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When should I get treatment for my varicose veins?

This question was asked in Coopers, Louisiana and has 11 answer(s) as of 07/18/2013.
I am a 23 year old female and fairly active but both of my legs have incompetent great saphenous veins. When is a good time to get these veins treated? Should I wait and close them later with lasers or ablation or should I have it done right away? What is the best course of action because they are causing ugly varicose veins but there are no other symptoms or pain.


Doctors Answers (11)

It is better to get them treated sooner rather than later. The longer you wait, the higher your chance of complications. You may want to consider radiofrequency treatment over laser. We are achieving the same long term results with less pain.

Consider treating your veins when you are bothered enough by either their cosmetic appearance or their symptoms. Some people tolerate their veins for years while others seek treatment sooner - it's your choice.

If the saphenous incompetence is causing issues with your activities (aching, heaviness, cramping, RLS etc) you should seek treatment now. We have treated many young men and women (18 yrs+) with wonderful results. A point to remember is when blood doesn't flow normally such as in refluxing veins, there is an increased chance of developing a blood clot in that vein. Typically these aren't the clots you hear about in the deep veins but in some circumstances the clots can extend. They will, however, be quite painful and tender to touch. If you decide to delay treatment, I would recommend you wear compression hose to keep the flow returning. You will need to do this for insurance coverage anyway.

The timing depends on your symptoms and whether you have or have had any complications. Symptoms such as tiredness, aching, tenderness and restlessness if bothersome are worth getting treated. If you have complications like leg swelling, varicose vein bleeding or skin changes then it is worthwhile to get them treated. If you have no symptoms and no complications then it is fine to wait. One caveat is that some people have symptoms which they attribute to general tiredness so not everyone is aware of their symptoms.

Generally, when you have known venous incompetence of the Saphenous veins with varicose veins their is no reason to put off treatment as this is a progressive condition and varicose veins will increase in size and number over time. Since you have started having this problem at a relatively early age, it would be expected to progress to other areas of the legs. The impaired venous circulation will eventually effect the skin over the lower legs, and may or may not ever have pain as one of the primary symptoms. Treatment by venous thermal ablation is an office procedure that is quick, safe and comfortable without any changes in your regular activities. Therefore, I would recommend treatment sooner and avoid the further accumulation of varicose veins and to be able to enjoy wearing shorts and going to the pool or gym without being concerned about your appearance.

I would recommend treatment if you are having aching pain, leg heaviness, leg swelling, night cramps or restless legs that do not respond to conservative measures such as compression stockings. I would recommend treatment If your symptoms interfere with your daily activities. I would not recommend laser or radiofrequency closure of your saphenous vein for cosmetic reasons only as the risks outweigh the benefits.

You need to consult with a qualified phlebologist. Generally, since the problem will only worsen with time, treatment of incompetent saphenous veins causing varicose veins, pain, tenderness, or swelling is better done sooner than later.

In order for your insurance company to cover the treatment of your varicose veins, they require documentation that you have symptoms, some degree of disability from these symptoms, and visible varicosities that measure 5 mm or more. You must also wear medical grade compression stockings for a minimum of 3 months, exercise, weight loss, leg elevation and a Duplex Ultrasound evaluation by an accredited vascular lab showing adequate vein size, and reflux.

You can fix them when you are ready. They will get worse with time. When and if you begin having symptoms, insurance will cover treatment of these veins. You should be evaluated and get a plan going so you will have a full understanding of what you can do to live with chronic venous insufficiency.

This is completely up to you if it is purely a cosmetic issue. If you start having symptoms, then the earlier the better.

That is difficult to assess over the web, but my guess is that the best time will be when you have symptoms or when the varicosities are getting tender to the touch. Delay can cause permanent changes, but they are always slow to occur.

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