By Robert Thompson, M.D., F.A.C.O.G
161 N. Binkley, Soldotna, AK 99669
907-260-6914

Varicose veins appear for various reasons, poorly understood, but related to structural weakness in tissues of the legs resulting in vessel dilation and vessel incompetence. Veins in the lower extremities are particularly susceptible to these changes, resulting in valvular incompetence. This typically results in a reversal of the direction of blood flow within the vessel. This reversal of blood flow leads to hypoxia in the tissues perfused by these veins with resulting symptoms of leg fatigue, pain, heaviness, aching, cramping, swelling, pigmentary changes or discoloration, dermatitis, superficial and/or deep thrombophlebitis, and ulceration. The clinical symptoms may be out of proportion to the amount of actual pathology. These veins seem to occur more often in the presence of various conditions such as pregnancy, obesity, sedentary lifestyle, occupations requiring prolonged standing, nutritional deficiencies in vitamin C complex (not ascorbic acid which depletes vitamin C complex, another discussion outside the bounds of this topic), copper deficiency, zinc excess, and others.

Varicose veins have been estimated to occur in 7% to 60% of the adult population, increasing with age. They are more common in women suggesting a hormonally related cause. Often times what appears on the surface in like the tip of an iceberg. While leg pains described above may be caused by other problems, often these vessels may be under the surface and not visible except with special instruments. Treatment of varicies protects the patient from future complications of ulcerations and dermatitis, and usually gives near immediate relief of symptoms. Support stockings (over 20mmHg) may be useful in differentiating varicies from other causes of leg pain if they relieve discomfort, however, they do not prevent varicies, only good tissue strength prevents these incompetent vessels from developing.

I use three forms of treatment in my practice. These include “Pulsed light therapy” (beyond laser technology), Sclerotherapy, and Ambulatory Phlebectomy.

“ Pulsed light therapy” (Photoderm) is used for superficial and often smaller blood vessels. It is amazing and very effective technology, probably the most advanced and most sophisticated of all the therapies available. It is relatively painless, very fast, and it can be used anywhere on the body. Its use is however limited to lighter skin complexions.

Sclerotherapy is also used quite commonly in my practice to treat varicies, especially those under the surface that gives rise to those we see on the surface. It is these vessels that are often under treated or missed when illumination technology is not used. Failure to treat these vessels when treating the superficial vessels will cause the blood to merely change directions and develop new varicies in the same area in another direction. There are many people who have had bad experiences with sclerotherapy; this due to the lack of standardization of care and the use of many different kinds of sclerosing agents that are painful and may ulcerate the skin, and failure to address the underlying vessels. This is not my practice. I use a non-ulcerating solution that acts as a local anesthetic, so that temporary numbness results which gives relief during and after the treatment. I also use the smallest needle available on the market today which also minimizes discomfort.

Ambulatory Phlebectomy has also progressed to a whole new level. This is less commonly needed, but gives remarkable results and improvement or resolution of symptoms. This is performed in the office, under local anesthetic, using needle size incisions and instruments that look like miniature crochet hooks. (No, I don’t crochet) Suturing of the skin is not required, just steristrips. The healing with this technology is rapid and relief of symptoms is nearly immediate.

If you are bothered by vague heaviness, aching, ankle swelling, or any of the other symptoms described above or merely have unsightly spider veins and would like to discuss or consider treatment of this problem, please call our office to schedule a consultation examination and receive an estimate of the cost of treatment. You may be surprised to find most insurance companies cover the cost(s) of treatment of this problem, especially if there are associated symptoms.

For more information or to schedule an appointment please call our office at 907-260-6914.