Venous disease affects roughly 70% of women and 40% of men. However, many cases are never diagnosed and therefore never treated. Vein expert Jessica Plotnick, PA-C, MMSc explains that varicose veins and spider veins are fully treatable, with little to no downtime.
Is it important to treat varicose veins & spider veins?
Some veins are merely cosmetic, pose no health risk and do not require treatment. However, Jessica has found that many patients who believe their veins are simply cosmetic in fact have underlying venous disease. Moderate to severe venous disease should be treated, as it can increase the risk of blood clots, skin ulcerations and skin breakdown. Patients with venous disease may experience leg swelling, heaviness, aching, bruising easily, itchiness and pain-although some, even with severe disease, may have no symptoms at all.
Who does it affect? When and why does it happen?
Venous disease is typically a genetic disorder that starts for most people in their late teens and early twenties, it is not an “old lady disease.” The one-way valves along a vein start to fail which causes blood to reflux. This results in too much volume in the veins below it, causing them to dilate.
Why are varicose and spider veins more common in women?
Women naturally have higher levels of estrogen and progesterone. These levels further increase from birth control pills, IUDs, HRT, as well as from hormone surges during pregnancy and menopause. These hormones dilate the veins thereby worsening a genetically pre-existing condition.
What are the treatment options?
The majority of unhealthy veins can be treated with sclerotherapy, considered the gold standard in care. This involves injecting a solution into the vein, which irritates the inside of the vein wall, causing it to collapse. To help the veins close down more rapidly, Jessica recommends wearing graduated medical compression stockings after the procedure for 2-3 days. Patients generally require multiple treatments to fully close down the veins. The sclerotherapy process needs to be done methodically and precisely. The results are well worth the time and cost, as the veins will be permanently closed. The treatment will eliminate the diseased veins as well as preventing the spread and formation of more unhealthy veins.
Occasionally, a patient requires an ultrasound to determine if a larger valve is incompetent. If this is the case, a surgical procedure might be necessary. Jessica never recommends laser treatment for veins. She firmly believes it is substandard care, is ineffective and often causes scarring.
A word of caution
Insurance fraud and unnecessary surgeries and procedures have sadly become a common practice in the world of vein treatment. Pop-up “vein clinics” are emerging and claiming to take all insurance with “no cost to you.”
The truth: Most insurance will cover an ultrasound if someone has symptoms and bulging varicose veins. Most insurance will cover surgery if proven medically necessary. However, since sclerotherapy is rarely covered by insurance, these clinics opt to perform more invasive and unnecessary procedures which often, not only don’t fix the presenting problem, but leave scarring.
Jessica Plotnick, PA-C, MMSc has been a vein specialist for over 20 years and practiced emergency medicine for 12 years in NYC. She is a graduate of Emory School of Medicine and Binghamton University and was a Faculty Professor at NYU from 2016-2020. Jessica’s expertise also includes many cosmetic procedures including injectables and laser devices. She is the owner of CPW Vein & Aesthetic Center, 75 Central Park West in NYC since 2004. Jessica recently opened a 2nd office in Chappaqua. To make an appointment at either location call 212-639-1259 or visit www.cpwmedspa.com
