FAQs about Vein Treatments

What are varicose and spider veins?

Varicose veins are enlarged, bulging, twisted, superficial veins resulting from poorly functioning valves, almost always occurring on the legs.  Depending on the severity of the varicose veins, they can be considered a medical problem.  

On the other hand, spider veins are finer, very superficial vessels which usually occur on the legs but sometimes the face.  They usually are of cosmetic concern. 

See our pages on Vein Disorders or our Photo Gallery 

How are varicose and spider veins treated?

We offer the most advanced treatments for vein conditions - most of which are non-invasive and non-sedation.  See our Services page for information regarding our office-based non-invasive procedures.   

Compression stockings are to be worn several days after the vein procedure.  Compression stockings will not prevent venous disease, but if worn regularly they will slow the progression of the disease and help with some of the symptoms.  

Don’t I need my veins?

Bulging varicose veins are incompetent veins and do not serve any useful function.  On the contrary, they can cause aching, heaviness, fatigue, throbbing, and itching and burning sensations of the legs.  Removal of these veins may actually improve circulation and relieve symptoms associated with the veins with a great cosmetic result.

Does it hurt? And how soon will I be able to return to my normal activities?

Sclerotherapy involves injections with a superfine needle.  It is bearable and not painful but nevertheless can be slightly uncomfortable.  Most patients report barely feeling the sticks.  All other procedures involve a local anesthetic.  The initial injections to numb the skin are delivered with a very fine needle.  Following the injection of the numbing medicine, the area is sufficiently numbed so that the experience is not painful.

After varicose vein and spider vein procedures, immediately returning to walking and light activities is required. For the following days after the procedure, frequent activity is encouraged. Additionally, compression stockings are required for 48 hours to one week after most procedures.

Will I notice an immediate difference?

After treatment of venous insufficiency, most patients quickly notice an improvement in the heaviness and aching of their legs.  After removal of the dilated varicose veins, there may be some temporary soreness and bruising, but the varices will be gone!  

After sclerotherapy of spider veins, the full benefit comes several weeks after the injections.  For this reason we recommend waiting 6 weeks between treatments.

How many treatments do I need? Will the veins come back?

The average number of treatments is one or twp for sclerotherapy.  For other procedures, the number of treatments necessary to clear or improve the condition differs with each patient and the extent of the varicose veins.  This will be discussed during your consultation.

Effectively treated, varicose veins do not recur.  To prevent recurrence, it is important to first treat the source of the varicose veins.  However, if the patient has a predisposition to develop varicose veins, other varices may become evident or develop further down the road.  Occasional maintenance or touch ups over the years may be necessary.


Will my insurance pay for my treatment?

Most patients treated at AV&V do have their procedures covered by their health insurer.  This will vary depending on the terms of the policy (exclusions, pre-existing conditions, deductibles, etc.)  as well as your venous problems.  Insurers will balk at paying for the treatment of spider veins with sclerotherapy, which is considered a cosmetic concern.  However, they will usually cover the interventions required for treating patients with documented venous insufficiency with the following documented criteria:

  1. Symptoms of pain, leg fatigue, skin changes, ulceration, or other significant symptoms and findings
  2. Failed conservative treatment for some period of time, such as compression stockings, over the counter analgesia, leg elevation.
  3. Venous insufficiency proven with a doppler examination
  4. Condition is affecting daily living (for example, you are on your feet all day for your job but must take breaks due to pain)

The initial evaluation and doppler examination are usually covered with a copay or deductible, depending on your policy.  If we determine that you have a medical condition requiring intervention, we will then check with your insurer and get a preauthorization prior to scheduling the procedure.  This preauthorization process may cause a delay from a few days to a month or more, depending on your insurance company.  As soon as your insurer responds, we will contact you to schedule the procedure.  We will also provide you with our best estimate of what your out-of-pocket expenses will be in order to avoid any financial surprises.  We will do our best to help you navigate the sometimes confusing insurance landscape  of co-pays, deductibles, pre-authorizations, etc.