Varicose & Spider Veins:
Diagnosis and Treatment
It is estimated that 20% of women and 10% of men suffer from varicose and spider veins worldwide. This
translates to tens of millions of people in the United States alone. Whether you desire cosmetic
improvement or relief of symptoms associated with leg vein problems, the following information should help
you to better understand the condition and the current treatments available.
What are varicose & spider veins?
Veins throughout your body return blood back to your heart. In order to do this efficiently, veins have oneway valves to prevent blood from flowing backwards (reflux). If they fail to close properly, blood will leak
through the valves and result in pooling. Over time, this pooling will force the vein walls outward resulting in
enlargement and sometimes bulging of the vein. These enlarged veins are telangiectasia (commonly called
spider veins) or varicose veins. Spider veins are small red, purple or bluish veins located just below the
surface of the skin. They can have a linear of web like appearance, hence, the term spider vein. Varicose
veins are larger veins located deeper under the skin which are abnormally enlarged. Varicose veins can
protrude from the skin surface resulting in a rope-like appearance.
Who gets varicose & spider veins?
Hereditary factors play the most important role in determining whether you will develop leg vein problems.
Women are more likely to have varicose or spider veins. Birth control pills, hormone replacement therapy
and pregnancy play a particularly large role in the development or worsening of veins. Other factors that
may accelerate the appearance of varicose or spider veins including aging, obesity, prolonged standing or
sitting, constipation, leg trauma or congenital conditions.
Do spider or varicose veins cause any symptoms?
Most spider veins are nothing more than a cosmetic nuisance. In some cases, spider veins can be associated
with symptoms of itching, burning, or throbbing of your legs. Although varicose veins can also be
unattractive, they are often associated with symptoms. The most common symptoms include leg pain,
cramps, fatigue, heaviness, swelling, or restlessness. With more severe cases, varicose veins can lead to
skin changes resulting in eczema, pigmentation, ulceration, or bleeding.
What treatments are available?
Conservative treatment
The most common type of conservative treatment is wearing graduated compression stockings (tighter at
the ankle than the thigh). Although such measures may not rid your legs of existing varicose and spider
veins, symptoms associated with vein problems can be greatly improved by wearing support stockings.
Conservative treatment is well suited for women who are pregnant or for those who are unable to undergo
medical therapy due to advanced age or illness.
Medical treatment
For many people, merely slowing the progression of varicose or spider veins will not be enough. If you fall
into this category, many corrective forms of treatment are available to improve both the cosmetic
appearance of your legs as well as alleviate associated symptoms. The first step, and likely the most
important, is finding a physician with experience and expertise in phlebology, which is the field of medicine
that deals with disorders of the venous system. In addition to a focused physical examination, additional
evaluation utilizing a variety of diagnostic instruments may be necessary when determining the cause,
severity and best treatment options available for your particular problem. These non-invasive diagnostic
tests include doppler, duplex ultrasound and plethysmography.
1851 Grant Avenue, Winnipeg, MB R3N 1Z2 Canada Phone: (204) 885.1419 Fax: (204) 885.1552
Toll Free: 1.866.379.7919 Web: www.theFirstGlance.ca Email: info@theFirstGlance.ca
The Lockwood Medical Corporation
Compression Sclerotherapy ($150.00 - $250 + GST per treatment)
Sclerotherapy involves a series of injections using a tiny needle to administer small amounts of a solution
into the vein. The sclerosant irritates the inner lining of the vein causing it to collapse and ultimately
disappear. Sclerotherapy is performed as an in-office procedure and should cause only minimal discomfort.
Following treatment, you can return to your normal daily activities. Medical grade compression stockings will
need to be worn during the day for a minimum of 1 week following treatment, this will aid in the closure of
your veins. (HANDS - $500.00 + GST per treatment)
Duplex ultrasound-guided sclerotherapy ($300.00 + GST per treatment)
Occasionally, patients with more severe varicose veins will need further therapeutic intervention. In the
past, surgical ligation and stripping was the only treatment available for these cases. Today, minimally
invasive in-office methods are available and offer good alternatives to surgery for many people. One such
technique is duplex ultrasound-guided sclerotherapy. In experienced hands, duplex ultrasound-guided
sclerotherapy is highly effective, very safe and painless.
Surgical ligation and stripping
Surgical removal (also called ligation and stripping) of the greater saphenous vein (the main superficial vein
of the leg) may be necessary in some patients with large varicose veins. This procedure is usually performed
under general anesthesia, although local or spinal anesthesia may be used. When properly performed, the
greater saphenous vein is removed from the groin to the knee through small (usually two) incisions using a
special instrument. (Not offered at this facility.)
Ambulatory phlebectomy ($300.00 + GST per treatment)
Ambulatory phlebectomy is a minor surgical procedure that can be used to remove some large varicose
veins. This procedure can be performed in the office using local anesthesia. The veins are removed in
segments through tiny incisions. No stitches are necessary and scars are barely visible in most cases.
Laser therapy ($300.00 + GST per treatment)
A variety of laser and light sources are currently available. Although many lasers have been highly effective
in the treatment of facial spider veins, laser treatment of spider veins on the legs has proven to be more
challenging. Currently, compression sclerotherapy remains the treatment of choice for removing most
unwanted leg telangiectasia, with lasers offering a complementary treatment modality in only a select group
of people.
EndoVenous Laser ($2500.00 + GST per one leg treatment OR $3000.00 + GST both legs)
Recently, a novel technique using laser energy delivered within the vein via a small laser fiber has been
developed for the treatment of varicose veins with excellent preliminary results. Compared to surgery, the
potential advantage of endovenous laser treatment is a minimally invasive technique performed in the office
with little to no scarring and a shortened recovery period. Compared to existing minimally invasive
techniques, endovenous laser treatment may allow for more precise control of vein wall damage, resulting in
lower recurrence rates and less potential for adverse side effects.
ClariVein ($2,500 + GST per one leg treatment OR $3,500 + GST both legs)
ClariVein is the latest minimally invasive technique for the treatment of varicose veins
The vein is identified at the knee level and a small amount of local is infiltrated and the ClariVein catheter is
inserted into the vein under ultrasound guidance. The tip is positioned at the top of the vein at the level of
the groin. The device is activated and the tip rotates agitating the inner lining of the vein. A sclerosant
solution is infused through the end of the catheter as the catheter is slowly withdrawn down the vein. The
combination of the rotating tip and the sclerosant causes the vein to seal. The vein seals off and turns into
fibrous tissue which is gradually removed by the body.
1851 Grant Avenue, Winnipeg, MB R3N 1Z2 Canada Phone: (204) 885.1419 Fax: (204) 885.1552
Toll Free: 1.866.379.7919 Web: www.theFirstGlance.ca Email: info@theFirstGlance.ca
The Lockwood Medical Corporation
The treatment of choice
The treatment of choice for the majority of varicose vein and nearly all spider veins on your legs will be
compression sclerotherapy. In some cases, additional intervention such as surgery, duplex ultrasoundguided sclerotherapy or endovenous laser treatment will be necessary. Often, a combination of the above
treatments will be most beneficial.
Varicose & Spider Vein FAQ’S
Q.
A.
Is treatment always necessary?
No. Although varicose veins can cause medical problems if left untreated, the majority of varicose
and spider veins are treated for cosmetic improvement.
Q.
A.
Does sclerotherapy hurt?
Most people report little if any discomfort. Occasionally, mild burning may be felt at the injection
site that resolves after a few minutes.
Q.
A.
How many treatments will I need?
This varies according to the severity and the number of veins that need to be treated. Although
most people will notice some improvement after the first treatment, most areas will need to be
treated approximately three times for optimal results.
Q.
A.
How long does the treatment take?
Your initial visit consisting of a consultation and sclerotherapy, if indicated, will take approximately
1 hour. Subsequent visits for sclerotherapy will take approximately 45 minutes.
Q.
A.
What are the side effects of sclerotherapy?
Bruising at the injection site is normal following treatment and resolves in 7 to 10 days. Slight
hyperpigmentation (staining) of the skin or telangiectatic matting (tiny new veins) can occur but is
usually temporary. Complications such as ulceration or allergies to the sclerosant are extremely
rare. Sclerotherapy is a very safe treatment.
Q.
A.
How long will the results last?
Since varicose and spider veins are a chronic condition, new veins will likely appear over time. Most
people can remain “vein free” by returning for touch-up visits every couple of years, the
compression stockings are also effective for keeping legs vein free.
Q.
A.
How can I prevent varicose and spider veins?
Unfortunately if you have hereditary predisposition, you will likely develop varicose and spider
veins. The good news is that by understanding the roles of diet, exercise, compression stockings,
hormones and pregnancy you can minimize your risk and control the progression.
Q.
A.
What restriction will I have following treatment?
You will be restricted from any type of aerobic exercise for a minimum of 2 weeks. You will be
restricted from taking any baths including hot tubs or saunas for 1 week. You are also restricted
from flying for 2 weeks following treatment.
Q.
A.
Can I get the treatments covered by my insurance plan?
Insurance policies vary in terms of coverage for vein treatments. Should your policy require
documentation of your visit/treatment, the doctor is able to complete insurance forms for a fee that
will be determined pending the length of the forms. Do save your receipts for income tax purposes.
There will be a fee for printing past receipts and insurance forms.
Please contact our office if you have further questions.
1851 Grant Avenue, Winnipeg, MB R3N 1Z2 Canada Phone: (204) 885.1419 Fax: (204) 885.1552
Toll Free: 1.866.379.7919 Web: www.theFirstGlance.ca Email: info@theFirstGlance.ca
The Lockwood Medical Corporation
COMPRESSION / FOAM SCLEROTHERAPY PROTOCOL
What should I do before my Compression or Foam Sclerotherapy treatment?
1. Do not shave your legs for one day prior to your appointment
2. Do not take Aspirin, Advil or blood thinners for seven to 10 days before the procedure.
3. It is recommended you bring shorts to wear during the procedure and compression hose to wear out of
the office as directed by your physician or nurse. If hose are not recommended, please bring loose-fitting
slacks and easy-to-slip-on footwear and a pair of compression support hose.
4. Do not wear cream on your legs the day of your appointment
What should I do after my Compression or Foam Sclerotherapy treatment?
1. For post foam sclerotherapy treatments only - keep the initial dressing on for twenty-four hours, unless
otherwise directed by physician.
2. We recommend extending your ankle several times each hour when you are sitting, otherwise a period of
15 to 20 minutes of walking shortly after the procedure is of value to prevent any deep vein clots.
3. You can resume walking, treadmill or stationery cycling right after the procedure but no resistance
training with weights for the lower body for a period of two weeks, similarly with step aerobics.
4. No hot baths, hot tubs or saunas for one week after the procedure.
5. No flying for two weeks following your treatment.
6. Wear your compression support hose as directed and certainly for at least one week after the procedure.
It may be removed for a quick five-minute shower and it may be removed the last thing at night before
going to bed, otherwise it stays on all the time.
7. Bruising, local swelling, some local tenderness and discomfort are normal after treatment, but please feel
free to call the Clinic if you have any questions or concerns.
8. If there is a lot of swelling, wrap ice in a cloth and apply to the affected area and give the Clinic a call.
9. You will not notice an immediate improvement. In fact, the treated veins may be darker in colour, more
noticeable and hard and firm to the touch for a period of weeks to several months afterwards. Rust-type
staining following bruising may take one to two years to clear in some extreme cases.
10. If you are experiencing a lot of pain and swelling in the treated leg, especially if the foot is swelling up,
your dressing may be too tight or you might have a deep vein clot. Call the Clinic and if Clinic personnel
are not available, please report to your nearest emergency department and ask for an examination with
ultrasound to rule out a deep vein clot.
1851 Grant Avenue, Winnipeg, MB R3N 1Z2 Canada Phone: (204) 885.1419 Fax: (204) 885.1552
Toll Free: 1.866.379.7919 Web: www.theFirstGlance.ca Email: info@theFirstGlance.ca
The Lockwood Medical Corporation