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Demystifying varicose vein treatments

Varicose veins
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Classic scenario: Annie gets out of the shower. As she’s applying her body lotion, she finds a blue vein, a little too noticeable, on one of her legs, on the surface of her skin. Oh, what a nightmare! What should Annie do? Get it treated immediately or wait a bit to see if it goes away? And how will she find her way through all the treatments out there? How will she know which one is the right one for her?

First of all, what is a varicose vein?

A varicose vein is an abnormal dilation of the vein. This expansion may be secondary to a loss of tone of the vein wall or can be combined with an abnormal backflow of blood detected by a Doppler examination or ultrasound. The blood cannot normally go back to the heart and, in turn, accumulates in the vein, which clogs up and becomes noticeable.

Did you know that varicose veins can appear at any age and anywhere on your body, although they are most commonly found on the legs? Rosacea (which appears on the cheeks, chin and nose) is also a form of varicose veins, but it affects the capillaries.

What causes varicose veins?

There are many causes of varicose veins — the key one is heredity. The risk of developing varicose veins is 20% in patients if both parents don’t have the condition, 44% if one parent has varicose veins and more than 70% if both parents have them.

The following are other factors:

  • Ethnicity
  • Age (the prevalence of varicose veins increases with age)
  • Gender (women are twice as affected as men)
  • Posture (standing or sitting for long periods of time)
  • Excess weight
  • Hormonal changes (for example, pregnancy and menopause

How should you treat varicose veins?

There are different treatments for varicose veins, depending on their size and origin. That’s why it is vital to get a thorough examination immediately, performed by a well-trained physician (a phlebologist) for an accurate diagnosis. This phlebologist will, in turn, direct you to the treatment that best meets your needs

Sclerotherapy and echosclerotherapy

Sclerotherapy involves the injection of a sclerosing solution that irritates the walls of the impaired vessel, causing inflammation (burning) inside the vein. In response to this irritant, the vein shrinks and closes, forcing the patient’s blood to resume the path of normal veins. Without any blood flow, the vein eventually disintegrates and disappears naturally within a few days to several weeks. The treatment is safe, requires no anesthesia, takes about 20 minutes and is affordable (about $150 per treatment). Best of all, you can immediately resume your normal routine.

Echosclerotherapy is preceded by an ultrasound to determine the origin of reflux, the anatomy of the venous network and the route of the impaired veins. Echosclerotherapy is sclerotherapy treatment performed under ultrasound, by injecting a more powerful irritant in the vein (depending on the size of the vein to be treated). The physician may decide to use echosclerotherapy to treat the reflux areas and deep veins, if necessary (plan on about $400 to $500 per treatment).

Sclerotherapy and echosclerotherapy are the most common types of treatment (about 90% of all cases). Both are available at Epiderma.

Endovenous laser

This treatment is used to destroy large varicose veins under local anesthesia. The impaired veins are burned by an optical fiber that is inserted into the vein through a small incision behind the knee. This is an effective, yet expensive treatment (about $2,500 to $3,000 per leg). There are also variations of the endovenous laser method, which use radiofrequencies rather than the laser to burn varicose veins.


This method involves extracting the impaired vein through surgery (usually day surgery). There is a recovery period of two to four weeks where patients must restrict their activities. The procedure is performed in a hospital (covered by RAMQ) and the waiting time for this treatment is up to three years.


Compression stockings

Wearing compression stockings prevents the appearance of new varicose veins and slows the progression of various venous diseases. Increasingly popular with athletes because of their many benefits, compression stockings maximize treatment outcomes and promote healthy blood circulation by exerting downward pressure from the ankle to the thigh. This technique helps keep blood flowing in the right direction (toward the heart), even if the bloodstream is impaired. With echosclerotherapy treatment, it is necessary to use support stockings.

These stockings are available in different support levels, which will be determined by the physician (based on the patient’s needs). Leg measurements must also be taken to confirm the correct stocking size. Some pharmacies and orthotic laboratories offer this service as well as all clinics in the Epiderma network.

In addition to wearing support stockings, certain steps can be taken to slow the appearance of varicose veins:

Doing activities that can increase circulation (walking, cycling, yoga or other exercises)
Wearing comfortable shoes
Maintaining a healthy weight
Elevating your legs when you’re lying down
Avoiding hot showers or baths, tight pants or belts and hot wax hair removal
Massaging your legs upward

Treat promptly

Besides being unsightly, varicose veins continue to deteriorate if they are not treated and can even lead to complications. Therefore, it is recommended to consult a phlebologist immediately, particularly since prevention is difficult due to this condition’s hereditary nature.

In conclusion

Before any treatment, it is necessary to consult a physician trained in phlebology. Also, make sure that a clear protocol is in place at the clinic, guaranteeing you maximum safety and the best results. During your first visit to Epiderma, for example, the patient will go through a medical check-up. The physician starts with a clinical examination of the patient’s lower legs and ends with an assessment of the blood flow, using an acoustic Doppler to assess the possibility of reflux. If there’s a possibility of reflux, the doctor would recommend an ultrasound and possibly an echosclerotherapy. The physician would also explain the possible side effects and treatment limits to the patient.

Today, with sclerotherapy and echosclerotherapy, varicose veins can be treated quickly and safely. The results are noticeable almost immediately, even for large and sometimes raised distended veins, and are permanent. It is possible — and, above all, easy — to say goodbye to varicose veins!

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