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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 varicose veins do not cause circulatory 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.

Aren’t 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.

Why isn’t sclerotherapy better known?
Sclerotherapy is very common in Europe. There are over 2000 phlebologists practicing sclerotherapy in France alone. 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. Vanishing Veins is seeking to address this as it opens in clinics across the South East.

Will my varicose veins worsen during pregnancy
Leg health during pregnancy is very important.
The influence of estrogens produced during pregnancy can upset the phlebo-lymphatic circulation of the body. Although pregnancy does not cause varicose veins, it can aggravate an existing or underlying problem.

It is therefore important to:

• Wear appropriate elastic support from the start of the pregnancy
• Exercise daily
• Watch your weight and eat a healthy diet
• Rest with legs elevated during the day
• Massage the legs with lotions, creams or venotonic gels.

What is the affect of contraceptive pill or HRT on varicose veins?
When discussing either the contraceptive pill or HRT, it is important that you let your doctor know of any personal or family history of deep or superficial venous thrombosis.

Any hormonal treatment can lead to, or exacerbate in vulnerable patients, venous symptoms such as leg heaviness, itching, restlessness, oedemas, and thread veins. If this is the case, you should talk to your doctor. The prescription of a venotonic treatment or light elastic support is often enough to solve the problem.

In rare cases, a hormonal treatment needs to be stopped for purely circulatory reasons. A change of medication may be necessary.

Do you have any advice for air travellers concerned about the risk of DVT?
Air travellers should be aware there is an increased risk of blood clots during flights, although the risk of a serious problem is very low if one follows a few simple rules:

• Move around when the aisles are free, twice during the night
• Don't cross your legs
• Drink one litre of water per 6 hours of flying time
• Avoid alcohol
• Avoid sleeping pills
• From time to time, squeeze the calf muscles (by swinging the foot from tip to heel) or roll a bottle of water under the plant of your feet
• Wear loose-fitting clothes
• Wear elastic compression stockings

The risk of a blood clot can increase if:

• The flight lasts more than 5 hours
• You take hormones
• You have a known clotting disorder
• You have had problems with phlebitis before or you have a family history of problems

Should I consult my doctor before travelling?
If you have already had serious phlebitis a preventive treatment may sometimes be necessary.

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