Treatment options: Surgery
The most invasive of treatments, surgery is usually performed when the valve that connects the leg to the body doesn't work, says Malik. The surgery is performed in a hospital, and the doctor either removes the vein entirely or ties it off surgically so that the blood flowing to the heart doesn't flow back down the vein, which would cause the legs to swell. In some cases, patients fall into a “grey area” between surgical and non-surgical treatment, and since surgery is covered by provincial insurance (such as OHIP in Ontario), it can be a more attractive option for some patients.
Treatable areas: Varicose veins requiring surgery are found in the legs.
Length of treatment: 30 to 60 minutes, depending on whether surgery is performed on one or both legs. Recovery time is 24 to 48 hours.
Cost: Surgery is covered by provincial insurance.
Possible side effects: Scarring, bruising, swelling and, though rare, infection can occur.
This type of treatment has been around for nearly 100 years, and is a very common treatment used for varicose, reticular and spider veins, says Nancy Luther, registered nurse at the Sherlase Clinic in Markham, Ont. Registered nurses can perform sclerotherapy when working under the direction of a physician. An irritant, usually a mixture of dextrose and saline, is injected into the vein. The substance causes the inner walls of the vein to be irritated. As a result, “the vein swells inwardly, sticks together, dries out and fades,” says Luther. A vein may need to be injected a second time or the solution may need to be strengthened. Larger-sized veins are treated first because they feed into the smaller veins, says Moya. Injections feel like pinpricks and, afterwards, compression stockings or bandages are used to aid in closing down the veins.
Treatable areas: Legs and face.
Length of treatment: Treatments can range from three to eight sessions, with 15 to 60 injections per visit. Sessions are generally two weeks apart.
Cost: Treatment is covered by provincial insurance if veins are over five mm in diameter and painful. Otherwise, costs range from $70 to $125 per session depending on the clinic and the number of injections.
Possible side effects: Redness, bruising, hypo- or hyperpigmentation and slight, temporary irritation can occur. Veins can return, often to the same area, says Luther. However, there is no limit to the number of treatments you can undergo without risk.
“Sometimes, veins are too small for sclerotherapy to be successful. In these cases, lasers are used,” says Dr. Brown of the Yorkville Vein Clinic in Toronto. They are also ideal for needle-phobes. The laser coagulates the blood, which causes the vein to shut down, and slowly it disappears. Patients should notice a difference in two to three weeks.
Treatable areas: Lasers are usually used for cherry hemangiomas, reticular veins and spider veins on the face and legs.
Length of treatment: Two to three treatments, six to eight weeks apart.
Cost: Laser is not covered by provincial insurance and costs range from $100 to $350 per session depending on the clinic and the duration of your treatment. Most treatments take one to two sessions.
Possible side effects: Burning, pigmentation or redness. After the treatment, a cold compress applied to the affected area can help constrict blood vessels. Heat and exercise should be avoided. Patients should also avoid sun exposure for two to three weeks before, during and after the treatment advises Dr. Brown.