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Varicose veins have troubled man throughout recorded history. The Ebers Papyrus described the then current treatment in 1550 B.C. Through the centuries, bloodletting, cauterization, stripping, strapping and injection have all been tried. As time has passed, we have learned more and our treatments have become more sophisticated and successful.
In modern times, varicose veins occur in up to sixty per cent of the adult population. Symptoms include pain, swelling, itching, cramps and restless leg syndrome. Findings on exam range from minimal spider formation to dilated tortuous veins and skin changes such as stasis dermatitis and even ulcer formation.
Family history, hormonal status, type of job and previous injury or blood clots all contribute to the risk of varicose vein development.
If you have varicose veins - what next? Evaluation should include a complete history and physical exam and in many cases a Doppler ultrasound. The Doppler ultrasound is a noninvasive pain free way to map the veins and check for reflux which is the reversal of normal blood flow. This reversal of flow causes high pressure in the veins and leads to the formation of painful dilated veins seen in venous insufficiency. If reflux is present, we close the vein using minimally invasive techniques. This is an office procedure using laser or radiofrequency and is far superior to vein stripping.
For those without reflux, the next level of treatment is laser or sclerotherapy. The laser delivers energy at a wavelength absorbed by blood cells so the vessel is coagulated. Sclerotherapy injections cause irritation of the lining of the vein leading to its collapse. Modern sclerosing agents are virtually pain free compared to older chemicals such as hypertonic saline.
The mainstays of treatment for any stage of venous disease are external support, frequent elevation and exercise. Compression stockings are recommended for all patients.
At Daws Wellness Center, we offer the full spectrum of treatment for varicose veins. Our medical director, A. W. Daws, M.D., F.A.C.S. is a board certified surgeon with training in vascular disease and we offer total vein care to Upstate South Carolina and Northeast Georgia.