Dr. Joan Warren

In this issue, Dr. Joan Warren answers frequently asked questions on treatment options for varicose veins.

Is there a cure for varicose veins?

Varicose vein disease is genetic and for the most part cannot be permanently cured. However, treatment for varicose veins will successfully result in symptomatic and/or cosmetic improvement in almost all patients when the entire treatment plan is carried out properly. Maintenance checkups and treatments are recommended to keep the venous insufficiency and/or pressure at a minimum. This differs with each person, but once or twice a year following treatment is usually all that is necessary. Some require more frequent visits and others continue to do well without any further treatments.

What are the best varicose vein treatments?

For the large vein insufficiencies, the Endovenous Laser or VNUS Closure procedure generally works the best. These minimally invasive procedures use laser or radiofrequency energy to occlude, or close, the larger diseased saphenous veins. Both procedures are performed under local anesthesia, generally in an ambulatory surgery center or doctor’s office, and there is little to no pain during or after the procedure. For small or medium sized veins, “sclerotherapy” is the treatment of choice. Sclerotherapy is the injection of a special chemical (sclerosant) with tiny needles, into the diseased vein, causing the veins to close. For spider veins, which are too tiny for sclerotherapy needles to enter and are often seen on face, chest and back, we see the fastest and best results using an Ohmic Thermolysis. This system uses a hair-thin probe to coagulate the blood causing its collapse and total destruction. Unlike a laser, it can be used on any type skin and has fewer complications and side effects.

What physicians are qualified to treat varicose veins?

To maximize the results of your care, we recommend that you see a vein care physician specialist called a “Phlebologist” who can remove all types of unwanted, unhealthy veins and alleviate many of the symptoms associated with these veins. A consumer should look for the specialized credential “Diplomate of the American Board of Phlebology” or “Diplomate of the American Board of Venous & Lymphatic Medicine” to know they will be seeing a physician having the most knowledge and skill to remove and care for your veins.

What should I expect at my first consultation?

Vein consultations by your physician will include a detailed history and exam of the legs, as well as a duplex ultrasound exam which will determine which veins are not functioning properly. You will then be given treatment options and any questions or concerns you may have can be addressed. It is at this time you should receive in writing a complete price quote for the services to be offered. Many insurance plans, including Medicare, cover vein disease treatments when there is a medical necessity. This can be discussed with the medical biller.

Joan L. Warren, M.D. RPhS, Diplomate of the American Board of Phlebology, has been providing Vein Care since 1999. Dr. Warren is Medical Director of Vein Institute of the Desert located at 74-361 Highway 111, Suite 5, Palm Desert. Dr. Warren welcomes your questions concerning vein care and treatment and can be reached at 760-610-5573.