Hi, Doctor Gan here. Some of the patients that I meet, have noticed varicose veins just pop up in their legs. There other patients that have had these varicose veins for many years. These same group of patients, for personal reasons, may not be ready to get treatment straight away. However, they do want to reduce their symptoms, even prevent the progression of vein disease. If you happen to fall into this category, today I’m going to be discussing some of the conservative options available to reduce symptoms, and even prevent progression.
Now, the first form of treatment is compression stockings. Now, compression stockings, in my opinion, is one of the best forms of treatments because it reduces symptoms such as aching and swelling in your leg, and it also prevents the formation of a clot. The only challenge that patients have is that they find it a little bit cumbersome to put these stockings on and even take off, and they may also find it uncomfortable because it’s probably the tightest stockings they’ve ever worn.
It’s important to note that these stockings are not the same stockings you get in the supermarket or store. They are actually medical grade stockings that you need to measure specifically for your legs, and therefore they can be a lot tighter than you expect. At our clinic, this is a service we offer, so if this is a form of treatment that you plan to pursue, we are happy to help.
Another option available is exercise. Now, the calf muscle pump is one of the best pumps we have in our body, and what it does is every time it basically squeezes together, it pushes blood all the way from your legs back up to your heart, and it improves the blood flow. So, by actually flexing and extending your foot, you’re actually activating this calf muscle pump that is pumping blood back up to your heart, and this can improve symptoms. Now, by exercising, you’re also keeping your weight down, which eventually helps reduce symptoms and even prevent progression of vein disease.
A third option is elevation of your legs. Now, elevation is great because when you’re standing for long periods of time, you’re basically through gravity, you’re getting blood flowing all the way to your legs, and if your valves in your veins are damaged, it’s going to be hard for it to be pumped up. And so, by elevating your legs by putting it up on a table or a chair, a little bit above your heart level, you’re basically allowing gravity to get that blood back into the heart.
Now, another option is lying on your bed and actually putting your legs on the wall, and this can actually help relieve symptoms quite quickly. The next option available is medications. Now, medications can include anti-inflammatories such as Ibuprofen or Voltaren, they are essentially non steroidal anti-inflammatory drugs. I’m not a huge fan personally, because anti-inflammatories can often cause a lot of trouble in your tummy, with your gut flora, which are the bugs in your tummy.
They can cause symptoms such as gastritis, and nausea at times, and even the formation of ulcers. So they cause irritating symptoms that you did not really want to have, but I can understand that for some patients that have reached the end, where compression’s not helping and elevation’s not helping, some anti-inflammatories can help. Now, I would advise that if you reached this level of pain or symptoms that you can’t handle and you need medication, you may have to look at treatment options because you using medication, is really kind of a bandaid effect.
Now, the final option that I have, which I think is actually very important, is essentially food, and we’ve heard the saying, food is medicine, and there are certain types of food, especially fruits and vegetables that are great for your vein health. And flavonoids is a type of chemical that’s actually found in vegetables and fruits. It’s an antioxidant. It basically prevents clot formation, and also improves vein health, reduces blood pressure and reduces cholesterol. This can be found in most berries, it can be found in grapes, it can be found in olives and even apples.
It’s full of vitamin C, which is great for your skin as well as your vein health, and if you’re eating healthy what that tends to mean, is that you tend to have a better weight, so it’s a win, win, any way you look at it. If you need further information regarding the conservative options available, we are always happy to help. Visit our website at doctorvein.com.au, or book yourself in for consultation.
Hi, Dr. Gan from Doctor Vein Medical Clinic. Some of the patients coming in for treatment of their spider veins or varicose veins often are a little bit concerned about needles, specifically, are they going to be painful? Is it going to cause discomfort? I can understand where this comes from because if you’ve never had this procedure done before, it’s quite normal to actually feel a little bit anxious because you’re not sure what’s going to happen on the day, and if you actually go to a doctor and you actually speak about this, no one really talks about, are you going to feel any discomfort? They just mention, “This is a procedure. We’re gonna do it. We’re gonna do it under local anaesthetic. You shouldn’t feel it, and it’s gonna be fine,” and most of the time, it is fine.
This probably stems from immunisations that people got when they were kids or even as adults, and even dental procedures where they had local anaesthetic, which, really, even with dental procedures these days, they do it so quickly and so finely that most patients do not feel anything at all.
Today, I’m going to actually be talking about the needles that I use, and, specifically, I’m going to actually use myself as a demo model and show you the placement of a needle into my skin.
It all comes down to what types of treatments that’s been done. If sclerotherapy or micro-sclerotherapy, whereby we’re injecting a solution to these really fine, baby spider veins, I usually use very, very small needles, and these needles are so fine that you just feel a little bit of a prick as it goes in, and other than that, you don’t really feel it. There’s some parts of our bodies, especially around your feet and ankles that are a little bit more sensitive, and also around the knees into the back of the knee. They’re more sensitive than the rest of your body, but for most places, especially in the legs, you’re not going to really feel much. I’m going to demonstrate with my arm, and I’m going to use my forearm, how it actually feels using one of these needles.
To give you a little bit of a back story, I’m actually terrible with needles. I can give needles, but receiving needles, forget about it. I’m really bad at it. Even though I’ve done thousands and thousands of needles in some form for patients, I’m really bad at receiving it. To be honest, I think about probably four to five years ago, I was getting blood taken, and the young girl was really worried because she thought I was going to pass out, but I’ve actually improved since then. I’m actually quite good. I can watch the procedure being done, and I’m getting better, and before you start judging me and thinking that, come on, it’s just a needle, it’s actually a very common thing for men, and I know I’m defending myself here, but it does happen for some patients, that are a bit worried about needles. I’m one of those people. I’m actually going to be sticking a needle in my forearm right now while I’m actually taking this video. If I can do that, then it can’t be that bad.
This is the needle that we use or I basically I use. Different doctors use different needles. I use a really fine needle here that is … It actually flows really well, and it doesn’t cause much discomfort, so most patients are quite happy.
Placing it on the skin, pierce the skin, in the skin. Didn’t really feel it. It’s actually not to bad. You feel a little bit of prick. I’d be lying if I didn’t say you felt a little bit of a prick. You feel a little bit of a prick, but, other than that, it goes in quite smoothly. Once it’s in, you don’t actually feel anything, and this is a sensitive part of the body, especially around the forearm, around the back of you hand, and take that off, not much of anything, no bleeding, very small needle.
If you’re having sclerotherapy or micro-sclerotherapy, these are the types of needles that I use. For other procedures, such as your ultrasound-guided sclerotherapy, we use a similar needle, but it’s a little bit longer. With this procedure, specifically, I can be completely honest with you, when it happens, patients don’t even realise that it’s happened. Oftentimes, I’ve finished the procedure, and they’re asking me, “Are you finished, or are you done? Did you already do it,” because they’re actually quite surprised that they didn’t actually feel much. Oftentimes, with these procedures, such as your ultrasound-guided procedures, you’re not really going to feel anything.
Moving on to your intravenous laser ablations and even, to that matter, surgical removal of some these varicose veins under local anaesthetic, most patients are quite happy. The ones that actually feel anything or feel a little bit uncomfortable are the ones that are a little bit more sensitive to the local anaesthetic that’s injected rather than the needles themselves. Oftentimes, it’s something that’s very much accepted by patients, and even when they do feel a little bit of the local anaesthetic, it’s very short lived, and they’re often speaking about their families or holidays that they’re going on, so it happens quite quickly and, actually, it doesn’t really concern them that much.
Overall, needles are really well accepted. My hope in this video is that it just removes any worry and concern about these needles, and that for the patient or for person that’s coming in for the first treatment, if you’re watching this, you have nothing to worry about.
To actually end this, I would like to mention a patient that I recently treated. She had a needle phobia. That’s why she came in. She said, “I have a phobia with needles.” The first thing I was thinking at that time was that this is going to be a very interesting case, and I was talking to her about, “Is this something you really wanna do because if you’re scared about needles and I’m gonna have give you a few needles into your legs, is this something that you really wanna do?” She was quite adamant that she wanted to do it. To be honest, after I treated her and we completed treatment, she did really well and she actually told me that she didn’t actually feel uncomfortable at all. She said most of the discomfort was in her head because she had this idea that it’s going to really, really hurt, and she didn’t actually feel any of that, so she did really well, and she said the needles are actually not a big deal.
I hope this gives you some sort of idea about needles. Hopefully, you have no concerns if you come in for your treatment.
Today, I am going to break down the three different groups of treatment available for varicose veins. The first group being endovascular laser ablations or radio frequency ablations. The second group being an injection technique or Sclerotherapy and finally the third group being surgery.
Now, with the first group, with endovascular laser ablation, this has become the gold standard for the treatment of varicose veins. Here a laser fiber is inserted directly into the damaged vein and what it does is that it basically destroys this vein by creating heat around the vein from the inside out. Now, this entire procedure is done under ultrasound guidance and with local anesthetic and therefore, patients actually tolerate this really well.
The next form of treatment is the injection technique or also known as Sclerotherapy. Here a special solution is injected directly into the damaged vein wall therefore irritating the linings of the vein and breaking down the vein. Your body then absorbs these destroyed vein, similarly to how your body absorbs a bruise. Now, glue can also be injected and what glue does is that, once it’s injected directly into the vein, it basically blocks off the vein wall, not allowing blood to flow directly through it. And therefore, it creates a block in that flow, reducing the symptoms of these varicose veins. Use of glue often takes almost two to three years before it breaks down completely, so it’s important that patients understand that.
Finally, we have surgery. Surgery used to be the only available treatment for varicose veins and the specific procedure was called stripping, that most patients have heard of. Here, similarly to pulling off a sock off your leg, the vein was basically pulled out from the inside out. The issue with this procedure is that the rate of recurrence or development of new veins was quite high after some time. Also, this procedure needs to be done in a hospital under general anesthetic. You also often have a hospital stay, your legs often wrapped with bandages and it can be quite painful. There are other forms of surgery that are non-invasive or minimally invasive, similar to a procedure called hooking technique or phlebectomies where by pieces or segments of veins are basically pulled out after a small incision is made along your leg. This procedure is done completely under local anesthetic and it usually yields the best cosmetic results and patients are quite comfortable going through this. It’s important to note that every patient that presents with vein disease may not have the same vein pathology, therefore it is really important to get assessed to find out exactly what types of treatments you need specifically.
I trust this gives you a bit of insight into the different forms of treatment. If you need further information about treatments of veins, please visit our website at www.doctorvein.com.au.
Hi, Dr. Gan here. Today, I’m going to break down a very common question that I get and that is, “What do I have? Do I have spider veins, or do I have varicose veins?” Now, the issue is a lot of patients actually look on line whether it be Wikipedia or on Google, trying to figure out what they have on their legs. And oftentimes, with the descriptions that you get, you often think that do you just have spider veins? Or do you have varicose veins? Or maybe a mixture?
Now, you’re not alone because many patients have the same question. The challenge is, sometimes spider veins can just look like little red spots on your legs as if someone’s actually drawn with a pen on certain areas of your legs. And they can be quite small, but you do notice them. They would look something similar to what this picture is, there we go. So we got sort of these red, little dots that you get. And these are little, small pen marks.
Another option is, you get spider veins, but they sort of look like little paint brushes have been made. Almost like little strokes have been made around those areas. These are pretty obvious and most patients that notice it will know straightaway that they are spider veins. And this would be an image of what it would look like. So essentially you’re looking at little paintbrushes that are made. And you can see these little spots right there whereby you get these little paint marks. And these are the paintbrushes that you get.
And a third form that you can get is you can have spider veins with varicose veins. Now this can be a little bit challenging to see because oftentimes these varicose veins, sometimes they’re just a little bit green, maybe slightly elevate out of the skin. So it can be a little bit deceiving because you think that it’s quite normal. But you will notice that when it’s actually hot these veins will actually pop out a little bit. So it’s quite obvious when these green veins pop out. But you’d also see spider veins and sometimes you get these blotchy patches.
Now an example out here, now obviously this has been overdone because, just for illustration. We’re looking at, so these spider veins and you see these little blotches with little green lines. Obviously they won’t look as green as that but this is sort of an example of what you’re going to be looking at. So that’s an example of you actually having a bit of spider veins and varicose veins.
Now for some patients, they may not have any spider veins at all and only have varicose veins, and these varicose veins might just be a bulging vein. Now it is very important to note that in some very athletic and slim people, they may only have on vein popping out and this may be normal. So it’s important to get it assessed to find out whether, is it a varicose vein? Oftentimes it will cause you pain, so if it’s causing some form, element of discomfort, then the chances are it is going to be a varicose vein and it’s something that needs to be treated.
Now I hope this sort of helps you distinguish between spider veins and varicose veins. It can be a little bit challenging. Oftentimes another issue is that some patients seem to focus quite a lot on the front, because that’s what you can see. And oftentimes at the back you may have more than just spider veins. You might actually have lots of varicose veins but because we don’t actually have eyes in the back of our heads we can’t really see it. So it’s important to know that you can get quite a lot of varicose at your back which is sort of creating this spider veins coming out in front. So it can be a little bit tricky to sort of figure it out.
But I hope that this video gives you some insight into what the possibilities are, of whether spider vein or varicose vein. If you need to find out a little bit more or you want to find out how you can get rid of them book yourself in for consultation.
We all know, through media or even through the news, that when you fly on a plane, there is always a risk of developing a deep vein thrombosis or DVT. That is why they encourage everyone flying to move around the cabin and do plenty of stretching exercises. Many of my patients are also worried about flying on a plane when they have varicose veins. In this video, I discuss the risk involved and answer the question based on current research, what the dangers are and whether it is acceptable to fly with varicose veins.
Sclerotherapy is one of the most effective ways to treat spider veins of all sizes. Often times if patients have clusters of spider veins, this is the only method available to get rid of them. With many patients, they do however also have varicose veins associated with their spider veins and again, sclerotherapy is a great way to treat both. In this video, I break down how it is done, what is to be expected and after care, once they have been treated.
#Sclerotherapy #SpiderVeins #TreatingSpiderVeins #TreatingVaricoseVeins
What Causes those Unsightly Varicose Veins? Why are you affected more than other people of the same age or even your friends and family. In this video, I break down the commonest causes as to why you develop varicose veins.
Simplifying Varicose Veins into the 3 Levels. Varicose veins and spider veins are a very common condition that many patients have. In this video, I break down the different types of veins and how each one is connected. More importantly, I highlight what type of treatment is required for each level.
Sclerotherapy (Pronounced skle-ro-therapy), has been around since the 17th century. It was not until 1916, when the use of modern sclerotherapy treatment for varicose veins was founded. The word “Skleros” itself comes from the Greek word to make hard. Different solutions and sclerosants have been created since then, that are not only safe but highly effective in removing varicose and spider veins.
Sclerotherapy is a medical procedure, whereby a “sclerosant solution” is injected directly into the vein. This then irritates the inner lining of the vein wall causing it to harden and then get absorbed by the body. The absorption by the body is similar to what happens when you develop a bruise after a fall. It eventually disappears.
It is commonly used for varicose veins and spider veins but can also be used for vascular and lymphatic malformations, hemorrhoids (dilated veins in the anal canal) as well as for hydroceles (fluid in a body cavity).
Sclerosant solution is injected using very small needles either directly into the vein or by using ultrasound guidance for veins that are not visible.
The solutions can be injected directly as a liquid or as a foam. Both are as effective for spider veins, but foam is generally found to be more effective for bigger veins hiding under the skin.
This is a very common question and the simple answer is no. Some solutions used for sclerotherapy can cause stinging when first injected and others cause some slight itchiness during the procedure. The solution I use has an anaesthetic property as well that further reduces any pain. It is important to note that the needles used are tiny and not ordinary sized needles. Generally, it is very well tolerated by most people. Many who do get treated are often surprised how little discomfort there is.
Most patients who get sclerotherapy can be treated and go straight to work or any other day to day activities. It is often recommended to not do heavy exercise or weight lifting for the first 5 days after sclerotherapy.
It is also advisable to walk daily for 30 to 45 minutes each day after treatment and wear medical compression stockings during that period.
This is challenging to answer without examining a patient and doing a duplex ultrasound. Most patients generally need at least 3 treatments of sclerotherapy. Some patients have multiple spider veins scattered everywhere and, in that case, more treatments may be needed. Also, some treatments may need a combination of different procedures with sclerotherapy just being one of them. I advise patients as to what will be required during their initial consultation.
Treatment of spider and varicose veins using sclerotherapy can be very effective. Even after the first few weeks post treatment considerable changes in the appearance of varicose and spider veins can be seen. The final results will be visible 6 months post treatment.
I personally treat all my patients and at Doctor Vein, our focus is only on veins. We strive for the best outcomes and endeavor to deliver the best results.
If you have any questions about Sclerotherapy, please send me an email to email@example.com
This is an age-old question, often surrounded by myths. The usual adage being, “Oh no, I have my mothers or fathers legs”. We do know that one third of the population suffer from varicose veins in one form or another. Some believe this number is actually higher, especially as many men tend to not seek treatment and therefore often do not contribute to the total. Studies conducted in the UK through the NHS, have highlighted that up to 56% of men and 60% of women have varicose veins.
This article breaks down the common causes and risk factors that increase the chances of developing varicose veins. In order to give you some insight into why it occurs in the first place.
Varicose veins are those bulging veins that are seen on lower limbs, especially the legs and thighs. They can occur because of weakening of the valves, absence of valves in some people, or even damage to the valves of the veins in the limb.
The most common cause for damage of the valves is following a deep vein thrombosis, whereby there is a clot in the deeper veins. This damages the wall of the vein, affecting the valves and impairing blood flow through the veins.
One way to think about it is to imagine a rubber pipe watering system with valves, that allow water to flow in one direction when opened and stops water from travelling when closed. If this valve stops working, it then allows water to travel in both directions, without any control. Eventually if the pressure is too great, this will cause the rubber pipe to expand or swell up and affect other valves up or down the pipe. When this happens, more valves in various locations along the path of the pipe stop working as well. As the pipe becomes bigger than the original valve, this allows water to leak through in other places, despite having a normal valve.
Similarly, when the valves in veins are abnormal or damaged, the veins can get distended along the length of the vein and not function properly. This then gets carried to other areas of the vein that may have had a well functioning valve in the first place. Almost like a domino effect.
The above is the predominant cause of varicose veins, but the question still remains: Why do some people have varicose veins and others do not?
This comes down to risk factors. Over the years, many studies have been done to show which are the highest risk as compared to those that may only cause a small risk or no risk at all after completing the study.
Below are some of the high risk factors for developing veins in no particular order:
Genetic or family history
Smoking has been postulated to be a risk factor of varicose veins, but the evidence is lacking. We do however know it affects management, but probably does not affect veins directly.
There has not been any conclusive evidence regarding posture and sitting cross- legged as a trigger for varicose veins. However, isolated direct trauma may trigger varicose vein developments in affected regions.
If you are not sure what is causing your varicose veins, but have noticed them and want to find out how to get rid of them, do not hesitate to contact us at Doctor Vein, on 03 91908922. We will be happy to evaluate and manage all your varicose veins concerns.