Frequently Asked Questions

Varicose veins
Are all varicose veins visible?
No, it depends on your weight and your size. Certain varicose veins can only be seen using a duplex ultrasound scanner.
 
Why treat minor varicose veins?
Most minor varices do not cause circulation problems and in general are not tender or painful. The aim of treatment is mainly cosmetic to improve the aesthetic appearance.
 
Why treat the larger varicose veins?
These are superficial veins that no longer function properly. In these veins the blood descends towards the feet rather than rising towards the heart. We call this "Reflux". This then causes a raised intra venous pressure with leakage of fluid and poor oxygenation of the tissues. This in turn causes pain, restless legs, oedema, superficial thrombophlebitis, eczema, skin discolouration and in the worst cases open ulcers. Sclerotherapy treatment prevents this reflux and all its attendant complications.
 
Arenít all the veins necessary?
Not in the legs. The essential venous return is by the deep veins and the superficial veins play a minimal role. When they are varicose, they do more harm than good to the circulation, and treating them improves the circulation in the legs.
 
When should I seek treatment?
Venous insufficiency of the legs is a progressive problem over time. The earlier the treatment, the better the long-term results and the better the cosmetic outcome. An early treatment is advised if you want to be able to avoid surgery.
 

Sclerotherapy
What is sclerosis?
Sclerosis consists of the injection of an irritant into the lumen of the vein. This irritation produces a contraction of the vein, which then fibroses up and is slowly absorbed by the body. The treatment is rapid and ambulatory and does not need any anaesthesia.

This technique will deal with most veins except the very large and can be used to tidy up the leg after vein surgery (stripping). It is now possible to perform the injection under the guidance of ultrasound, which allows treatment of deeper veins and gives additional security and effectiveness.
 
Is it painful?
Through constant daily use our doctors are able to place the needle directly into the vein with the minimum of fuss. Some of the products used cause a brief mild stinging for a few seconds only. In the days following treatment there may be a bit of aching in the legs but this disappears with no further action needed.
 
What is the level of success?
On condition that the veins are accurately mapped out using the Doppler ultrasound, and that treatment is with one of our highly experienced doctors you can rely on a success rate of over 90%.
 
Are there any contra-indications allergies etc?
Certain blood disorders may predispose to clotting problems and affected individuals should avoid this treatment. There are rare cases of allergy to the sclerosing products used, but our doctors are experienced and well able to deal with any problems. With the modern tendency to use the sclerosants in the form of a mousse the older more irritant products such as iodine are now rarely used.
 
Are there any particular measures to be taken after a sclerosis treatment?
Plasters are put over each injection site and kept on for a maximum of 48hrs. During this time it is best to avoid baths and showers. Maintain normal physical and sporting activities and try to avoid periods of bed rest during the day. Sometimes haematomas form (a collection of blood) and these disperse after a couple of weeks. After the treatment of thread veins its not necessary to wear elastic support stockings. After large vein treatment local inflammation is possible but normal activities should carry on regardless, and it will disappear with elastic support and mild painkillers.
 
Why is ultrasound treatment necessary before the start of treatment?
Certain veins, which are neither visible nor palpable, may be important in supplying the superficial visible varices. Its essential to treat these veins first. The ultra sound examination, which is painless, is the key to planning an accurate and effective treatment whether by surgery or sclerosis. Good results are only obtained with good quality initial ultrasound imaging.
 
Are the results permanent?
Individuals who develop varices have a tendency to go on producing new ones over the years. The treatment will sort out varices present at that time but over the years new ones will develop and they can readily be dealt with. We recommend one or two top up treatments a year to maintain trouble free legs. It will avoid the need for major treatments at a later date.
 
How many treatment sessions are needed?
This depends on the severity of the varices and the desired aesthetic result. Several sessions are usually necessary at monthly intervals.
 
Do the injections have to be done by a doctor?
In France only doctors are allowed to practice sclerotherapy. An initial examination is essential and a doctor is able to check for contraindications and manage any rare instances of allergy.
 
Is it possible to treat large Varicosities by injection?
When the veins are very large and long, surgery is the preferred treatment for a quick result. Sclerotherapy is indicated however if surgery is not possible or the patient does not want an operation. All other veins can readily be treated by sclerotherapy. In all cases the results are dependent on how susceptible the patient is to the sclerosing solution and occasionally it will not be successful for the largest veins.
 
What about veins in other parts of the body?
On the face, laser, electrocoagulation or thermocoagulation may be the treatment of choice. Elsewhere sclerotherapy gives excellent results.
 

General enquiries
Where does the blood travel after treatment?
The veins that are Ďremovedí by treatment are those that no longer do the job they are supposed to do. The blood is either stagnant in them or flows backwards into the leg. The superficial venous network is very extensive and the blood is always able to find healthy veins to leave the leg by. The vast majority of the blood however, leaves the leg by the deep veins.
 
Is the treatment possible at any age?
It is possible, but unusual to treat below the age of 18. Above this age there is no upper limit.
 
Is it necessary to have completed all pregnancies before undertaking sclerotherapy?
No. The results are always better when the veins are caught early on. It is always better to start a pregnancy with the legs in a good state; however it is best not to undertake a treatment if pregnancy is contemplated within the following 6 months. It would be better to delay treatment until after delivery.
 
Can one have sclerotherapy during pregnancy?
No. It is not dangerous but does not achieve much. It is preferable to wait until a few months after delivery, as the veins will invariably reduce during this time.
 
The Laser?
While being useful for the treatment of very superficial telangiectasias (thread veins-rosaceae) with low internal blood pressure, the laser is disappointing in the treatment of leg veins. By contrast sclerotherapy can treat veins of all sizes and in particular it will deal with the larger veins that are feeding the superficial ones.
 

Other questions
Why isnít sclerotherapy better known?
It is very common in Europe.
There are in France alone, over 2000 phlebologists practicing sclerotherapy. In most other EU states such as Germany, Italy, Switzerland, and Belgium sclerotherapy is equally popular and actually paid for by the state.
Some countries, in particular the UK, have failed to develop and offer sclerotherapy.
 
Why are the prices so reasonable?
The costs are even lower in France due to the large numbers of patients treated. We have tried to keep the costs to the minimum but there are the expenses of materials used and the doctors have to cross the channel.