Is Darkening of the Skin A Sign of Venous Disease?

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When the skin becomes darker around the ankles, it may indicate underlying venous insufficiency. If you notice that your skin around the ankles changes color, you should see your doctor. Venous insufficiency can be diagnosed with ultrasound scanning by specialists.

Is Darkening of the Skin A Sign of Venous Disease? Yes.   Skin discoloration, also referred to as skin hyperpigmentation or venous stasis, describes the darkening of the skin as a result of venous insufficiency.    This is most frequently cause by venous reflux, an underlying condition that can be treated. When skin changes like these are present, the condition is termed chronic venous insufficiency.  Over time, the skin condition may worsen and the skin may become darker, firm to touch, scaly and itchy, and the skin may break down causing a venous leg ulcer.  It usually occurs around the ankles.  

Should I Wear Compression When I Travel to Prevent a DVT?

Should I Wear Compression When I Travel to Prevent a DVT?

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Using compression stockings during travel can reduce the risk of developing a flight-related deep venous thrombosis (DVT).

Yes. Compression stockings are great to use during air travel and long trips where you will be sitting for long periods of time. When you sit for long periods of time you are more at risk of blood clots and swelling. Compression stockings can reduce your risks and prevent swelling.  Ask your doctor the strength that is recommended for you.

Why Compression Socks?

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Olympic champion and Boston Marathon winner, Meb Keflezighi wears CEP compression socks while running. CEP compression socks can be found at compressrx.com.

Graduated compression stockings apply external pressure to your legs reducing venous pressure. Graduated compression stockings are great to use if your want to increase circulation, support you leg veins, and want to reduce uncomfortable leg symptoms such as swelling, tired and achy feeling legs.

They are important in the conservative management of varicose veins to reduce symptoms. They are also used after any type of vein treatment to improve the effectiveness of treatment, to reduce bruising and swelling, and for comfort.

Anyone can benefit from compression stockings. Compression stockings are great for relieving ones symptoms when sitting, standing or moving around for long periods of time. They are also great for professionals such as nurses, hairdressers, desk workers, and everyone in between.

Athletes wear compression stockings too.  There is some evidence that medical compression helps to reduce muscle fatigue and improves muscle recovery.  But, not all compression socks are made equal.  They should be medical graduated compression, like CEP socks by Mediven. These are the socks preferred by Olympic champion and Boston Marathon winner, Meb Keflezighi wears CEP compression socks while running.   Find medical CEP compression socks at compressrx.com.

 

Laser and Radiofrequency Vein Treatments

What is the difference between laser and radiofrequency procedures for varicose veins?

Both laser and radiofrequency ablation techniques are used as an alternative to surgery for the treatment of varicose veins and underlying venous insufficiency.  The concept behind both laser and radiofrequency treatments is that an energy source is used to heat the vein, causing it to collapse and seal shut. Over time, the treated veins will dissolve. This is offered as an alternative to surgical removal of the veins. The basic difference between the two, are the types of energy sources used.

Laser vein treatment, also known as laser ablation or endovenous laser ablation therapy (EVLT or EVLA) utilizes laser energy to heat the vein.

Radiofrequency vein treatment, also known as radiofrequency ablation (RFA), or the Venefit procedure (previously known as VNUS Closure) utilizes radiofrequency energy to heat the vein.

Both procedures are used to treat the small, great or anterior saphenous veins.

Either procedure involves making a tiny incision the size of a grain of rice on the skin, and a narrow catheter is inserted into the vein. The machine applies either laser or radiofrequency energy to the vein interior, an action that heats the vein and seals it closed.

Unlike traditional surgery, this new minimally invasive procedure takes about 30 minutes to perform and patients can walk out of the office afterward.

While both are effective options for vein treatment, we prefer radio-frequency ablation over laser because it has been proven to be more comfortable than laser yet equally effective. It is also our experience that there is less bruising,  pain and quicker recovery associated with radio-frequency closure of the veins.

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Laser vein treatment, also known as laser ablation or endovenous laser ablation therapy (EVLT or EVLA) utilizes laser energy to heat the vein.
Radiofrequency vein treatment, also known as radiofrequency ablation (RFA), or the Venefit procedure (previously known as VNUS Closure) utilizes radiofrequency energy to heat the vein.

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The radiofrequency catheter is inserted inside the vein. Radiofrequency energy then heats the vein causing it to collapse and seal shut. We prefer radiofrequency over laser vein treatment because we find that it is more comfortable for the patient with less bruising.

Remember, that more than one treatment type is often needed such as radiofrequency of the saphenous vein + sclerotherapy of superficial branches. Talk to your doctor to find our which is best for you or schedule a consultation at 858-550-0330.

 

What is Stasis Dermatitis?

Stasis dermatitis or venous stasis dermatitis is a change in the skin that occur when blood collects (pools) in the veins of the lower leg. ‘Stasis’ refers to pooling of the blood in the lower legs from venous insufficiency, and ‘dermatitis’ refers to the inflammation and related skin changes. Because of the inflammation, the skin around the ankles is usually itchy and discolored.

At first, the skin of the ankles and lower legs may look thin or tissue-like. You may slowly get brown stains on the skin.

The skin may become irritated or crack if you scratch it. It may also become red or swollen, crusted, or weepy.

Over time, some skin changes become permanent:

  • Thickening and hardening of the skin on the legs and ankles (lipodermatosclerosis)
  • A bumpy or cobblestone appearance of the skin
  • Dark brown color
Stasis Dermatitis with Ulceration

Chronic venous insufficiency over time can lead to skin changes and eventually ulceration. This image demonstrates stasis dermatitis (also known as venous dermatitis). Stasis dermatitis refers to the skin changes including skin discoloration around the ankles, dry itchy skin that can be thin, and it may eventually break down to cause an ulceration. You need to see a doctor if these signs are present.

Skin sores (ulcers) may develop (called a venous ulcer or stasis ulcer). These most often form on the inside of the ankle.  For this reason, whenever stasis dermatitis or skin changes are noticed around the ankle, you should see your doctor or vein specialist to stop the progression of venous insufficiency and prevent the skin from forming an ulceration.

  

 

8 Warning Signs of Vein Disease: #5 Pregnancy Related Varicose or Spider Veins

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Pregnant women should talk with their doctors about using medical compression therapy during pregnancy to reduce the risk of varicose veins and vein related issues.

8 Warning Signs of Vein Disease: #5 Varicose or Spider Veins, especially during or after pregnancy. During pregnancy, the amount of blood greatly increases throughout the body to almost double the normal volume, stretching leg veins far beyond their normal capacity.  Even though the visible signs of varicose veins may disappear after birth, the damage done to veins during pregnancy may be permanent and can cause pain and discomfort later in life. These problems may be avoided if compression therapy is prescribed during pregnancy. Women with a history of vein disease in their family or who experience swelling, pain or varicosities in the their legs during pregnancy are strongly urged to talk to their doctors about medical compression therapy or be evaluated by a vein specialist.

Varicose Veins vs. Spider Veins

What is the difference between varicose veins and spider veins?  Are they the same thing? Spider veins and varicose veins both refer to dysfunctional, dilated leg veins but the main difference is the size of the veins. Spider veins are small, thread-like veins at the surface of the skin. They often appear in clusters or can have a ‘starburst’ or spider-like pattern. Varicose veins, are larger veins that appear swollen, twisted cordlike veins that ‘bulge’ at the surface.

Both spider veins and varicose veins can cause pain and other symptoms like burning, aching and throbbing. Both can be treated without surgery.

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This image describes the difference between spider veins and varicose veins. Both are manifestations of unhealthy veins. Spider veins are essentially, tiny varicose veins.

How To Make Varicose Veins Vanish

How To Make Varicose Veins Vanish Without Surgery
Physicians have many options for treating varicose veins. The choice often depends on the severity and cause of the problem. It’s important that patients are carefully evaluated so treatment can be tailored to individual needs.

In some cases varicose veins may present a primarily cosmetic problem. In others they may be a symptom of a more severe underlying circulatory condition that should be addressed by a vascular specialist.

Compression hosiery can be used to provide support, and reduce symptoms such as the aching and tiredness associated with varicose veins but they cannot make varicose veins disappear.   There are no supplements or creams that can make varicose veins disappear. There are a variety of creams, lotions and ointments that are advertised in newspapers and magazines to make veins disappear. There is no scientific evidence that these creams or lotions can make varicose and spider veins disappear. Once veins are dysfunctional, it is a mechanical problem and the valves cannot be repaired. But, they can be removed. There are many ways to accomplish this.

Sclerotherapy is used for smaller varicose veins and for spider veins, also known as telangiectasia. A fine needle is used to inject a chemical solution into the veins. The chemical causes the vein to collapse and eventually disappear. The procedure can be done in a doctor’s office and doesn’t require an anesthetic. Patients feel only a slight burning when the chemical is injected. Often several sessions are needed to treat the veins.

Foam sclerotherapy, or ultrasound guided foam sclerotherapy is used to treat large varicose veins.

Ambulatory Phlebectomy is an alternative to foam sclerotherapy, and involves making a series of tiny incisions along the length of the vein and gently removing the vein in sections using a hook. The procedure can be done on an outpatient basis and can be used for both large and small veins.

Radiofrequency ablation,  is a minimally invasive procedure involves using a catheter to introduce an electrode into the saphenous vein (great, small or accessory saphenous veins). The energy from the electrode shrinks and seals off the vein. Nearby healthy veins take over the job of carrying blood from the legs.

Surgical ligation and stripping are rarely performed because the newer, minimally invasive procedures have replaced surgery for removing varicose veins.

For more information about treatment types and non-surgical methods to make varicose veins vanish, go to www.lajollaveincare.com. 

Before >> After

Before and After Pictures: Varicose Vein Treatment at La Jolla Vein Care. At La Jolla Vein Care, we utilize minimally invasive techniques to make varicose veins vanish- all without open surgery or general anasthesia.

How is Venous Reflux Diagnosed?

 

Venous duplex imaging uses ultrasound waves to create pictures.  La Jolla Vein Care utilizes state-of-the-art ultrasound scanners to image the veins beneath the surface of the skin, not visible to the naked eye. Duplex ultrasound imaging can identify if the vein is healthy, or if it is refluxing, or if there are any blood clots in the vein.

Duplex ultrasound combines Doppler flow information and conventional imaging information, sometimes called B-mode, to allow physicians to see the structure of your blood vessels. Duplex ultrasound shows how blood is flowing through your vessels and measures the speed of the flow of blood. It can also be useful to estimate the diameter of a blood vessel as well as the amount of obstruction, if any, in the blood vessel.  Conventional ultrasound uses painless sound waves higher than the human ear can detect that bounce off of blood vessels. A computer converts the sound waves into two-dimensional, black and white moving pictures called B-mode images.

Doppler ultrasound measures how sound waves reflect off of moving objects. A wand bounces short bursts of sound waves off of red blood cells and sends the information to a computer. When performing duplex ultrasound, your ultrasound technologist or physician uses the two forms of ultrasound together. The conventional ultrasound shows the structure of your blood vessels and the Doppler ultrasound shows the movement of your red blood cells through the vessels. Duplex ultrasound produces images that can be color coded to show physicians where your blood flow is severely blocked as well as the speed and direction of blood flow.  Venous reflux refers to back flow of blood across dysfunctional vein valves.  The direction of blood flow is detected by ultrasound.  This is measured in seconds.

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La Jolla Vein Care image that shows reflux in the great saphenous vein. Duplex ultrasound combines Doppler flow information and conventional imaging information, sometimes called B-mode, to allow physicians to see the structure of your blood vessels.