One of the most common treatments for varicose veins is laser (a.k.a., endovenous laser treatment, EVLT, EVLA). The procedure has become extremely popular in the last 15 years as it is safe, comfortable, cost-effective and has a high success rate. It is one of several different treatments which are commonly performed for varicose veins. Whether laser treatment is right for you depends on a number of factors. But first, a little background on varicose veins.
Varicose Veins
Varicose veins are large, bulging veins that typically appear on the lower extremities (thighs and legs), but they can in other areas as well. These protruding veins can be caused by a number of reasons, the two most common being genetics and a job that requires prolonged standing or sitting. Other causes include pregnancy, increasing age, trauma, obesity, history of blood clots, and prior vein surgery. Varicose veins most commonly occur when one-way valves in veins beneath the skin surface become faulty, causing blood to pool in veins at the skin surface. These superficial veins become dilated, causing them to be more noticeable.
Symptoms of Varicose Veins
Patients with varicose veins may or may not have symptoms. Typical symptoms are pain (aching, cramping, throbbing, burning), itching, swelling, leg heaviness, restless legs, and leg fatigue. In more advanced cases, skin changes may occur (especially on the lower legs), with darkening of the skin color, hardening of the skin, and even development of open wounds on the lower legs called ulcers.
For some people, varicose veins may purely be more of an aesthetic concern. However, recent studies have shown that the presence of varicose veins increases the risk of the development of deep venous thrombosis, a potentially life-threatening condition. So even if there are no symptoms, treatment of varicose veins may still be a good choice for many patients.
Treatment of Varicose Veins
To obtain long-lasting results in the treatment of varicose veins, one must eliminate the source of the problem (under skin surface). This can be done in a number of ways. Endovenous laser treatment is one of the most popular ways to do this. Other treatments include radiofrequency ablation (RFA), mechanicopharmaceutical ablation (Clarivein), chemical ablation (Varithena), and VenaSeal. These are all good treatments and each has its relative advantages and disadvantages. Today we will focus our attention on EVLT. First, a bit about laser.
What Is Laser Surgery?
Laser surgery is a blanket term that refers to a wide number of treatments that all involve lasers. The laser itself is a highly focused beam of light, and the heat from the light can be used to either heat certain tissues to treat them or to precisely cut instead of using a scalpel.
How are Lasers Used to Treat Veins?
It is important to understand the distinction between laser treatment of spider veins (the tiny red or blue veins on the skin surface) and varicose veins (the large bulging veins that protrude from the skin).
When lasers are used to treat spider veins, a tiny handpiece is passed over the veins on the outside of the skin, heating the veins and causing them to close. Laser for varicose veins is done quite differently.
Laser for Varicose Veins (EVLT) – How is it done?
This simple elegant procedure is easily performed in an office based setting. After a tiny amount of local anesthetic is provided at the skin surface, a small fiber-optic fiber is threaded up the affected vein under ultrasound guidance. Anesthetic is then place around the vein, so that the laser treatment is painless. The laser is then activated and slowly moved down the vein, effectively heating the vein so that it will close and eventually disappear. The fiber is then removed and a small steri-strip is placed at the entry site. No stitches are needed. A bandage is then applied to the leg and you are able to walk to your car.
Adjunctive Treatments after Laser for Varicose Veins
Laser (EVLT) is utilized to treat the underlying source of the varicose veins. It doesn’t directly treat the bulging veins on the skin surface. While EVLT may cause some or all of the varicose veins themselves to disappear, often times adjunctive treatments such as microphlebectomies (removing the veins through tiny incisions) or ultrasound guided foam sclerotherapy (injecting the veins) are performed to obtain the very best cosmetic results. While these adjunctive treatments are sometimes done on the same day as the EVLT, it is often better to stage the procedures, performing the secondary treatments later. This allows some of the varicose veins to shrink and disappear, which may result in a better cosmetic outcome, with less scarring and/or hyperpigmentation after treatment.
How do I know if Laser is best for me?
That’s a great question. When it comes to varicose veins, it’s not a one-size-fits all world. Treatment choice depends on many factors, including your anatomy, lifestyle, tolerance for wearing compression stockings, budget, and insurance. In general, it is best to be seen by someone who is able to make an accurate diagnosis, takes the time to understand your needs and goals, and has a wide range of treatment options available for you to choose from.
It’s important to choose a medical provider who is qualified. Dr. Rayman is a board certified physician and interventional radiologist. He has a great deal of experience in the diagnosis and treatment of varicose veins, offers a complete range of treatments to his patients, and will help you to determine the best course of action for your particular circumstances.
What’s Next?
If you are interested in varicose vein treatment and live in the greater Los Angeles area, you owe it to yourself to visit Dr. Rayman at Beach Cities Vein and Laser Center in El Segundo.
It is not just the wide range of treatment options for varicose veins, including laser, which makes this place special. It’s the total patient experience – one geared toward your personal needs, with attention to your comfort and the best medical and cosmetic outcome possible. Call (310) 906-2287 and schedule your consultation with Dr. Rayman and his team and start your journey to a refreshed appearance without noticeable varicose veins today!