From the desk of Dr. Raffy Karamanoukian, Vein Specialist

What are Varicose Veins?
Varicose veins are like the end branches of a tree. The base of the tree is a vein that is normal, but for whatever reason -- hormones, age, genetics, pregnancy or trauma -- the vein starts to branch out. Sometimes those branches are very superficial (right under the skin). Approximately 50 percent of women over the age of 50 will start to see them in their legs. As you get closer to the feet, you see more and more veins.

How Do People Get Varicose Veins?

• Family history - Runs on the mother's side of the family
• Hormones - Birth control pills increase your chance of getting veins as well as taking estrogen replacement therapy in your 40s or 50s
• Pregnancy
• Occupation - If you are sitting at a desk for long periods of time or standing a lot, you may be at high risk
• Crossing your legs - Crossing legs changes the position of your vein's valves


One way to treat varicose veins is with a laser that heats up the blood and shuts off the blood flow to the veins. The second is by injecting a chemical (sclerotherapy) to collapse the vein and make it go away.

Risks of Sclerotherapy

There are always some risks with any type of injection. The risks are similar to shaving. You may have a little bit of bleeding and some irritation of the skin, but infection is very rare. Some pigmentation, or discoloration, occurs because the veins are closed off right under the skin. When the vein is destroyed, blood leaks into the tissue. The blood consists of iron, which can stain the skin, but this will go away with time. The darker your skin complexion, the higher your risk of skin pigmentation.

Who is a Good Candidate for This Procedure?

Patients who are good candidates for sclerotherapy are those who have varicose veins, as well as those who have multiple spider veins that arborize, or branch out like a tree. Varicose veins are thicker than spider veins, but it is the same process for both. When you inject a varicose vein, you are closing off a big vein, but it will take the body a long time to absorb that. If it is too big, it can take the body up to a year to heal. We like to reserve sclerotherpy for spider veins and reticular veins, which are veins that are enlarged due to pressure.

How Long Does It Take to Recover?

Sclerotherapy is almost like a lunchtime procedure. You'll be in the procedure about 20 to 30 minutes, and then you can go back to work. Redness and itching will subside in about 24 hours, and it will take the body about three to four weeks to absorb the vein. Also, you will have to use some type of compression for a few days, such as an Ace bandage or compression stockings.

Watch foam sclerotherapy in action!