Does treatment hurt?
Sclerotherapy uses a small needle to inject a solution into diseased veins. Laser uses heat energy from concentrated light beams to destroy diseased veins. Some patients are not bothered at all by these treatments. Most find them slightly to moderately uncomfortable but not overly painful. Very sensitive patients can be helped with pre-treatment medication but this is rarely necessary.

Don't I need these veins for my circulation and where does the blood go?
Spider veins develop from tiny veins that are not important to your circulation. Varicose veins are larger veins that are part of the superficial venous system. When functioning normally, the entire system of superficial veins returns less than 10% of the blood flow from the legs. But varicose veins are not normal veins. They are diseased vessels that allow blood to move backwards. This interferes with normal circulation and forces normal veins to work harder since it is the normal veins that will eventually have to pump the backwards flowing blood back up again. Eliminating the diseased veins is good for your circulation and reduces the workload for normal veins. When varicose veins are eliminated, patients often notice that their legs feel better and less tired.

Do varicose veins come back?
Microsurgical procedures remove varicose veins permanently while sclerotherapy and laser treatments destroy the veins so they will not return once sclerosis is complete. However, no treatment can guarantee completely against any possibility that new veins may form. Some patients are at higher risk and some are at lower risk for developing future veins. Dr. Cunningham will be able to discuss your particular situation once he has had a chance to perform your initial examination.

How do I begin treatment?
During the initial consultation, Dr. Cunningham will review your history and examine the areas of concern.  Any questions you have will be answered and an individualized treatment plan will be developed. Expectations and anticipated results are discussed at the time of this visit. An estimate of the type and cost of treatment will be also provided to you at this time.

Will my insurance pay for treatments?
The initial consultation and office visit are usually covered by insurance, although we ask that you pay the small consultation fee at the time of your visit.  Treatment of large varicose veins is covered by Medicare and most other insurance plans when the patient has discomfort, pain, clots, ulceration, or other symptoms. Patients are responsible for co-payments, deductibles, and other amounts not covered by their insurance.  Patient "out of pocket" expense varies by policy.  We will contact your insurance company for you to get approval and we will be able to discuss your policy coverage with you before we begin any treatment although we have no control over how your insurance company ultimately handles your claim.  Treatment of spider veins is always considered "cosmetic" by insurance companies, even if the patient has symptoms, and such treatment is not covered under any insurance plan (although some FLEX plans may provide coverage).

How long will treatment take?
Treatment sessions for spider veins and small varicose veins are usually about 20-30 minutes. The number of sessions varies depending on the severity of your condition and your individual response to treatment. A typical patient will need three to five treatments for significant improvement of spider veins but the number could be more or less depending on the specifics of your condition and your response.  Treatment of large, bulging varicose veins usually takes 1 to 3 treatment sessions per leg.  Sessions are typically scheduled about four weeks apart. These are only guidelines and your individual case may be different. Microsurgical or laser treatment for underlying vein disease may require a treatment session lasting 1 to 3 hours. Microsurgery and surgical laser treatments are routinely performed in the office with mild oral and/or intravenous sedation. Patients are never completely unconscious, but they are typically relaxed and sometimes nap while the procedures are being performed.

Are there any restrictions to my activity?
Swimming and highly strenuous activity, such as weight-lifting or high impact aerobics, will need to be limited for about a week. Otherwise, there are no restrictions following surgical treatment. In fact, regular activity and exercise are encouraged on the day of treatment even for patients treated by microsurgery or surgical laser. Patients treated for spider veins may return immediately to normal activity except highly strenuous exercise, suntanning, or use of hot tubs for one week. Most surgical patients return to normal work and home activity the very next day, although some patients may elect to take off a few days from work if it is convenient. Surgical patients who work at extremely strenuous or hazardous jobs or jobs in a very dirty work environment may need to have modified duty or take a few days off from work.