What causes varicose veins?
Heredity is the primary factor in most cases of varicose veins. Other contributing factors include hormonal effects, pregnancy, obesity, standing for long periods, aging, and injury.

How are varicose veins treated?
There are several methods by which varicose veins can be treated. The best procedure or combination of procedures depends on the specifics of your condition. Some treatment options include the following:

Conservative Treatment:
Special support stockings are prescribed to slow down the progression of leg varicose veins. This is done for symptomatic relief, but they must be worn pretty much every day for the rest of your life to be effective. Stockings may help vein symptoms so long as they are worn, but they do not cure the problem.  Pain medication may help keep you more comfortable.

Sclerotherapy:
Sclerotherapy is performed by injecting solutions into the diseased veins. The solution causes the veins to harden then shrink and gradually disappear. Ulltrasound may be used when treating larger varicose veins to guide the injections into underlying diseased vessels below the surface of the skin. This allows the medications to be injected into precise locations safely and accurately so that superior, long lasting results may be achieved.  This works well for most minor varicose veins and also for cosmetic treatment of hand and foot veins.

VNUS Closure Procedure:
The VNUS Closure procedure was the first successful, technologically advanced method to treat underlying vein disease without surgical stripping. This treatment uses a very small cathether inserted into veins. Radiowaves are applied to the vein through the catheter which causes the broken vein to close and shrink. The broken vein usually disappears completely over time. Unlike stripping, VNUS Closure can be performed through a very tiny incision, usually with no stitches and no significant scars. VNUS Closure often results in the least post-operative pain, bruising, and recovery compared to stripping surgery or laser surgery. The Vein & Laser Clinic has experience with the original VNUS RF Generator and catheters as well as the more advanced VNUS RFG-PLUS Generator and rapid ClosureFAST treatment catheters. To learn more about the benefits of VNUS Closure, click here.

Endovenous Laser Surgery:
In the past, treatment of vein disease by stripping of deeper veins through large incisions required numerous stitches and left signficant scars. Dr. Cunningham was one of the pioneers for endovenous laser surgery which allows such veins to be treated through a tiny incision, usually with no stitches and no signficant scars. These veins can also be treated with VNUS Closure, a similar procedure which offers certain benefits compared to laser for many patients. Dr. Cunningham has performed minimally-invasive vein treatment for many years and he is one of the most experienced physicians in the region, often performing many endovenous surgeries every week. Dr. Cunningham's patients have the advantage of choice since the Vein & Laser Clinic has the experience and equipment to perform whichever procedure is best for the patient's condition. 

"No-Stitch" Micro-Surgical Procedures:
These procedures are used for surface varicose veins that are too large to be easily treated by sclerotherapy. The incisions are only 2-3mm (about an eighth of an inch) and are so small that they do not require stitches. Advanced micro-surgical procedures such as ambulatory phlebectomy are performed in the office under local anesthesia (like at the dentist) with mild sedation.  They leave no large scars and in most cases the incisions will be invisible within a few weeks or months. 

Image Guided Ligation:
Ligation may be needed to treat deeper vein disease in some patients who cannot be treated by other methods. Unlike older "blind" surgery requiring large exploratory incisions, the surgical site is localized using ultrasound imaging and a very small incision is made. When we perform this surgery, the incision will usually be closed from underneath without any surface stitches or may not require any stitches at all. This makes a minimal scar that is and often undetectable once it heals. Ligation is usually performed in combination with injection sclerotherapy and/or micro-incisional removal of surface varicose veins.

Stripping:
Vein stripping is an effective but very old surgery.  The procedure has been around in it's "modern" form for about 100 years.  Incisions are made to cut down into the leg and locate underlying diseased veins. A long "stripper" is passed through these underlying veins and the stripper and vein are pulled from inside the leg.  This is almost always performed in a hospital or equivalent surgical facility, usually under general or other strong anesthesia.  Surface vessels are commonly removed at the same time through several incisions measuring 1 to 4 inches each. Recovery times vary, but are typically about two to four weeks.  Stripping is usually an outpatient surgery with the patient going home at the end of the day, but a hostpital stay of a day or two may be required by some patients.  This is still a commonly performed surgery for varicose veins although it is rapidly being replaced by more advanced methods.   We generally do not recommend vein stripping and we do not perform stripping surgery at the Vein and Laser Clinic.

General information about varicose vein treatments:
Treatment for large bulging veins may require the patient to wear a compression bandage for a short time. A support hose may need be worn for one to two weeks when treating leg veins. A compression glove is sometimes needed for a day or two after treating hand veins.   All patients (even surgery patients) are encouraged to walk immediately, even on the day of treatment. Very strenuous exertion will need to be limited for a few days, but endolaser, microsurgical, and minisurgical patients usually return to most work and home activities within 24 hours. Pain medication is not usually needed, although some patients use over-the-counter medication such as Tylenol or Motrin for a few days. From time to time, a patient may need something a little stronger and Dr. Cunningham will provide a prescription if it is necessary for the patient to be comfortable. Patients may drive themselves to and from all appointments except for the day of surgical treatment. We ask that someone else drive home on that day due to the mild sedatives which are used.