- Does the injection procedure hurt?
- Does the vein treatment interfere with my work or home duties?
- What if I do not treat my varicose veins?
- Do I need these veins?
- Will the treated veins come back?
- What about topical skin lasers for spider vein treatment?
- Should I wait until I have completed my family?
- What are the costs of treatment?
- Do you offer a payment plan?
- How many treatments will I require?
- What are the possible complications if I do not have any treatments?
- What type of solution is injected into veins?
- What is the significance of me taking the oral contraceptive pill or hormone replacement therapy (HRT)?
- Can I have treatment if I am pregnant or breastfeeding?
The amount of discomfort felt will vary with the individual. The needles used are extremely fine (similar to acupuncture needles) and many are hardly felt at all. The injected solution can sting slightly for short periods of time. If EVLA is used, then minimal discomfort is experienced as it is performed under local anaesthetic.
This is a walk-in, walk-out procedure. Most treatments take about 30 minutes to perform. Following treatment, your daily routine should not be disrupted, normal duties can be resumed.
Vein disease is progressive which if left untreated is likely to become worse with time. Increasing symptoms that can occur with untreated varicose veins include leg tiredness, heaviness, aching, throbbing, restlessness, tingling, itching, numbness and swelling. More serious complications such as phlebitis, blood clots, dermatitis and vein ulcers can develop if varicose veins are left untreated.
Varicose veins and spider veins are NOT functional. Once veins become abnormal, our body finds alternative pathways with healthy veins to carry blood. You can never run out of veins. Varicose veins are not missed by the circulation. In fact, it improves without them.
Treated correctly the veins will not come back, as the body has absorbed them. New veins however, may appear with time. How quickly and how many appear, depends on whether you have inherited veins that are more likely to deteriorate. Other factors such as starting the pill, becoming pregnant or occupations with prolonged standing, can affect the development of abnormal veins.
Despite the proven usefulness in the treatment of large varicose veins using EVLA, the treatment of leg veins by laser light to the skin has thus far been disappointing. Currently available lasers can be very useful in treating the tiny cosmetic facial veins, but have been significantly less effective on leg veins when compared to expert sclerotherapy. Also, topical laser therapy is far from painless.
Becoming pregnant with existing varicose veins will only lead to the veins becoming significantly worse as the pregnancy develops. Phlebologists agree that treatment for varicose veins is best performed before or between pregnancies.
The expected cost for treatment varies between individuals and will be provided in writing following your assessment. Rebate is claimable through Medicare except for the smallest spider veins. In Australia , the Medicare Safety Net reimburses eligible patients 80% of out of pocket for medical expenses once a threshold has been reached. Please ensure that you are registered as a family or couple for the Medicare Safety Net. Forms can be provided at your initial consultation or are available online at Medicare Australia. All payments are to be made on the day of review/treatment, by cash, eftpos, credit card or cheque. Amex and Diners cards are currently not accepted.
Your treatment protocol , which includes the number of treatments required, will be determined at your first consultation.
With large varicose veins, spontaneous blood clots may develop in the superficial veins and more rarely, the deep veins. Clots in the deep veins (deep vein thrombosis or DVT), can dislodge and travel to the lungs, which can cause pulmonary embolism, a life threatening condition. Skin changes, including increased or decreased pigmentation, eczema of the skin (venous dermatitis), hardening of the skin and underlying fat (lipodermatosclerosis), and leg ulcers, may develop in the lower legs. Ulcers may become weepy, infected and painful and take longer to heal.
The current recommended and TGA approved solutions used for sclerotherapy in Australia are referred to as "Detergent Sclerosants". Sodium Tetradecyl Sulphate and Polidocanol are the 2 detergent sclerosants used widely across the world. Hypertonic Saline (concentrated salt water) has limited use in the treatment of varicose veins. Dr Paraskevas will discuss these sclerotherapy solutions in greater detail at the initial visit.
What is the significance of me taking the oral contraceptive pill or hormone replacement therapy (HRT)?
Oral contraception and hormone replacement therapy-both oestrogen and progestogen have been implicated in increasing the risk of thrombosis whether you have a vein treatment of not. Taking the low dose contraceptive pill or HRT increases the risk of deep vein thrombosis 3 fold as compared to those not taking these products. Total correction of this increased risk requires ceasing hormone treatment for a minimum of 4 weeks. The increased risk seems to lessen the longer you have been on the medication. There is no current evidence that during sclerotherapy or EVLA treatment the taking of low dose contraceptive pill or HRT actually increases the risk of thrombosis above the already existing risk before treatment. The relative merits of ceasing or continuing hormone therapy prior to sclerotherapy and EVLA treatment will be discussed further with you.
Sclerotherapy is best avoided when pregnant or breastfeeding. This is advised even though there is no current documented evidence to suggest that sclerotherapy is unsafe during pregnancy or breastfeeding. Vein treatments during pregnancy are not as effective often-producing poor results. It is recommended that sclerotherapy should be avoided if pregnancy is contemplated within the treatment course. Veins that appear during pregnancy should be treated before the next pregnancy to avoid deterioration with subsequent pregnancies.