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Leg Veins

Smaller, superficial veins

We don’t know exactly why leg veins occur, but we know that the tendency to develop them can be inherited and that conditions such as pregnancy and menopause, and occupations that require prolonged standing or sitting can increase the risk of developing veins.

Also, that tendency cannot be cured so veins can be treated to improve symptoms and appearance but may need more treatment over time.

To maximise the efficacy and longevity of treatment it is vital to keep good habits ongoing such as regular exercise, good weight control and wearing compression socks if required to do prolonged standing or sitting in the workplace.

Why treat leg veins?

  • They have become large and tortuous (varicose) and are producing problems with leg skin such as pigmentation, itch, rash, swelling or ulcers.  These veins are producing significant health issues and should be addressed.
  • They are starting to get darker and produce lots of small spider veins especially on the inside of the feet, this can indicate a problem with the deeper veins.
  • They are causing symptoms such as ache or itch and are looking unsightly.
  • They are spreading and hard to hide and preventing exercise due to self-conciousness.

Why do they come?

  • All these unsightly leg veins are abnormal and should not be there. They are coming from diseased veins that have dilated over time so the valves inside them are pulled apart leaving a gap for blood to flow backwards down the leg, which it should not do.
  • This backflow causes increased pressure inside the veins which respond to this by producing new abnormal veins that carry the blood back out to the skin and end in capillaries or spider veins.  These are the end of the line and need to be treated last.  Iit is important to find out where in the legs the backflow problem starts and address that first.

How are they treated?

  • Non varicose veins or smaller skin veins can be treated with sclerotherapy which means getting rid of a vein by injecting it with an irritating solution (sclerosant) that makes it stick together over time. This is done with multiple small injections, usually one leg at a time depending on how many veins there are as there is a limit to the amount of sclerosant that can be injected at one time. To help keep the vein closed, compression stockings are applied to wear each day for a week or so and the patient is required to walk for 30 mins a day.
  • Larger veins and some varicose veins that are originating from the groin or behind the knee are not fully seen on the skin and can be visualized under ultrasound and injected directly- this is called Ultrasound Guided Sclerotherapy or UGS 
  • Large varicose veins with deeper feeding veins >5-6mm can be treated with Radiofrequency or Endovenous Laser Ablation. This procedure can be done under general or local anaesthetic and is very successful at eliminating the source of these big veins. 

Anyone with large veins or extensive veins on most aspects of the leg will be sent for a duplex ultrasound to assess size and origins of the veins and then the most appropriate treatment can be arranged.

After each treatment, some of the peripheral small veins will disappear or become less obvious so waiting a month or two between treatments can be very beneficial and mean less injections later. Once the feeding veins are treated, most spider veins are also injected with a more dilute sclerosant and occasionally they can be lasered if very small or under high pressure.

Important Information re changes in Medicare rebates for Sclerotherapy

Up until now, there has been a Medicare rebate available for the treatment of varicose and surface leg veins by Sclerotherapy, if those veins were greater than 2.5mm in width.

Recently, the requirements to be eligible for a rebate have changed.

Under new Medicare rules, now ultrasound images must demonstrate that a vein is “refluxing” or flowing backwards for more than 0.5 secs to qualify for a rebate.

This would apply to most larger varicose veins but would not apply to smaller skin veins.

Essentially this means that non varicose surface veins and spider veins on the legs are now considered “cosmetic” and no Medicare item number can be applied.

Contact our friendly, knowledgeable reception staff to discuss your needs and to book an appointment.

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