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Varicose Veins Natural Treatment

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NationalInstitute of Health Public domainPart 1- Varicose Veins Natural Treatment

What are Varicose Veins?

Varicose veins can be a cosmetic problem or cause aching pain and discomfort in the area affected. They happen most commonly in the legs but can occur in area that undergoes increasing venus pressure, such as the feet, testicles, anus and vaginal area. One variation of varicose veins are spider veins. In order to better understand what varicose veins are, it is important to have a general understanding of how of the venous and arterial blood system works.  Our bodies are fed oxygen by the arteries.  Oxygen enters the lungs and is transferred into arterial blood supply.  The heart then pumps this blood around to the rest of the body.  At some point the blood loses all of the oxygen available to it and returns through the venous system back to the heart. Review the information below regarding varicose veins natural treatment and how to get rid of varicose veins.

 

Venous Blood Flow

The arterial blood supply is pushed around the body by the function and power of the heart.  However, the venous blood must move back up through the body without the benefit of the heart muscle.  When we are in an upright position the blood works against gravity to return to the heart.  Leg muscles will squeeze the deep veins of the legs and feet and one-way valves keep the blood from flowing back down in the wrong direction.  So, when the leg muscles contract, the valves inside the veins open.  When the legs relax the valves close, which prevents the blood going in reverse.  This process is called the venous pump.

When we walk, the leg muscles squeeze the blood through the venous system which works very well.  However, when we sit or stand for long periods of time the blood can pool and increase the amount of pressure on the valves in the veins.  There are actually three different kinds of veins in the legs.  The first are superficial and lie closest to the top of the skin.  There are deep set veins which lie within the groups of muscles and there are perforating veins, which connect the superficial veins to the deep veins.  The deepest vein leads to the vena cava, which is the body’s largest vein and runs directly back to the heart.

 

Repeated Sitting or Standing

The deep veins in the perforating veins are usually able to withstand very short periods of increased pressure.  However, if you are susceptible, repeated standing or sitting can stretch the walls of the veins and damage the valves.  Varicose veins may results.  Spider veins are a milder case of varicose veins which are not a serious medical problem but can be a cosmetic concern.

Varicose veins become swollen and you can see them through the skin.  They may look blue, bulging and are twisted.  If they are left untreated they become worse over time and can cause feelings of fatigue as well as some skin changes in the area in which they occur.  This is because the venous system which normally drains the area of waste and toxins is no longer functional.  As many as 40 million Americans, the majority of them women, have varicose veins.

If you have varicose veins your legs may feel heavy or tired during the day.  You’ll notice that when you stand on your legs for too long your symptoms will increase.  Some people who have varicose veins will also have cramping at night.  If you have severe varicose veins there is also a slightly increased chance of developing a deep vein thrombosis.  This is a condition that requires immediate medical attention. (1)

 

Risk Factors for Varicose Veins

Researchers have identified several factors that increase the risk of developing varicose veins which include a family history, obesity, lack of exercise, smoking, standing or sitting for long periods of time each day or having a deep vein thrombosis.  Interestingly, women are more likely to develop varicose veins than men are and they often appear between the ages of 30 and 70.

One of the side effects of pregnancy appears to be the development of varicose veins because of the increased pressure placed on the venous system secondary to the pregnancy.  However, varicose veins that appear with in that time period often return to normal status within the first year after childbirth.

 

Varicose Veins Natural Treatment

There are some natural treatments to help individuals with improvement of the venous return from those areas of the body.  This is desirable because of conventional treatment  complications which may occur are blood clots or skin ulcers.  Many treatment protocols are easy and do not require a long recovery time. Read further below for specific details.

How to Prevent Varicose Veins

Prevention in the first place is much easier than to determine a way to get rid of varicose veins. To find the best cure you should investigate preventative measures such as regular exercise, keeping fit, maintaining a normal body weight and not sitting or standing for too long without moving around.

 

Symptoms of Varicose Veins

Varicose veins are veins which are abnormally and irregularly swollen. Veins are the segment of the arterial system that returns blood to the heart after oxygen has been delivered to the tissues. Varicose veins can occur in multiple different areas of the body on both men and women. The most common form goes occurs in either one or both of two large veins near the surface of the leg. Varicose veins can also occur inside the anus, the vagina and the testicles, as well as smaller varicosities called spider veins, which can occur on the face and upper arms.

The signs and symptoms of varicose veins will depend upon the area of the body which is experiencing the varicose veins. In the legs, individuals will recognize symptoms such as itchy or heavy legs, especially if they have been sitting or standing for any length of time. Varicose veins will also appear blue and twisted. If they are severe the skin covering the leg can also become dry, itchy and swollen. (2)

Both men and women can experience itchiness over the area where the vein is located as the skin becomes dry and stretches. A section of the vein can also become engorged with blood and tender after prolonged sitting and standing. This condition is called phlebitis. Although it is uncommon, varicose veins can be injured and bleed. More commonly individuals will suffer from open sores in the area of the leg normally drained by the vein. These open ulcerations can also occur near the ankle where individuals may suffer increased amounts of swelling and decreased amounts of perfusion from both the vein and the artery system. The ulceration is caused from a reduction in delivery of oxygen and removal of waste products from the area.

Individuals who have varicose veins of the legs may also suffer from the entire leg swelling or swollen feet and ankles. They may complain of leg muscle cramping, especially at night, as well as poor healing of any open sores. Oftentimes varicose veins are accompanied by spider veins. And, related to the decreased removal of blood and toxins from the area, an individual can suffer from eczema on their legs.

Varicose veins can also occur in the testicles where they cause swelling and feelings of heaviness. Men find that the swelling reduces quickly after lying down, but can just as quickly become swollen once they stand up. Some men are plagued by pain and discomfort while others experienced a reduction in fertility related to the increased heat from the blood supply in the scrotum.

Varicose veins can also occur around the anus and rectum, commonly called hemorrhoids. Hemorrhoids are more likely to occur when individuals have hard stools, are chronically constipated and strain to have a bowel movement. All of these issues increase the amount of pressure in the veins that feed the rectal area and increase the risk of the development of hemorrhoids. Individuals will experience itchiness, pain and swelling.

Varicose veins are also common in the vaginal area, especially during pregnancy. Women who experienced vaginal varicose veins may require surgery to correct the problem. Women will be able to feel bumps and lumps within the vaginal vault or around the vulva. They may experience heaviness, difficulty walking, pain and painful sexual intercourse. (3)

The signs and symptoms of varicose veins are dependent upon the area of the body which is affected. By recognizing the signs and symptoms and seeking prompt treatment you are more likely to reduce the progression of the condition and prevent the formation of any further varicose veins.

 

Endovenous Ablation

Varicose veins develop when the one-way valve system within the vein, which helps to move blood from the lower extremities to the heart, is damaged. Blood will begin to pool inside the veins and cause unsightly blue and red tinged bulges, as well as discomfort, pain and swelling. They occur most commonly on the legs but individuals can suffer from these swollen veins in the face, testicles, vagina and anus. Although they are not usually a threat to your long-term health, they can be painful and can cause ulcerations, or openings in the skin.

One treatment option is an endovenous ablation. The goal of the procedure is to shut down the vein using targeted heat energy. The heat can be created with a laser, also known as an endovenous laser ablation, or with radio frequencies, known as a radiofrequency ablation. Both of these use the latest technologies and are a better option than vein stripping which was used for decades. (4)

The vein stripping procedure was often painful and invasive. Both ablation procedures, using either laser or radio frequency, are minimally invasive and highly effective. The procedures can be performed in the office setting with just local anesthetic. For a variety of different medical reasons only one large vein should be treated at a time using laser ablation. If you have more than one vein that must be addressed, it is best done two to three weeks apart at different sessions.

The ablation therapies can be done within less than an hour and performed in the doctor’s office. Most physicians report a success rate of 98% or greater and individuals often report an immediate relief of their symptoms. Because it is minimally invasive it also requires no general anesthesia or hospitalization. Most people are able to return to their normal activities immediately. Another advantage to the procedure is that there are also no scars left, as opposed to vein stripping which leaves large scar tissue over the legs.

People who undergo this procedure may find that they have some pain and tenderness as well as some slight bruising at the point of entry of the catheter. The chance of subdermal bruising and burst capillaries are negligible. However, since there is a slight break in the skin where the catheter is inserted, there is also a slight chance of infection. (5)

Although the procedure is usually not prescribed for cosmetic reasons alone because it is not a covered procedure, it is more commonly used to help alleviate symptoms such as aching pain, swelling, skin irritation or sores, discoloration and venous inflammation (phlebitis).

During the procedure, if the laser is used, the patient is asked to wear protective glasses. The area of the leg will be cleaned, shaved and numbed. The patient feels a slight pressure when the catheter is inserted but shouldn’t feel more pain. After the procedure the patient must wear a compression stocking to reducing bruising, tenderness and minimize the possibility that blood clots will form.

The process works when a laser or radio frequency is inserted through the length of the vein. The machine generates heat and burns the interior of the vein as it is retracted. This causes the vein to scar, tighten and shrink until it is invisible through the skin. And, although the valves continue to be non-functional, the vein no longer swells and pain disappears.

There are several different options for treatment for varicose veins. So, before making a choice do your research and determine which procedure will work best in your lifestyle, with your overall health concerns and your willingness to do follow-up care. Only you and your physician can determine what will work best for you.

 

Laser Treatment for Varicose Veins

Millions of both men and women are bothered by the embarrassment and discomfort of spider veins on their legs or faces. Spider veins are those small red, blue and sometimes purple blood vessels that appear on the surface of the skin and are usually asymptomatic. In some circumstances, when the spider veins get larger in size or surface area they can cause some minor symptoms.

A varicose vein is an entirely different animal. These are tortuous large veins that have lost the function of the one-way valves that keep the blood from pooling. Without those valves, the blood pools in the veins and decreases the ability to adequately perfuse oxygen to the tissue and remove waste from a specific area of a leg. Treatment for varicose veins has progressed over the years. Initially, individuals were recommended to sit with their feet elevated as much as possible during the day. Next, manufacturers produced support hose which helped to move the blood along in the venous system towards the heart. Surgeons then began using a veins stripping technique where the vein itself was removed from the body. Today, less invasive treatments are available, such as sclerotherapy and laser treatment that causes the veins to collapse and eventually become reabsorbed by the body.

This venous laser treatment works by thermal destruction of the vein tissue. The laser energy is delivered to the area of the vein that is incompetent and a variety of wavelengths are used. When the laser is fired, thermal energy is deposited in the blood and venous tissues causing irreversible localized damage. The entire vessel is treated and, although a hole may be made during the laser treatment, permanent changes are caused by the thermal injury. (6,7)

Prior to the procedure your physician will evaluate your health and situation to determine whether or not you are a good candidate. Be sure to report all medications that you are currently taking, including herbal supplements and multivitamins. If you have any allergies, especially to local anesthetic or general anesthetic, you must also advise your physician. Your doctor will talk to you about removing any aspirin, nonsteroidal anti-inflammatory drugs or blood thinners for a specific period of time prior to the procedure in order to decrease the risk of bleeding.

Arrive for the procedure wearing comfortable loose fitting clothing. Be sure to bring a friend or relative with you in order to have them drive you home after the procedure. Your doctor will most likely order compression stockings for use after the procedure in order to reduce the likelihood of bruising and tenderness. These stockings should be worn for approximately 1 week and are often kept in place continuously for the first 72 hours. Patients are encouraged to do aerobic activity and are highly discouraged or are forbidden from bed rest, hot baths, heavy lifting or long travel for approximately 1 to two weeks.

Reports of any major complications are very rare. Patients who are not good candidates for laser therapy are those who are allergic to local anesthetic, have current infections in their legs, lymphedema, nonambulatory patients, experienced peripheral arterial insufficiency or are in poor general health. Women who are pregnant or those who have had an active venous thromboembolism should also not undergo this procedure.

The benefits include no surgical incision and a relatively non-invasive procedure. The treatment is more effective than traditional vein stripping and is associated with less pain and fewer complications during recovery. The procedure leaves virtually no scars and patients are usually able to return to daily activities immediately.

As with any procedure that penetrates the skin there is a risk of infection, tenderness, heat damage to the nerves or inflammation of the vein (thrombophlebitis). Any blood clots that may form in the veins can potentially travel to the lungs, but this is an extremely rare problem.

Laser treatment for spider veins doesn’t make any puncture into the vein or skin. The laser is applied over the skin. Patients describe the experience like having a small rubber band snapping against the skin. The veins usually disappear over the next 2 -6 weeks.

 

Sclerotherapy

Varicose veins and spider veins will affect close to 40 million Americans, mostly women. Sclerotherapy is a medical procedure which is used to treat these varicose veins and spider veins through the use of sodium chloride injected directly into the vein. This particular procedure has been used since the 1930s to treat varicose veins. If left untreated these normally cosmetic problems can increase the risk for blood clots, skin ulcers, pain and discomfort.

Sclerotherapy is performed in the physician’s office using a 23% solution of sodium chloride mix with lidocaine. Lidocaine is a local anesthetic used to help numb the area. Heparin is also added to the solution. This is injected directly into the blood vessel using a very fine needle. The solution is designed to irritate the lining and cause it to swell and stick together. According to radiologyinfo.org, the blood will clot within the vessel and eventually the vessel turns to scar tissue and is reabsorbed by the body. (16)

The physician will determine the number of varicose veins that are injected within one session. This will depend upon the size and location of the veins as well as the patient’s overall medical condition and willingness to be compliant following the procedure. If a larger vein is being injected, the sclerotherapy can cause cramping sensation for about one to two minutes. The procedure itself usually takes between 30 and 45 minutes.

Sclerotherapy has been in use since the 1930s because it is very successful. It is estimated that as many as 50% to 80% of those veins which are injected will be eliminated in that injections session. Less than 10% of the individuals who have sclerotherapy will not respond at all and in these instances a different solution or a different method may be tried.

Spider veins are a smaller version of a varicose vein. These generally respond to sclerotherapy within three to six weeks while a larger vein may take three to four months. Once a vein responds to the treatment it will not reappear. However, it is not uncommon for new veins to appear in the same area over time. In order to decrease the risk for new varicose veins or spider veins to develop in the same area, it is important to use preventative measures.

Varicose veins and spider veins form because of the increased pressure on the venous system from number of factors. Women who are pregnant, or men and women who are obese, smoke or spend much of their day either standing in place or seated, will be at greater risk for developing varicose veins and spider veins.

If you believe you’re a candidate for the use of sclerotherapy, you should have an initial consultation with your dermatologist or vascular medicine specialist. Women who are pregnant, or on bed rest, are not good candidates for this treatment. If you have had blood clot in the past your eligibility will be decided on an individual basis based on your overall medical health and other underlying medical conditions. The veins that could be usable for any future surgical bypass procedures, such as the saphenous vein, will not be considered unless they are already unusable.

Sclerotherapy is currently considered safe to perform on the hands, arms, face in other areas that were previously avoided.

Prior to the procedure, your physician will give you instructions such as avoiding certain medications up to two weeks prior to the procedure which may stain the skin or interfere with the action of the agents. Directly before the procedure no lotion should be applied to the area and the individual should wear shorts for easy access to the venous system. Most physicians will recommend the use of compression hosiery to support the venous system after the procedure is completed.

Some individuals will experience side effects, such as veins which become lumpy and hard before totally disappearing and raised red areas which can appear at the injection site. Other more rare side effects include inflammation within 5 inches of the groin, sudden onset of a swollen leg, formation of small ulcers at the injection site, red streaking or allergic reactions to the sclerosing agents. Any of these more rare side effects require the immediate attention of your physician.

Most patients are encouraged to resume the regular activities immediately after the procedure and should walk and exercise in order to help the venous pump system work appropriately. Compression wraps or support hosiery is used to help compress the vessels.

While sclerotherapy is highly effective, insurance companies will not usually cover it because it was performed for cosmetic reasons. Check with your insurance company prior to the procedure. They may consider it if a letter of request from your physician is sent concerning the nature and reason for the treatment.

 

Spider Veins

Spider veins are like varicose veins but they are much smaller. They often begin as small capillaries that are blue or red squiggles on the skin. Most common areas are over the surface of the thighs, calves and ankles. Unfortunately, it is estimated that at least one third of the adult female population will experience spider veins at one time or another in their life.

Women often seek treatment for spider veins because they are of cosmetic concern. And, for cosmetic reasons, insurance companies will not cover the treatment. However, it is not uncommon for spider veins to also cause specific symptoms, such as aching, heaviness or itching on the legs. Spider veins are associated with larger underlying varicose veins and are sometimes a precursor to those larger medical problems. (8)

To fully understand how a spider vein will materialize it is important to understand the underlying physiology of the vascular system. Normally, oxygen enters the lungs and is transferred to arterial blood supply. This blood is then pumped around the body using the force behind the heart muscle. Once the blood gets to the furthest end of the arterial supply and no longer has oxygen to deliver to the cellular system, it begins its long journey back to the lungs to pick up more oxygen.

The blood that travels through the arterial system has the advantage of the heart muscle to provide force, but the venus system must use another process to move against gravity back to the heart. This system is the venus pump system. Using a system of one way valves and muscle contraction, the blood moves slowly against gravity to the heart. If a person stands or sits for long periods of time without any muscle contraction, these valves can be damaged from pooling of the blood. This leakage causes the blood to pool near the surface and triggers the development of varicose veins and spider veins.

Experts say that spider veins occur mostly on the legs and face and are also known as telangiectasia. They begin in a woman’s 40s and 50s and are formed when superficial veins near the skin surface leak tiny amounts of blood.

Spider veins can actually take on three different forms. They can appear in a spider shape, with a group of veins radiating outward from a central point. They can appear as a pattern that resembles the branches of a tree or they can be linear as separate thin lines. Men and women can have specific risk factors that increase the probability that they will develop spider veins. These factors can include heredity or genetics. In other words when a family member also has the same difficulty they are at higher risk for developing spider veins. Women who are pregnant, suffering from menopause or other hormonal metabolic diseases, increased weight gain, occupations or activities that require prolonged standing or sitting and trauma all increase the risk that an individual suffer from spider veins.

Many of these factors that increase risk will increase the pressure on the lower extremities and venus system. For instance increased weight gain, pregnancy and standing or sitting for long periods of time will all increase the risk of valvular damage in the veins.

A common form of treatment for spider veins is sclerotherapy. This is a procedure done in the office where the spider veins are injected with a solution that causes them to collapse, clot and eventually become reabsorbed. This procedure is not usually done for cosmetic reasons but because there are other associated symptoms. Many people will require several different sessions to receive the maximum benefit.

Another treatment option for spider veins is done with a laser. During this process an intense light is directed onto the veins, which eliminates them permanently. This is especially suited to treating veins in which a needle cannot be used.

Treatment of spider veins is also common enough to have started a global market of creams and over-the-counter treatments. The products do not generally meet with the approval of physicians because no studies have been done to prove their efficacy. In some cases the topical treatment will contain vitamin K oxide which has been shown to rebuild vascular walls and repair damage that reduces the appearance of spider veins.

While the gold treatment of spider veins is sclerotherapy, many will choose an initial $50 over-the-counter cream before spending several hundred dollars for a treatment in the physician’s office. Prior to starting any type of treatment you should have your spider veins evaluated by your primary care physician to determine whether or not there are any underlying medical conditions which may have precipitated the onset of spider veins and must be treated as well.

 

Treatment of Spider Veins

Spider veins are those small blue, red or purplish looking vessels that are close to the surface of the skin and often cause individuals embarrassment and some discomfort. More women than men are at risk for the development of spider veins. Risk factors include obesity, pregnancy, hormonal changes and standing or sitting for long periods of time. Individuals who have a genetic history, in other words have family members who also suffer from spider veins or varicose veins will have a higher risk for developing the same the problem.

While you may be more interested in how to treat the condition than in how it occured, by learning how they develop, you are able to decrease the likelihood that you will develop more.

The gold standard for treating spider veins is a procedure called sclerotherapy. This is a process in which a 23% saline solution, with lidocaine and heparin are injected into the vein using a very small needle. The saline solution causes the blood to clot and the veins to collapse. Within two to six weeks the body has reabsorbed the veins and they are no longer visible either on ultrasound or to the naked eye.

Sclerotherapy is a very safe procedure that is done in the doctor’s office. Once the procedure is finished patients can use ibuprofen or Tylenol for discomfort and are encouraged to remain active during the day. It is very minimally invasive process that allows the patient to return to their daily activities on the first day. Patients often find that their symptoms from the spider veins are reduced or eliminated quickly. Unfortunately, individuals who suffer from multiple spider veins may require multiple office visits to remove all of the offending veins.

Another procedure currently available for spider veins is laser treatment. Laser treatments direct a variety of wavelengths to the veins. This thermal energy causes damage to the blood vessels, after which they clot and eventually are reabsorbed into the body.

Laser treatments are the preferred method of treatment for individuals who suffer from spider veins on the face. While this treatment process is slightly more expensive than sclerotherapy, it also is completely pain-free and allows the individual the ability to go through one process or one procedure in order to rid themselves of all spider veins.

The choice in treatment for spider veins is between the patient and the physician. The physician will inform the patient of the different options, and help them to make a decision based on their overall general health, the location of the spider veins and the number of treatments they anticipate will be necessary in order to successfully treat the condition.

 

Vaginal Varicose Veins

Varicose veins develop in men and women when the one-way valves that control the return of blood from the lower extremities to the heart are damaged. These valves prevent the blood from pooling in the veins and the subsequent swelling that results. Unfortunately, some men and women are prone to varicose veins and spider veins because of a genetic predisposition. Women can also develop varicose veins in the vaginal area, especially during pregnancy.

These vaginal varicose veins can occur both within the vaginal vault and outside where they can be seen more clearly. Some women complain of pain and discomfort while others noticed the bump but have no change in sensation. Just as with other varicose veins, women who spend the majority of their day on their feet, will experience greater heaviness and pain at the end of the day. Also, it is not uncommon for women to find that sex is now uncomfortable or painful. (9)

Women can improve their pain and discomfort by spending some time lying down with their feet elevated for 30 minutes both in the morning, afternoon and evening. Women also find that adding pressure against the varicose veins can help them from increasing in size as the day goes on. A product that is sold specifically to provide support in this area is the Fembrace. Originally designed to assist women who suffer from genital prolaspe, it also helps those who have vaginal varicosities. Another option is to use a pair of bike shorts and put a thick pad inside the shorts in order to add pressure against the varicosities.

Most obstetricians and gynecologists will tell their female patients that these varicose veins are not uncommon during pregnancy. And, fortunately, they also usually resolves after the child is born. If you know you have a varicose vein, or suspect you have one in your vagina, it is important to tell your obstetrician in order to receive any further advice that may affect other underlying medical conditions and for specific support during birth.

Some women find that icing the vaginal varicose veins will help to reduce the swelling and decrease the pain. You cannot use any topical ointments are medications on these veins without first consulting with your primary care physician or obstetrician in order to ensure that it is safe for use during pregnancy.

One of the home remedies that has some reported success is the use of corn starch paste applied to the varicose veins which helps to shrink them and improve the ability of the woman to be functional throughout the day. NEVER put any hemorrhoid cream on these varicose veins. And always speak with your obstetrician about any products you use, even corn starch.

 

Varicose Veins During Pregnancy

Varicose veins are swollen veins that can bulge near the surface of the skin. Many men and women are both embarrassed by the sight of these veins and experience the discomfort of swollen legs, itchy skin or small ulcers. Women, who have no genetic predisposition and thought they were much too young to experience a varicose veins or spider veins, can be surprised by the appearance of these little cosmetic problems during pregnancy. Although you may have little or no discomfort, they can make the legs feel heavy and achy.

The good news is that varicose veins that developed during pregnancy tend to improve significantly once you have given birth. And the better news is that these problems do not have to be problems if you take preventative measures. Women who work to reduce their risk of the development of varicose veins or spider veins will find they have a reduced likelihood of developing this unsightly condition. (10)

Although your obstetrician probably recommends that you exercise on a daily basis for other reasons, daily exercise will also help your circulation in your lower extremities and decrease the risk that you will develop varicose veins.

The development of spider veins and varicose veins is often a result of extra stress placed upon the venous system. This can happen when an individual sits or stands for any length of time, or add extra weight. Just the act of becoming pregnant and growing a baby for nine months, means that you have added an extra 20 to 30 pounds over the course of your pregnancy. Work hard to keep your weight within the recommended range for your stage of pregnancy and do not view this time as nine months of eating poor nutritional choices and gaining more weight than your physician recommends. (11)

Women who are pregnant find that they benefit greatly by elevating their feet and legs whenever possible. This elevation helps to reduce the swelling in the lower extremities but also helps to reduce the pressure on the venous system and therefore reduces the risk of development of varicose veins or spider veins. If you find that you will be sitting for any length of time, use a stool or box to elevate your feet. If you will be standing for any length of time try to place one foot on a stool and alternate every five to 10 minutes. (12)

Men and women who cross their legs while sitting find that this increases their risk of varicose veins. This risk increases even more during pregnancy.

Sleeping on the left side with a pillow wedged between your legs and behind your back will help to increase the venous flow back to the heart. Because the inferior vena cava is on the right side, when you lay on the left side you relieve the stress on the vein by removing the weight of the uterus.

Consider the purchase of special support hose or graduated compression stockings. These will help to improve the blood flow back to the hearts and prevent swelling in the lower extremities. To help prevent blood from pooling in the legs, put these stockings on before getting out of bed in the morning and keep them on all day long. These stockings may be uncomfortable in hot weather but will save your legs in the long run.

Interestingly, women who are pregnant may get varicose veins in their legs but are also at higher risk for development of varicose veins in their vulva and their rectum (hemorrhoids). However, like the venus insufficiency that clears up in the lower legs after the birth of a child, these particular types of varicose veins also usually clear up once the baby is been born.

Women who practice Kegel exercises during pregnancy will help to prevent the occurrence of hemorrhoids, which are varicose veins in the rectum. These exercises also help to improve the delivery process and reduce the risk of urinary leakage.

 

Varicose Veins in the Testicles

Of the many different causes of male infertility, a varicocele is one of the most common. A varicocele is very simply a varicose vein that develops in the venous system of the testicles. This varicose vein develops in much the same way that others do. This means that the one-way valves that control the blood flow in the veins are damaged and allow the blood to pool. This pooling results from poor circulation. This increases the temperature inside the scrotum and decreases sperm production because of the heat. (13)

Urologists estimate that between 10 and 20% of all men will experience a varicocele at some point in their lives. And only 40% who have a varicose vein in the testicle will have any discernible symptoms. Most men can feel the swelling or lump that surrounds the testicle inside of the scrotum. Interestingly 96% of all cases this will be on the left side. There is a physiological reason for this. The spermatic cord on the left side is longer and requires a more circuitous route to the heart. It also connects to the left kidney vein which has a higher blood pressure than the right one. A higher pressure on the side increases the likelihood of swelling in this vein which may be weakened. (14)

Many times the swelling will be present when standing but will disappear when the man lies down. The degree of pain, discomfort or swelling will vary from person to person. In fact, some may not have any discomfort at all while others may have significant pain. Men may first notice a varicocele directly after puberty and before the age of 35. Any man can be affected, although it seems to be more frequent in individuals who are tall and thin or who live in very hot climates.

When a man presents to his primary care physician with these complaints most diagnoses can be made with medical history and a thorough physical examination. Sometimes an ultrasound is ordered if there is any doubt about the diagnosis or in order to confirm that there are no other growths present at the time. The varicocele can be large or small. Prominent ones can be easily seen with the naked eye. Small varicoceles may require the use of a Doppler in order to visualize the internal organs. A thermogram is a procedure which detects pockets of heat that may be used in order to diagnose a varicose vein in the scrotum. (15)

If the urologist requests this examination because of suspected infertility, several sperm samples may be requested for comparative anaylsis. This is because infertility that is brought on by a varicocele will have an inconsistent pattern of development.

In some cases, the decrease in circulation to the testicle will cause it to shrink in size. Those who develop the condition gradually will assume that this shrinkage or discomfort is in some way associated with aging. Others can attribute the onset of pain to some type of muscular strain following heavy lifting. Any man should be aware that any recurrent or constant discomfort in the genital region is abnormal and they should seek the care of the urologist or primary care physician as soon as possible.

If a varicocele is not causing the man any discomfort there is no treatment required. For individuals who suffer from mild discomfort or swelling a jock strap or firm fitting underwear can help to keep the swelling down as well as the discomfort. Surgery may be recommended if a varicocele is causing significant discomfort or if it is associated with a reduced size of the testicle. Although the operation is straight forward it is a delicate procedure which must be done by a skilled and experienced surgeon.

Part 2: Much More About Varicose Veins, Chronic Venous Insufficiency, and Thrombophlebitis

Varicose veins are the result of damaged one way valves that help push the blood through the veins and forward to the heart.  When the valves become damaged, the blood is able to pool within the veins and decreases the ability of the body to remove toxins and oxygenate the tissues (16). The first sign of a varicose vein is swelling along the path the vein takes down the leg.  After this most people notice bluish or reddish tinged coloring to the area as well as a swelling along the vein. Chronic venous insufficiency (CVI) is a condition that occurs from partial occlusion of a vein or malfunctioning valves of the veins. CVI does not pose a serious health threat, but the condition can be disabling and cause pain. Symptoms of chronic venous insufficiency may include chronic leg swelling, leg pain, itching, a tight feeling calves, brown-colored skin of the lower legs, varicose veins, and leg ulcers. In CVI, the veins do not return blood from the legs to the heart well. Treatment for CVI may include compression stockings, medication, or surgery. Several Integrative medicine options are provided here for the treatment of CVI.

 

How to Prevent Varicose Veins

Varicose veins are unsightly and uncomfortable. They affect both men and women and appear to have a genetic predisposition.  If family members suffer from varicose veins, other family members may have weak valves and have the same experience. Varicose veins occur when the one way valves that stop blood from pooling in the feet are damaged.  When the blood leaves the heart it is pumped throughout the body by the force of the heart muscle.  When it comes to the end of the route and has delivered all of the oxygen available, it turns around and heads for home, the heart and lungs.  On the return trip there is no heart muscle to pump the blood back against gravity.  Instead, there are a series of one-way valves in the venous system that work with muscle contraction to force the blood through the legs, up to the inferior vena cava which then delivers the blood to the heart and lungs.

This particular system is called the venous pump.  The pump part of this system works through muscle contraction in the lower legs and thighs.  When the muscle strength has been decreased for any reason it can cause pooling of the blood in the lower extremities.  People may notice some swelling in their feet and legs after having stood for several hours during the day.  This is a result of the blood not returning in an effective and efficient manner to the heart. Researchers know the types of things that can cause damage to the venous valves and trigger the development of varicose veins.  By avoiding these triggers you can also help to prevent the development of any varicose veins or help to decrease the progression of the ones you already have.

One of the biggest factors is weight, in a combination with other criteria.  For this reason, those who are overweight, obese or put on a significant amount of weight in a short period of time will find that they are more prone to varicose veins.  Individuals who are overweight will also find that by losing weight they reduce their risk and decrease the progression of the disease they may already have.  Women who are pregnant may find that they are at an increased risk for developing varicose veins but that these veins may resolve after the baby has been born.

There are several ways of reducing the risk of developing varicose veins, including weight loss.  Individuals who find that they sit or stand for several hours during the day also increase their risk of developing varicose veins because of the lack of muscle contraction in the lower extremities which drives the venous blood back to the heart. If employment entails long periods of time sitting or standing, it is important to reduce risk by moving around several times an hour.  People who are in a position of traveling in planes or cars for long periods of time will find that contracting and relaxing their calf muscles, ankles and feet every 10 minutes will also help to reduce their risk.

Many individuals have found that doing calf raises, or rising up onto their toes, while in the standing position will help to reduce their risk of varicose veins.  Women who are pregnant who must stay in a standing position can also rest their venous system and lower back by alternately placing one leg and then another on a short stool or box. When seated for any length of time it is important not to cross your legs at the knees.  This increases the pooling in the lower extremities and cuts off the return route for the venous blood to the heart and lungs.

Consistent and regular exercise helps to increase the muscle strength in the lower extremities and therefore keep the venous pump working throughout the day.  It is advised to walk for a mile and a half every day, rain or shine, will help reduce risk or progression. Even if there is not a genetic predisposition to the development of spider veins or varicose veins it is helpful to perform these minor preventative measures in order to reduce overall risk.

Treatments for Varicose Veins

At this time, traditional Western medicine believes that sclerotherapy is the gold standard for treating varicose veins.  However, some insurance companies do not cover this expense if there are no other underlying medical symptoms.  And, some women would like to try other more natural remedies in order to treat their varicose veins and prevent any further from occurring.

Many women find their varicose veins have a genetic predisposition.  In other words, there were other men or women in the family who suffered from varicose veins in years past.  This meant that the valves in the veins were predisposed to being weaker and giving them trouble.  However, by using some of the preventative measures outlined below many times men and women are able to significantly reduce their risk of developing spider veins or varicose veins.

Prior to trying any alternative medicine treatments, it is important to check with the primary care physician to ensure there is no negative impact any other underlying medical condition.

One of the reasons that varicose veins and spider veins will form is because the muscle contractions required to move the blood through the venous system are not strong enough, and the blood begins to pool.  In response to this, many women and men find that doing calf raises and other exercises for the lower extremities throughout the day will help to improve muscle strength and therefore the venous pump system.

Calf raises are done either on a stair or on a set of stacked books. Stand with the ball of your foot on a couple of stacked books and raise and lower your entire body using only the ball of the foot.  This exercise works the calf muscle which plays a significant role in the venous pump system.

Up to 50 to 100 calf raises each day as well as raising up on the toes from time to time throughout the day should enhabce the venous system of the legs.  In response to the development of these calf muscles, they should also be stretched.  This can be accomplished by placing one leg behind the other approximately 6 to 8 inches from a solid wall.  Hands should be placed on the wall, with the knee of the extended leg straight and the other knee bent, while leaning into the wall.  The calf area will begin to stretch.

Walking is another exercise that can be done, rain or shine, every single day, in order to improve muscle development in the lower extremities.  Walking aids the return of the venous blood, not only during the walk but also for several hours afterwards.

When one will be sitting or standing for any length of time they should be sure to make it a point to get up every 10 to 15 minutes and move around.  If employment entails standing in one place, then have the patient do some calf raises and move the legs at least every 10 minutes.  After working, legs should be elevated up above the level of the heart for at least 30 minutes to help improve the flow of blood through the venous system.

Compression stockings are another means of improving circulation and have been the mainstay of treatment for varicose veins for decades.  Compression stockings can also be used to prevent the formation of varicose veins, especially when you know there is a genetic predisposition to the condition. Individuals who suffer from varicose veins will also experience some relief from symptoms using compression stockins. (17,18)

Excess weight is another risk factor that significantly changes the percentage of individuals who will develop varicose veins or spider veins.  By exercising and controlling weight, the circulation will also improve and decrease the amount of pressure placed on the valves.

Another way of maintaining an appropriate weight is to eat a balanced diet.  The nutrients may also help prevent varicose veins.  For example, vitamin C and protein are both components of the production of collagen.  Collagen, while a significant factor in anti-aging products, is also one part of the development of veins and valves.  If you have enough collagen in your veins and valves and in good shape, you are more likely to be resilient to varicose veins.

While standing for too long can be an issue, so can sitting.  Some experts theorize that even sitting for extended periods can contribute to the development of varicose veins.  The theory is that the bending of knees and hips will slow the return of blood to the heart.  So, it is important to routinely move the legs during any long car ride, plane ride, or sitting at a desk.

While sitting can create greater pressure in the lower extremities, crossing your legs will slow the circulation even further.  If legs want to be crossed, they should be crossed at the ankles only.  Crossing at the knees not only causes increased pressure and increases the risk of closing the veins, but it also negatively impacts any problems with the knees and hips.

Those with a genetic predisposition to varicose veins, or have some chronic swelling in the lower legs already, it is helpful to sleep with a few pillows under the feet in order to keep them elevated above the level of the heart.  One should look for shoes that have lower heels that require the calf muscles to do more work.  Some of the new tennis shoes, now being produced for women who want to increase their caloric burn while walking, are also helpful for women and men who want to treat and prevent varicose veins.

Patients should not wear underwear that are tight at the waist or in the groin.  This acts as a tourniquet that restricts blood flow and can not only increase your risk of developing varicose veins, but can also increase your risk of developing cellulite.

Some women find that the use of vitamin E, witch hazel or Apple cider vinegar can help reduce the effects of varicose veins or spider veins when applied to the skin in the morning or evening.  The herb horse chestnut is another of the most widely used natural treatments for spider or varicose veins.  The active compound appears to block the release of enzymes that damage the capillary walls.

Researchers in a 2006 study found that individuals who used horse chestnut had improvements in the signs and symptoms of venous insufficiency, including spider veins and varicose veins.  There were some adverse events which were usually mild and infrequent and included nausea, vomiting, diarrhea, headache.  Individuals who choose to take horse chestnut should do so from a reputable dealer since there is a toxic component which must be removed prior to sale and can cause circulatory and respiratory failure or even death. (19)

Grape seed extract and pine bark both contain anti-oxidants that appear to strengthen the connective tissue and reduce inflammation.  The most common side effects are digestive complaints such as nausea and upset stomach.  But people who have an autoimmune condition, such as rheumatoid arthritis or Crohn’s disease, should not take either grape seed extract or pine bark because of its effects on the immune system. (20,21)

Lastly, Reflexology is a form of therapy that focuses primarily on the feet.  This form of medical treatment was studying with pregnant women and showed significant reduction in leg swelling.  Reflexology has little adverse side effects but must be applied by a a trained practitioner in order to receive maximum benefits.

 

Flavonoid treatment for chronic venous insufficiency, and venous ulcers:

Flavonoid agent for chronic venous insufficiency (CVI): In two randomized, double-blind, 2-month studies, Daflon 500 mg twice daily significantly decreased ankle and calf circumferences, discomfort (nocturnal cramps and sensations of leg heaviness, swelling, or heat), and plethysmographic parameters (measures of changes in volume in organs or the body), such as venous capacitance, distensibility, and emptying in patients with CVI. More leg ulcers (<11 cm in diameter) were completely healed with Daflon 500 mg 2 times per day (plus standard care of compression treatment) for 2-6 months compared to placebo or standard care alone. (1)

Flavonoid agent for healing venous leg ulcers: In a multi-center, randomized, parallel-group, double-blind, placebo-controlled trial of 105 patients with venous leg ulcers, using conventional therapy (standardized local treatment with compression therapy) with either Daflon 500 mg (two tablets/day=1 g/day) or placebo (1 g/day) during an 8-week period, complete healing of ulcers ( <10 cm) was significantly higher in the Daflon 500 mg group (32%) compared with placebo (13%). Time to complete ulcer healing was also significantly shorter in the Daflon 500 mg group. (2)

A tree nut used for chronic venous insufficiency:

Tree nut used as anti-inflammatory for chronic venous insufficiency (CVI): Research suggests that horse chestnut seed extract (HCSE), found to have anti-inflammatory effects. In a systematic review researchers analyzed seven clinical trials and concluded that horse chestnut seed extract is an effective and safe treatment for CVI. Compared to placebo, HCSE was associated with significant reduction in leg pain in six studies. Leg volume (associated with swelling caused by CVI) was also reported to be better in the HCSE group compared to placebo (average difference 32.1 ml). One study showed HCSE to be as effective as compression stockings. No serious side-effects were reported. (3)

Natural anti-inflammatory for chronic venous insufficiency (CVI): A meta-analysis including 13 randomized controlled trials suggests that horse chestnut seed extract (HCSE), found to have anti-inflammatory effects, may be useful in the treatment of chronic venous insufficiency (CVI), a condition in which the veins do not return blood from the legs to the heart well and is associated with leg swelling, leg pain, and itching. Findings show that compared to placebo, HCSE reduced leg volume by 46.4 ml, increased the chances of improving leg pain (4.5 times), edema/swelling (1.5 times), and itching (1.7 times). Serious side-effects were not reported. (4)

A standardized natural treatment for edema in chronic venous insufficiency (CVI): Researchers conducted a randomized, placebo-controlled, parallel, double-blind study on 40 patients suffering from venous edema (swelling) in chronic deep-vein incompetence, a condition in which the veins do not return blood from the legs to the heart well and is associated with leg swelling, leg pain, and itching.  Participants received with 75 mg escin twice daily (Escin is an extract of horse chestnut) or placebo. Compared with placebo, horse chestnut significantly reduced edema, determined by measurements of leg volume and leg circumference. With measurements of leg volume before and after provoking edema, the clinical benefits of horse chestnut appeared to be present in all everyday situations, whether in movement or in sitting or standing. (5)

Naturally derived topical gel in chronic venous insufficiency (CVI): The effectiveness of aescin (or escin, an extract of horse chestnut), and essential phospholipids (AEPL) gel on the microcirculation was tested by measuring transcutaneous skin PO2 and PCO2 in subjects with chronic venous insufficiency (CVI), venous hypertension (CVH, high pressure in the veins of the legs). The results reveal that treatment with AEPL in the areas of disease of blood vessels is effective in improving skin perfusion (restoring microcirculatory blood flow) and nutrition and prevents venous ulcerations (ulcers that develop on the skin due to improper blood flow). (6)

Natural treatment used for chronic venous insufficiency (CVI):

Natural extract for leg swelling in chronic venous insufficiency (CVI): Swelling (edema), leg ‘heaviness’, and pressure in the veins were significantly reduced in a study with 40 patients after the use of Pycnogenol at a dose of 100 mg, 2-3 times per day for 2 months No side-effects were reported. (7)

Pycnogenol, French maritime pine bark extract, significantly reduced swelling (edema), pain, and leg heaviness in patients with chronic venous insufficiency (CVI), a condition in which veins do not return blood from the legs to the heart well and is associated with leg swelling, leg pain, and itching. For 2 months, participants (n=40) received Pycnogenol 100 mg x 3/day or placebo. Findings show that in about 60% of patients administered Pycnogenol swelling disappeared, pain was reduced, and 33% had reduced leg heaviness. No changes were seen in the placebo group. (8)

A natural extract for venous thrombosis and thrombophebitis on flights: Pycnogenol, French maritime pine bark extract, may help reduce the risk of blood clots (deep vein thrombosis (DVT) and superficial vein thrombosis (SVT)) on long airplane flights. The study subjects (n=198) received either 200 mg Pycnogenol 2-3 hours before flying, 200 mg six hours later and 100 mg the day after flying or placebo . Air travel lasted an average of eight hours and 15 minutes. Compared to a placebo, researchers concluded Pycnogenol supplementation was effective in protecting against DVT and SVT in moderate to high-risk subjects with no thrombotic events reported (vs 5.15% of placebo patients with a reported event). (10)

A tree bark extract vs. a tree nut extract used for chronic venous insufficiency (CVI):

A 4-week study followed 40 people with chronic venous insufficiency (CVI), compared the benefits of Venostasin (horse chestnut seed extract) at 600 mg oral daily against Pycnogenol (pine bark extract) at 360 mg oral daily. The results showed improvements in both treated groups, but Pycnogenol was significantly more effective than Venostasin. Pycnogenol significantly reduced lower limb circumference, CVI symptoms (pain, cramps, night-time swelling, feeling of ‘heaviness’, and reddening of the skin), total cholesterol and LDL ‘bad’ cholesterol without affecting HDL ‘good’ cholesterol. Venostasin did not significantly improve symptoms nor did it effect lipid values. However, both were well tolerated. (9)

Natural treatment for superficial vein thrombosis and venous hypertensive microangiopathy :

Natural extract used for superficial vein thrombosis: Authors investigated the effect of Essaven gel (EG) with the active ingredient, aescin,( or escin) a horse chesnut extract in comparison with placebo in 30 patients with superficial vein thrombosis (SVT, a blood clot in a vein, which forms in a superficial vein near the surface of the body) in this 8-week study. Reductions in the signs and symptoms of SVT were significantly greater in participants receiving EG, compared to placebo. EG improved signs/symptoms of SVT much faster than placebo and no serious side-effects were reported. (11)

Natural extract used for venous hypertensive microangiopathy : Twenty-two individuals with venous hypertensive microangiopathy (VHM, high pressure in the veins) were included in this randomized, placebo-controlled study investigating the benefits of Essaven gel (EG). Results show that compared with placebo, EG significantly improved microcirculation in patients with VHM, even with a single application. (12)

A natural combination treatment for chronic venous insufficiency (CVI):

A double-blind, placebo-controlled trial for plant extract, vitamin, and flavonoid combination for chronic venous insufficiency (CVI): A venotropic agent containing (per capsule)16.5 mg Ruscus aculeatus, an evergreen shrub otherwise known as butcher’s broom (RAES), 75 mg hesperidin, and 50 mg ascorbic acid was found to be better than a placebo for treating chronic venous insufficiency (CVI) of the lower limbs in this double-blind trial (n=40).  The trial involved 2 periods of treatment lasting 2 months with participants receiving 2 capsules or placebo administered 3 times daily. Symptoms and measures of plethysmograph circulatory capacity was significantly better in response to RAES treatment. RAES was also well tolerated. (13)

A meta-analysis for a plant extract, vitamin, and flavonoid combination for chronic venous insufficiency (CVI):

Cyclo 3 Fort in the treatment of chronic venous insufficiency: In a meta-analysis of 25 studies (n=10,246) of patients with chronic venous insufficiency (CVI), Cyclo 3 Fort (each capsule contains 150 mg Ruscus aculeatus, 150 mg hesperidin methyl chalcone, and 100 mg ascorbic acid) was found to be superior to placebo. Compared to placebo, Cyclo 3 Fort significantly reduced severity of pain (0.44 points on 4 point scale), cramps (0.26 points), heaviness (0.53 points), paraesthesia or tingling/burning/numbness of a person’s skin (0.29 points), and venous capacity (0.70 ml/100 ml). Swelling (edema), calf and ankle circumference were also significantly better among patients receiving Cyclo 3 Fort versus placebo. (14)

Endotelon in chronic venous insufficiency (CVI):

Endotelon is a brand name product produced from grapeseed, and procyanidolic oligomers, (Sanofi-Labaz Laboratories, Sanofi Winthrop). This agent was evaluated in a study including 50 females during pregnancy for response to chronic venous insufficiency with Endotelon® dosed at 150 mg per day and diosmine (semi-synthetic flavonoid) dosed 450mg per day for 30 days. The randomized, double-blind, equivalence trial found that Endotelon compared to the diosmine faired better for heaviness, sluggishness, cramps and swelling. Over 65% of the patients responded to Endotelon verses 45% for diosmine. After stopping Endotelon, the treatment effect lasted for 15 days. Diosmine treatment related effects lasted for 10 days. This is statistically significant. Endotelon therapy was found to show consistent benefit for treatment of venous insufficiency in this study. (15)

Assessment and Plan: Chronic Venous Insufficiency and Varicose Veins

 

 

References: Part 1- Varicose Veins Natural Treatment

(1) Vein Clinics of America: Varicose Veins May put Some at Risk for Dangerous Blood Clots
www.veinclinics.com/assets/documents/uploads/DVT_Awareness_Press_Release_FINALv2.pdf

 

(2) UC Davis Health System: Varicose Veins
www.ucdmc.ucdavis.edu/vascular/diseases/varicose_veins.html

 

(3) Phlebolymphology: Treatment of Vulvar and Perineal Varicose Veins
http://www.phlebolymphology.org/2011/01/treatment-of-vulvar-and-perineal-varicose-veins/

 

(4) Cleveland Clinic: Endovenous Thermal Ablation
my.clevelandclinic.org/services/vascular_surgery/vs_endovenous_thermal_ablation.aspx

 

(5) Dermatologic Surgery: Endovenous Laser Ablation-Induced Complications: Review of the Literature and new Cases
www.ncbi.nlm.nih.gov/pubmed/19469796

 

(6) Medical Journal of Australia: Treatment of Varicose Veins by Endovenous Laser Therapy: Assessment of Results by Ultrasound Surveillance
https://www.mja.com.au/journal/2006/185/4/treatment-varicose-veins-endovenous-laser-therapy-assessment-results-ultrasound

 

(7) Cleveland Clinic: Endovenous Thermal Ablation
http://my.clevelandclinic.org/services/vascular-surgery/vs_endovenous_thermal_ablation

 

(8) WomensHealth.gov: Varicose Veins and Spider Veins Fact Sheet
www.womenshealth.gov/publications/our-publications/fact-sheet/varicose-spider-veins.cfm

 

(9) Phlebolymphology: Treatment of Vulvar and Perineal Varicose Veins
http://www.phlebolymphology.org/2011/01/treatment-of-vulvar-and-perineal-varicose-veins/

 

(10) American Pregnancy Association: Skin Changes During Pregnancy
www.americanpregnancy.org/pregnancyhealth/skinchanges.html

 

(11) BabyCenter: Varicose Veins During Pregnancy
www.babycenter.com/0_varicose-veins-during-pregnancy_271.bc

 

(12) WomensHealth.gov: Varicose Veins and Spider Veins Fact Sheet
www.womenshealth.gov/publications/our-publications/fact-sheet/varicose-spider-veins.cfm

 

(13) PubMedHealth: Varicocele
www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002263

 

(14) PG Blazer: Varicocele is More Common in Left Side: Mechanism
www.pgblazer.com/2011/01/varicocele-is-more-common-in-left-side-mechanism.html

 

(15) MetroUrology: FAQ About Varicocele
www.metro-urology.com/services-and-specialties/male-fertility/varicocele/

 

(16) RadiologyInfo: Sclerotherapy of Varicose Veins and Spider Veins
www.radiologyinfo.org/en/info.cfm?pg=sclerotherapy

 

References Part 2: Much More About Varicose Veins, Chronic Venous Insufficiency, and Thrombophlebitis

1.Lyseng-Williamson KA, Perry CM. Micronised purified flavonoid fraction: a review of its use in chronic venous insufficiency, venous ulcers, and hemorrhoids. Drugs. 2003;63(1):71-100. http://www.ncbi.nlm.nih.gov/pubmed/12487623

2.Guilhou JJ, Dereure O, Marzin L, et al. Efficacy of Daflon 500 mg in venous leg ulcer healing: a double-blind randomized, controlled versus placebo trial in 107 patients. Angiology. 1997;48:77-85. http://www.ncbi.nlm.nih.gov/pubmed/8995348

3.Pittler MH, Ernst E. Horse chestnut seed extract for chronic venous insufficiency. Cochrane Database Syst Rev. 2012 Nov 14;11:CD003230. http://www.ncbi.nlm.nih.gov/pubmed/23152216

4.Siebert U, Brach M, Sroczynski G, Uberla K. Efficacy, routine effectiveness, and safety of horsechestnut seed extract in the treatment of chronic venous insufficiency: a meta-analysis of randomized controlled trials and large observational studies. International Angiology 2002 Dec; 21(4): 305-315. http://www.ncbi.nlm.nih.gov/pubmed/12518108

5.Diehm C, Vollbrecht D, Amendt K, et al. Medical edema protection – clinical benefit in patients with chronic deep vein incompetence. A placebo controlled double blind study. Vasa 1992;21(2):188-92. http://www.ncbi.nlm.nih.gov/pubmed?term=1621440

6.Ruffini I, Belcaro G, Cesarone MR, Dugall M. Efficacy of topical treatment with aescin + essential phospholipids gel in venous insufficiency and hypertension. Angiology. 2004 May-Jun;55 Suppl 1:S19-21. http://www.ncbi.nlm.nih.gov/pubmed/15156253

7.Petrassi C, Mastromarino A, Spartera C. Pycnogenol in chronic venous insufficiency. Phytomedicine. 2000 Oct;7(5):383-8. http://www.ncbi.nlm.nih.gov/pubmed/11081989

8.Arcangeli P. Pycnogenol in chronic venous insufficiency. Fitoterapia. 2000 Jun;71(3):236-44. http://www.ncbi.nlm.nih.gov/pubmed/10844161

9.Koch R. Comparative study of Venostasin and Pycnogenol in chronic venous insufficiency. Phytother Res. 2002 March;16 Suppl 1:S1-5. http://www.ncbi.nlm.nih.gov/pubmed/11933130

10.Belcaro G, Cesarone MR, Rohdewald P, Ricci, A, et al. Prevention of venous thrombosis and thrombophlebitis in long-haul flights with pycnogenol. Clin Appl Thromb Hemost. 2004 Oct;10(4):373-7. http://www.ncbi.nlm.nih.gov/pubmed/15497024

11.Incandela L, De Sanctis MT, Cesarone MR, Ricci A, Errichi BM, Dugal M, Belcaro G, Griffin M. Treatment of superficial vein thrombosis: clinical evaluation of Essaven gel–a placebo-controlled, 8-week, randomized study. Angiology. 2001 Dec;52 Suppl 3:S69-72.

http://www.ncbi.nlm.nih.gov/pubmed/11775653

12.Cesarone MR, De Sanctis MT, Incandela L, Belcaro G, Griffin M. Microvascular changes in venous hypertension due to varicose veins after standardized application of Essaven gel–a placebo-controlled, randomized study. Angiology. 2001 Dec;52 Suppl 3:S11-6. http://www.ncbi.nlm.nih.gov/pubmed/11775643

13.Cappelli R, Nicora M, Di Perri T. Use of extract of Ruscus aculeatus in venous disease in the lower limbs. Drugs Exp Clin Res 1988;14(4):277–83. http://www.ncbi.nlm.nih.gov/pubmed/3048951

14.Boyle P, Diehm C, Robertson C. Meta-analysis of clinical trials of Cyclo 3 Fort in the treatment of chronic venous insufficiency. Int Angiol . 2003;22:250-262. http://www.ncbi.nlm.nih.gov/pubmed/14612852

15.Delacroix P. Double-blind study of Endotelon in chronic venous insufficiency (translated from French). La Revue de Medecine 1981;31(27-28):1793-1802. http://www.veinpc.com/pdf/TreatingChronicVenoCC522.pdf

16. WomensHealth.gov: Varicose Veins and Spider Veins Fact Sheet, www.womenshealth.gov/publications/our-publications/fact-sheet/varicose-spider-veins.cfm

17.Mayoclinic.com: Varicose Veins, www.mayoclinic.com/health/varicose-veins/ds00256/dsection=treatments-and-drugs

18.Phlebology: A Systematic Review of Compression Hosiery for Uncomplicated Varicose Veins, www.rsm.ac.uk/academ/downloads/vein1_3.pdf

19.Medline Plus: Horse Chestnut, www.nlm.nih.gov/medlineplus/druginfo/natural/1055.html

20.University of Maryland Medical Center: Grape Seed, www.umn.edu/altmed/articles/grape-seed-000254.htm

21.MedlinePlus: Pycnogenol, www.nlm.nih.gov/medlineplus/druginfo/natural/1019.html

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