never needed.

How soon can I return to work?
You will not need any time off work.

How many treatments will I need?
Most people need a course of six treatment sessions lasting for about 30 minutes each. Larger veins are easier to treat. Spider veins need more injections and do not respond as well.