Losing the Blues : Exploring Options for Permanent Removal of Unsightly Varicose Veins

ABOUT 36 million women in America are happy that pants are in and minis are out. They’re the women who hate wearing shorts and always select dark or opaque hosiery. They’re the ones who have varicose veins, a painful vascular problem that for some is also a distressing beauty concern.

Women can conceal veins with makeup, but some want permanent relief.

Vein specialists are beginning to stress the aesthetic benefits of treatment as much as the therapeutic advantages. And like ear, nose and throat doctors and gynecologists who discovered the lucrative rewards of adding cosmetic surgery to their practice, doctors in other fields are now specializing in the non-surgical varicose-vein removal.

Two procedures--surgery and sclerotherapy--have been used for years to permanently remove the veins. “Stripping” the distended veins is done surgically, actually cutting out or tying off the affected veins. Sclerotherapy involves the injection of a caustic solution directly into each varicosity. The vein closes up, shrivels and is eventually absorbed. The blood automatically reroutes to other veins deeper in the leg.


In vogue in the 1930s and 1940s, sclerotherapy took a back seat to surgery during the last few decades, says Dr. Mark Forrestal, an internist who for three years has specialized in sclerotherapy. “Today, because of hospital overcrowding and rising costs, procedures that can be done in the office are becoming very popular,” he says. Forrestal operates the Beverly Hills offices of Chicago-based Vein Clinics of America.

According to Dr. Samuel S. Ahn, an assistant professor of vascular surgery at UCLA School of Medicine, sclerotherapy is the method of choice for all but the biggest varicose veins. “For small varicose veins, I do not recommend surgery--and I’m a surgeon,” he states. “I recommend sclerotherapy or nothing.” When a patient decides to live with the veins, Ahn recommends prescription-only compression stockings to help prevent the condition from worsening, and camouflage makeup to hide the discoloration.

For very large, distended veins, Ahn says that sclerotherapy is generally not as effective as surgery. Several weeks of recuperation are required after surgery, and there may be some scarring. Sclerotherapy patients walk out of the office after the procedure and are encouraged to walk at least 30 minutes each day. Noticeable improvement can be seen in less than two weeks, Forrestal says. In about 20% of the cases, there can be bruising or scarring, Ahn reports.

“Varicose veins have a strong psychological impact,” Forrestal says. “I’ve seen people who never uncovered their legs because they were so self-conscious. The first thing they do when the veins are gone is buy a pair of shorts.”


Styling: Karen O’Neil; model: Susan McNabb / Prima