Before any type of invasive surgical procedure, it may be possible to control earlier stages of varicose veins disease by conservative means. These include:

• Weight control: Obesity has an adverse effect on the condition of venous circulation in lower extremities. The veins struggle to carry the blood up against gravity towards the heart. Varicose veins are much more common and more ominous in obese people.
• Lifestyle: Avoid standing still in one place or sitting with your legs hanging down for too long. Keep your legs elevated whenever possible.
• Occupation: People who stand behind a counter for many hours a day, for example barbers, hair stylists, cashiers and bank tellers, are at risk for varicose veins disease with serious complications.
• Pregnancy: Pregnancy affects the condition of venous circulation in the legs adversely and in many different ways. Pregnant women, especially those with varicose veins need special care and appropriate support for their legs.
• Surgical compression stockings: Generally, people have a negative attitude towards compression stockings. In our experience a majority of patients, after wearing these stockings for a little while, feel very comfortable with them because their legs feel so much better. A variety of styles are now made with consideration of their appearance and comfort.
    

Spider Veins

Spider veins are usually harmless, except for their unsightly appearance. They can be treated with injection (sclerotherapy) or Laser or both. Each area of spider veins may require more than one or two sessions of treatment, usually one month apart. Slight bruising or discoloration can occur which is temporary and clears within a few weeks.
 

Varicose Veins

For almost a hundred years surgeons have been treating varicose veins by stripping the greater saphenous vein and removing the bulging veins through large incisions, all of which require hospitalization and general anesthesia. Recovery is prolonged and patients are left with unsightly scars.

Today, we treat varicose veins quite differently. Before surgery, patients are evaluated by ultrasound (sonography machine), and if the valves in the greater saphenous vein are not working properly, allowing the blood to flow in the wrong direction, the vein can be closed off by use of laser technology. This is called Endoluminal Laser Ablation, a procedure that can be done in the office under local anesthesia. The bulging veins on the legs or the thighs are removed through microsurgical techniques called Ambulatory Phlebectomy. Under a special type of local anesthesia and through tiny incisions no larger than a needle hole, the veins are removed. No sutures. Minimal to no scarring. Fast recovery. Sclerotherapy can also be used to treat mildly bulging varicose veins. With minimal to no discomfort, small amounts of sclerosing solution is injected into the vein with a tiny needle. The solution causes the injected vein to close up or sclerose. Sclerotherapy relieves symptoms due to varicose veins in most patients.
 

Bleeding Varix

Bleeding from a bulging varix usually occurs spontaneously, or following minor trauma, scratching, etc. Here is what you should do:

1. Do not panic. The bleeding can be controlled or stopped easily.
2. Lie down and keep the leg elevated as high as possible.
3. Fold a sterile gauze and place it on the site of bleeding.
4. Wrap the leg snuggly with Ace bandages.
5. Call your physician or go to the Emergency Room.
    

Venous Insufficiency:

Patients with chronic venous insufficiency usually have swollen legs, bulging varices and skin discoloration. Here the condition is advanced and would require a comprehensive approach for accurate diagnosis and appropriate treatment. Every contributing factor, such as obesity, life style, occupation, and pregnancy should be addressed. Varicose veins should be treated and long term plans with compression stockings should be made. At this stage of the disease, every patient is best served by a vein specialist, also called a Phlebologist.
 

Stasis Dermatitis and Ulceration

By the time a venous ulcer develops, the leg has suffered many years of untreated varicose veins disease, high venous pressure, chronic swelling, marked skin discoloration and thickening at the lower leg. Yet this is just the beginning of many years of struggling to get the wound healed and prevent it from coming back.

In addition to vigorous and persistent wound care, debridement and antibiotics, treatment of venous ulcers requiring correcting the underlying causes such as venous insufficiency, varicose veins, obesity, strenuous occupation and so forth.