The following bullet-points provides an overview of the information on this page:
Frequently Asked Questions
Q: What are the symptoms of varicose and spider veins?
A: Varicose veins develop gradually and progressively. They are unsightly and are often a source of considerable discomfort. Symptoms often become worse during the menstrual cycle and pregnancy. The symptoms can include:
- Aching, tenderness
- Heaviness, fatigue
- General restlessness in the legs
- Burning pain
- Throbbing pain
- Itching
- Leg cramps, particularly at night
- Ankle swelling
- Skin discoloration at the ankle
- Skin ulcers above the ankle
Q: Are varicose veins preventable?
A: Varicose veins are not preventable; however, there are some things you can do to ease mild symptoms:
- Exercising to strengthen leg muscles to help push the blood back to the heart (walking, bicycling, and swimming are recommended).
- Maintaining ideal body weight
- Wearing graduated elastic support hose that are properly fitted to your size and with the compression level recommended by your physician
- Elevating the legs eases discomfort
Q: What happens to untreated varicose veins?
A: Varicose and spider veins will not disappear by themselves. The effects of faulty valves and the pressure of gravity continue to work on the veins, causing them to stretch further and to become more extensive.
The changes in the size and number of varicose and spider veins are difficult to predict. They vary greatly from patient to patient. Some varicose veins do not change but recent studies indicate that 20% of untreated varicose veins worsen and become leg ulcers, which are painful and difficult to heal. Therefore, it is important to pay attention to symptoms and to have a thorough clinical evaluation.
Q: How are varicose veins treated?
A: Injection of a sclerosant medication into the vein or sclerotherapy is the safest, simplest, and most effective treatment method for spider veins as well as larger veins. It has proven to be a successful method of treatment for over a century. It is minimally invasive and almost painless. No anesthesia is necessary and it is done in our offices. There is no down time: you may resume your normal daily activities. It has replaced painful, debilitating surgery and proven to be superior and much more cost-effective than other procedures in the treatment of larger veins.
Q: How is Sclerotherapy done?
A: A specially trained physician performs this procedure using a very fine needle to inject a safe, effective sclerosing agent directly into the blood vessel. The effectiveness of the procedure comes as a direct result of the training, experience, and judgment of the physician to make sure that the sclerosant’s volume, concentration, and exposure time are exactly right.
The solution displaces the blood in the vein, causing it to immediately appear lighter in color and sometimes vanish. Further, the solution irritates the vein lining, causing it to collapse and blocking it from getting more blood. Within a few weeks the unused vein is absorbed by the body and disappears.
The number of injections done in one session and the number of treatments required varies according to the size and location of the veins and the patient’s overall medical condition. The Sclerotherapy procedure for large veins takes about 30 to 45 minutes. Typically, several visits, usually fifteen to thirty minutes long, are scheduled a few weeks apart for spider vein treatment. The first treatment for large veins is followed up three to weeks later and veins that were not treated are injected. There is another follow-up at three months and then again at a year. A laser may be used in later treatments to obliterate the smallest remaining veins and discoloration.
It is important to complete the series of recommended treatments to make sure that all of the veins have been removed. Many patients quit treatment once their legs look good enough. This is a mistake because venous disease is progressive and the remnants of the veins left in the legs can quickly grow into more veins.
Q: What results can I expect from treatment?
A: Your legs will look worse before they look better; however, spider veins generally respond to treatment in three to six weeks while larger veins respond in three to four months. Symptomatic relief is almost immediate because eliminating varicosities actually improves the body’s ability to carry blood by redirecting it to the healthy veins. Scelerotherapy has a success rate of 80-90% when done by an expert.
For spider veins, most people require two to five treatment sessions. Some people do not see visible results until after the second session. Spider veins develop over a period of years and do not go away by one treatment session although some patients report that symptoms resolve as early as after the first injection session.
Q: Do veins grow back after they are removed?
A: Effectively treated varicose veins do not grow back. New veins may appear over time because if you have weak valves in other veins as well. Over time, multiple factors cause the weak valves to give, eventually forming what appears to be new varicose veins. Think of sclerotherapy as maintenance for the looks and life of your legs.
Q: Is circulation impaired after vein treatment?
A: No. On the contrary, removal of diseased vessels improves circulation because varicose veins are a burden on your circulation. In treating varicose veins, we eliminate only the bad veins, leaving the healthy veins, which the body naturally uses to return blood from the heart.
Q: Is Sclerotherapy painful?
A: There is minimal pain in sclerotherapy but individual injections can cause a slight burning sensation, similar to an insect bite, for a few seconds. We use a sclerosant that was developed as a local anesthetic so it does not sting or burn like some other sclerosants. No pain medication is required to have sclerotherapy.
Q: Is Sclerotherapy safe for everyone?
A: You should wait three months after major surgery or pregnancy. People with clotting disorders, suppressed immune systems, those with deep vein thrombosis or incompetence, and patients who cannot walk for other reasons are not good candidates for vein treatment.
Q: What are the concerns with Sclerotherapy?
A: No medical therapy has a 100% cure rate or is performed with 0% risk; however, complications are uncommon and relatively minor. Possible side effects include redness and swelling on the injection site, but these typically go away in a day. Brown lines or spots sometimes appear on the site where larger veins were treated. These generally disappear within a year. There can be temporary bruising or a mild allergic reaction to the sclerosant but this is quite rare. Lumps can appear in injected vessels. This coagulated blood and not dangerous.
Q: What to expect during your first visit
A: To save time, you will be emailed paperwork to fill out before your visit. At your first visit, we take a history and do a focused physical exam. Your circulation will be tested with a non-invasive Doppler which will show exactly what type of problem exists and where. The junctions between the deep venous system and the superficial veins are looked at as well as perforator junctions. Your physician will then make an individualized treatment plan based on the result of your history, physical and ultrasound examination. Expert diagnosis is the beginning of good care.
After your medical consultation, one of our office staff will then discuss pricing and the possible involvement of insurance. Our insurance specialist will assist you to maximize your benefits. The evaluation, ultrasound, pictures and discussion will take about 45 minutes. We will provide you a pair of disposable shorts for the examination.
Q: Can I have treatment after my first vein consultation?
A: Yes, if you anticipate having your vein procedure done during the first visit, let us know and we’ll schedule you with time allotted for treatment.
Q: Do you treat hand veins?
A: Prominent hand veins can be treated with sclerotherapy. Enlarged hand veins are normal and do not cause pain. They appear more prominent as one ages as a result of decreased collagen in the skin. As the skin becomes thinner, the hand veins appear larger. Treatment is purely cosmetic.
Q: Do you treat facial veins?
A: Yes. The latest generation of technology has just arrived. The newest device for treating small veins is beyond laser technology; The veinwave device uses radiofrequency energy.
Q: What do I do before treatment?
A: You should avoid certain medications prior to sclerotherapy. Tetracycline or Minocin, both antibiotics, may possibly cause a staining of the skin if taken 7 to 10 days before or after sclerotherapy. Ask your doctor about other medications you may take. Do not take aspirin, ibuprofen (i.e., Advil and Nuprin) or other anti-inflammatory medications for 48-hours before and after sclerotherapy because these medications might interfere with the action of the sclerosing agent. Tylenol is permitted. Prednisone also decreases the effectiveness of the sclerosing agent. Ask the doctor who prescribed your medication to see if it can be safely discontinued for 4- hours before the sclerotherapy procedure. No lotion is to be applied to the legs before or after sclerotherapy. If you have compression hosiery from previous treatments, please bring them with you so we can make sure they will provide adequate support after the sclerotherapy procedure.
Q: What do I do after treatment?
A: You will be able to drive yourself home. You may resume your regular activities and are encouraged to walk. Avoid prolonged sitting or standing. Immediately after the procedure, a pair thigh-high compression stocking is applied to each treated leg and is worn for 72-hours continuously to promote healing and keep the blood from collecting under the skin. After 72-hours,you may remove the hose and take a warm shower. The injection sites may be washed with a mild soap. Wear compression hose for the next two – three weeks during the day. For large vein treatments, tighter compression is worn for a longer time. You will be instructed specifically.
After the procedure, avoid aspirin, ibuprofen, and other anti-inflammatory medications for at least 48-hours. Tylenol may be used if needed. Do not take hot baths, sit in a whirlpool or sauna, apply hot compresses, or any form of heat to the injected areas for 48 hours after treatment. In addition, avoid direct exposure to sunlight (sun bathing , tanning beds, jogging, high-impact aerobic,s and swimming for two weeks after the procedure).
Q: Will I have to wear compression bandages or stockings after my sclerotherapy treatments?
A: Compression following sclerotherapy is an adjunct to the treatment. Current medical literature supports the use of compression to insure the best possible cosmetic result. Your legs will feel better if you wear compression hose at least during the day for several weeks after treatment. If your occupation involves standing or heavy work or if you have chronic venous disease, it is recommended that your wear compression hose on the job and also when engaging in any sort of vigorous activity during the day.
Physiologically, compression therapy increases venous blood flow back to the heart, reduces reflux in diseased veins, increases venous blood flow, reduces elevated water content of the tissue, reduces inflammation, and sustains reparative processes. In short, compression therapy not only improves results after treatment, but it also improves blood flow and reduces leg swelling and symptoms.
Do Spanx, TED hose, and other over-the-counter products provide sufficient compression?
A: No. Over-the-counter products or TED hose do not provide sufficient compression. There is a medical science to the concept of graduated compression therapy. The concept of compression therapy lies on a simple and efficient mechanical principle: it consists of applying an elastic garment around the leg that exerts a controlled pressure on the limb. By compressing the limb with graduated compression, which is strong at the ankle and decreasing going up the leg, the compression stocking helps the venous return, decreases venous pressure, prevents venous stasis and impairs of venous walls, and efficiently relieves aching and heavy legs. This level of compression can only be achieved by medical grade, prescription only stockings. Depending on the pathology, medical compression therapy can be applied in different forms: socks, stockings, pantyhose, or bandages.
Q: I am pregnant. Will my varicose veins go away after the baby is delivered?
A: It is estimated that 70% to 80% of pregnant women develop varicose veins during the first trimester. Pregnancy causes an increase in blood volume, but it is hormonal changes that cause the veins to enlarge. Elevated levels of progesterone, which the body produces to stabilize the uterus, allow veins to dilate. Later, the uterus enlarges and causes increased pressure on the veins in the pelvic area. 60% to 80% of varicose veins that develop during pregnancy disappear a few months after delivery, but it must be remembered that damaged venous valves do not repair themselves.
Q: How soon after pregnancy can I be treated?
A: If after three months following a delivery the varicose veins are still present, they are not likely going to regress. We suggest waiting 12 weeks post-partum.
Q: Does crossing your legs or wearing knee high stockings with an elastic band or tight anklets cause varicose veins or spider veins?
A: No.
Q: Do insurance companies pay for vein treatment?
A: Insurance does not cover sclerotherapy when performed for cosmetic reasons. Some insurance companies, however, cover sclerotherapy for specific medical conditions. A number of insurance companies will pay for testing of venous disorders. Your insurance company might request a letter from your physician concerning the nature of your treatment. One of our services is to contact your insurance provider to obtain pre-certification.
Q: Can you accommodate foreign and out of town patients?
A: We receive and treat patients from around the world. Our offices are conveniently located 20 minutes from the San Diego International Airport, 90 minutes from LAX, and 45 minutes from TIJ. We can arrange to have you met at the airport and brought to and from our office until your treatment needs are met. A wide variety of local hotel accommodations, from affordable to ultra luxurious, are available in the area. Please contact us today at 858-550-0330 and we’ll be happy to assist you in these arrangements.
Q: How soon after the procedure may I fly?
A: 24-hours after the procedure a patient can fly while wearing compression stockings. Moreover, you will have to regularly pump the calf muscles and get up out of your chair every two hours to avoid economy class syndrome.
Glossary of Terms
Ablation
Removal or excision.
Competent Vein
Blood flow occurs in the proper direction back to the heart. Also referred to as Having No Reflux Or Normal Flow Direction.
Incompetent Vein
Blood flows in the wrong direction. Also referred to as a vein that has reflux.
Reflux
Blood that flows backward in the veins.
Perforating Vein
A vein that passes directly from a superficial vein to a deep vein.
Popliteal Vein
The deep vein located behind the knee. The small saphenous vein originates from the popliteal vein.
Posterior
Back of a body part.
Small Saphenous Vein
A superficial vein that starts at the outside of the foot and travels up the back of the calf where it empties into the deep vein (popliteal vein) in the crease of the knee.
Spider Vein
A tiny varicose vein that may be blue or red color that does not protrude above the skin surface and frequently looks like a spider. Common medical terms you may hear for spider veins are telangiectasias and telangiectatic veins. Slightly larger varicose veins that do not protrude above the skin are called reticular veins.
Superficial Vein
Any vein in the lower extremity above the deep fascia that covers the muscles of the thigh and leg.
Thigh
The part of the lower extremity above the knee.
Varicose Vein
A bulging vein that protrudes past the skin surface and usually measures greater than one-fourth of an inch (6.4 mm) in diameter.
Patient Forms
Patient forms, including new patient registration and instructions for sclerotherapy are available at the office and are sent by email. If you need forms to be re-sent by email or fax, please email Lisa at lurtiaga@lajollaveincare.com.
Compression Stockings
We carry a full line of support hose and compression stockings for men and women. While most pharmacies carry only over the counter compression socks, we offer prescription strength support hosiery, custom fitting, and accessories. Stockings such as TED hoses or support stockings that are found in pharmacies are not strong enough to treat vein problems. Medical grade compression garments or stockings used to treat venous disease are available by prescription only. These are distinctly different from support stockings, which do not provide enough compression to help with the signs and symptoms of venous disease.
We have even expanded our product offering to include a large inventory of compression stockings available for both men and women. The styles have become more fashionable and come in a variety of materials and colors. Men’s compression stockings now have the appearance of trouser socks and women can order sheer thigh highs, pantyhose or trouser-like socks as well. Most compression stockings are latex-free and there are a variety of styles and types of material available. We also carry travel socks to reduce leg swelling and prevent blood clots on airplanes and diabetic socks for foot care.
Things to Do in La Jolla and San Diego
La Jolla in Spanish means “The Jewel.” As a result, it comes as no surprise that it is the Jewel of America’s finest big city, San Diego. La Jolla is located 15 minutes from downtown San Diego along the pristine California coast. Known for its beautiful beaches, fine restaurants, upscale hotels, and art galleries, it is also home to several renowned institutions such as the Scripps Institution of Oceanography, Stephen Birch Aquarium & Museum, and the University of California, San Diego. La Jolla Vein Care is located just a few miles from La Jolla beaches and the Downtown area right in the heart of a bustling research and science center. San Diego itself is home to fine dining, popular beaches, and attractions such as the Padres, San Diego Zoo, Seaworld, Coronado Hotel, and more. If you’re visiting us from out of town, we’ll be more than happy to make suggestions to help you enjoy your stay in one of the country’s premier areas.
