Frequently Asked Questions about Vein Treatment at the Sydney Skin and Vein Clinic:
How long is each treatment and how often do I need to come back?
Treatments for Sclerotherapy can last up to 30 minutes and are usually booked weekly or fortnightly, as EVLA can last from 60-90 minutes. At the completion of your course of treatments, we start the follow up system and you may need to come back at six weeks, one year and occasionally beyond this period.
Do I need to take time off work?
You do not need to take any time off work as all the procedures are walk-in walk-out. In general, no medical certificates can be issued for you to take time off work. For interstate patients, a certificate of attendance may be issued.
Can I go straight back to work after my treatment?
After treatment of varicose veins you may need to go for a 30 minute walk. After that you can go back to work.
How many treatments will I need?
The number of treatments needed to clear or improve the condition differs from patient to patient. One to six or more treatments may be necessary. The average is four treatments. After your ultrasound maps, a follow-up consultation will be organised during which the doctor will give you an estimate of the number of treatments you may need.
Does the procedure hurt?
The degree of pain varies from person to person, depending on the person's general tolerance to pain. The injected solution stings but generally does not cause severe pain.
Does it interfere with my work and lifestyle?
Each Sclerotherapy treatment session lasts up to 30 minutes, with EVLA lasting from 60-90 minutes. It is a walk-in and walk-out procedure. The treatment does not disrupt your daily routine. Weight bearing exercises are to be avoided during this period.
Do I need to wear bandages?
Most patients do not need to wear bandages but compression stockings need to be worn.
Do I need these veins and how would the blood get back if you remove these veins?
Varicose veins are unhealthy superficial (surface) veins and do not function correctly. That means that they are not doing what they are meant to do, which is to take the blood back to the heart. Once these veins are removed, your blood circulation will improve. So, in summary you do not need these veins. The blood mostly returns to the heart via the deep veins. Most people with varicose veins have healthy deep veins that function correctly. In the presence of varicose veins, deep veins have to work harder to drain the leg. By removing the varicose veins, there is less pressure on the deep vein to perform. With the duplex ultrasound we check both the superficial and deep veins.
Will the veins come back?
Once treated, the veins should not come back as they are dissolved and absorbed by the body. New abnormal veins, however, may appear in time due to hormonal, hereditary and environmental factors. If new veins appear, they can be treated. We recommend a yearly ultrasound check.
How successful is the treatment?
In experienced hands Sclerotherapy has a very high success rate and EVLA has a 96% success rate in all cases. The success rate depends on the skills of the physician, the type and concentration of the solution used, the compression used afterwards and the severity of the condition. This is the reason why it is important to be treated by a physician who has the optimal training and experience in this field.
Does Sclerotherapy work for everyone?
Done correctly, Sclerotherapy is a very successful treatment. In our clinic more than 90% of patients are cleared or at least see a very impressive improvement. The success of the treatment depends on your age, severity of the disease, your speed of healing, your other concurrent medical conditions, and how well you follow the doctor's instructions. It is important to remember that due to genetic and hormonal factors you may develop new veins in future. These can be treated as they appear.
What are the small lumps that appear on the legs after Sclerotherapy?
After treatment of varicose veins, small tender lumps (trapped blood) may develop along the injected vein. The lumps will be tender to touch. This should not alarm you. The doctor may choose to release these on your next visit. Any pain or discomfort will settle down when the doctor has released the trapped blood. THESE ARE NOT DANGEROUS CLOTS. If you experience discomfort, contact the clinic for an appointment to release the trapped blood.
Can you treat both legs at the same time?
The answer is No. Only one leg gets treated at a time. We are limited by how much we can inject per session to avoid complications.
When will the veins disappear?
The process of Sclerotherapy is unfortunately a slow one. Although most of the injected veins die fairly quickly, it takes the body a long time to remove the dead tissue. So the injected veins initially look worse. It may take a couple of months to a year for the dead veins to disappear completely.
Residual marks and staining of the skin can also take months to disappear, so you need to be patient.
Can you treat my spider veins only and leave the varicose veins?
The answer is No. In most cases, varicose and larger blue (reticular) veins feed the spider veins. In the presence of larger feeding veins, the treatment of spider veins is very unsuccessful and can lead to complications. We always treat the larger veins first. This will spontaneously remove a lot of smaller veins but not all of them. If you have many varicose veins and many spider veins, the priority goes to the treatment of varicose veins. Please note, we do not treat cosmetic spider veins, only spider veins situated from varicose veins.
Will spider veins disappear when you have finished treating the varicose veins?
The answer is No. Most people need a few sessions of micro-Sclerotherapy dedicated to treating the spider veins AFTER the treatment of varicose veins. Varicose and larger blue (reticular) veins feed spider veins, but only the spider veins which are in direct communication with them.
For example, if you have spider veins on the inside of the foot, treating your Great Saphenous vein (inner aspect of the leg) will help a lot of those go away but that will not remove spider veins on the outer aspect of the leg.
I have veins on my face, what type of treatment do I need?
Depending on the size of the veins, either sclerotherapy or vascular laser treatment may be appropriate. The doctor will assess your individual case and discuss treatment options during your consultation.
Can I have a treatment close to a major operation?
Operations requiring general anaesthesia are likely to increase your risk of clotting in the deep veins. We recommend you postpone your vein treatment for at least a month after any major operation booked. You should discuss any operations you have had or are intending to have with your doctor.
Can I see a Physiotherapist /Chiropractor/Osteopath for treatment whilst undergoing treatment for my veins?
Yes. However, if the treatment involves the legs, please ask your practitioner to contact us first.
Can I travel before or after my treatments?
If you are only having your small blue veins treated, there is no limitation. In other words you can travel any time you want. If you are having your larger varicose veins treated, you cannot travel long distance - more than five hours - within four weeks of your treatment. . This means if you have just come back from overseas, you need to wait four weeks before treatment can commence. Also, if you have just finished treatment of large varicose veins, you need to wait four weeks before you can travel long distance. Long distance travel is defined as any form of travel (car, coach or plane) lasting more than five hours with no break. If you need to travel by car, you need to have multiple breaks so you can go for a long walk. This will stimulate blood flow.
Shorter trips should be broken down to one hour segments. You should wear your stockings while you travel. This is to prevent deep vein thrombosis. Refer to our specific travel guidelines if you have a trip, discuss it with our doctors
Can I exercise during my treatments?
Walking is very good for the veins as it helps the calf muscle to pump the blood in the deep veins back to the heart. We recommend a walking regime of 30 minutes per day.
Running is not recommended. Weight lifting with legs must be avoided during the treatments. Upper body stretches are not a problem. For the suitability of a particular type of exercise, please ask the doctor at your consultation. You need to wait at least one month after the end of all your treatments before you can commence heavy exercise such as weight lifting or running.
Can I take the Pill?
The Oral Contraceptive Pill must be stopped before treatment. Ideally it should be stopped one month before. Female hormones have been reported to increase the possibility of complications such as thrombosis and matting. Oestrogen containing foods such as tofu, soy, flaxseed oil and chickpeas should be avoided in high quantities throughout your treatment. You can resume the oral contraceptive pill one month after the completion of the treatment. Meanwhile, you need to make sure that you do not get pregnant before the completion of treatments.
Can I take HRT?
The hormone replacement therapy must be stopped before treatment. Ideally it should be stopped one month before. Female hormones have been reported to increase the possibility of complications such as thrombosis and matting. You can resume the HRT one month after the completion of the treatment. If you develop severe flushing while off hormones, discuss the issue with your GP or Gynecologist. There are alternative medications that can be used in these situations.
Can I take Aspirin or Anti-inflammatorily drugs?
If you only occasionally take aspirin or anti-inflammatories (such as Nurofen, Naprosyn, Voltaren, Brufen etc) for one week prior to treatment. Also, it is advisable not to take vitamin E or use creams containing vitamin E during the treatments. This is to prevent excessive bruising. Panadol and other paracetamol are OK. If you have arthritis or other conditions for which you must take these drugs, do not stop but inform the doctor at your initial consultation.
Can I take Iron Tablets, Vitamins, Chinese herbs, Supplements or Fish Oil?
Iron tablets and Vitamin E supplements should be stopped at least one month prior to your treatment. The excess iron stores are associated with staining of the skin in form of haemosiderin pigmentation. Even though the staining will fade in time, it is better avoided. Vitamin E and Fish Oil may cause excessive bleeding and bruising. You also should not be using creams containing Vitamin E on your legs. All Chinese herbs and supplements need to be stopped one month before your treatments. If you wish to, you can re-commence taking these one month after all your treatments are finished.
Can I have antibiotics while having treatments?
Yes there is no interaction between antibiotics and the treatments offered.
Can I apply Creams to my legs?
Please do not apply any creams to your legs on the day of the treatment. You can moisturize your legs on other days. Shaving is OK. Avoid using anti-bruising creams and creams containing vitamin E.
Can I wax or shave my legs?
Shaving is ok but waxing should be avoided during treatments.
Can I get pregnant or have treatment during?
We strongly recommend that you do not get pregnant while having treatments. No-one has studied the effects of injections on babies so we do not know if it is safe to have treatment while pregnant. In general, it is better to treat your veins BEFORE pregnancy but if you are pregnant, you should wait till you have stopped breastfeeding and then come for another assessment of your veins.
Can I smoke, have a sauna or have hot showers?
Smoking should be avoided right throughout your treatment. Hot saunas and very hot showers should be avoided. In general, heat dilates (opens) up the veins.
I have more questions about the procedure, can I discuss these with the doctor over the phone?
Our doctors do not perform phone consultations. If you are still not clear about any aspect of your treatment, another consultation with the doctor will be organised to discuss your queries and concerns.
