Understanding the Playing field
Hi, Dr Gan from Doctor Vein Medical and Cosmetic. Today I’m going to be addressing a very common question that comes up. It is probably a comment that pops up a lot when you’re at dinner tables and when you talk about any treatment for varicose veins. That is, “Will my varicose veins come back after I’ve had treatment.” Now the reason this pops up a lot is because in the past, the passing statement that usually follows is, “Why bother having treatment because it all comes back anyways.” Now today, I’m going to address this because there might be some truth to that comment, but more importantly I think it’s important to address that comment by itself because there are multiple factors here.
Different Treatments for Varicose Veins
And so the first and most important question you need to ask when you hear such a comment is, “What type of treatment did you have?” Now in the past, the only way of treating varicose veins was by surgery and specifically a type of surgery known as stripping. Here the vein was basically pulled out after you’ve had general anesthetic and it was pulled out from the inside out and the chances of a new vein developing in that area where it was treated was very high. And what I mean by that is that in a year, in two years, in five years, there could be a high possibility that you develop more abnormal veins in that region, which was treated. Now in comparison with the newer treatments, and I’m specifically talking about endovenous laser ablations, and to a certain degree radiofrequency ablations, the chances of any new vein development after it has been treated is close to 0%. That means that when you’ve had that vein treated, the chances of it coming back is almost nil.
Endovenous Laser Ablation for Varicose Veins
So we sort of guarantee that we are up to 99.8% which is almost a hundred percent sure that that treated vein will be gone once it has been treated. Now an important point to remember is that sometimes you can get abnormal veins, or maybe I should put it this way. Sometimes you can get veins that are normal currently, so if you’ve come in for an assessment and I’ve had a look at your veins on the ultrasound, I usually mention to most of my patients that these are veins in this location, this area, are completely normal now. Now in three years, in five years, in 10 years, if that vein becomes abnormal, then sometimes it can pop out on the skin and come across the area where you used to have a vein and it can almost feel like that vein has reappeared.
But if you’ve had the newer treatment, I can often guarantee that that vein that we’re seeing pop up is a new vein. And with most of my patients, I usually show them their normal veins and I usually tell them, “This vein is completely normal.” And I show them the abnormal veins as well so that they know exactly which veins I’m actually treating. So in that way, they’re crystal clear that the vein that is affected them causing them the symptoms, causing them the signs that they see on their leg are treated. Now another important factor too to note is that if you produce veins often (and you usually know which patients these are, because you often get veins at a very early age), there could be a high chance that you can develop more veins as you get older. We tend to call them the vein makers because they keep making veins.
Following Up Treatments
We can always treat the veins and we can guarantee those veins are gone, but then there’s a high likelihood you’re going to create new veins. So coming back to the first comment about, “It’s going to come back anyways.” It’s not completely true, especially for the new treatments because when we treat these veins, we can guarantee they’re gone. The last point I want to make is if you’ve had a vein treated, for example, there’s a vein on your leg that has annoyed you for longest time and you’ve had it treated and you’ve gone through the entire procedure and you find that vein hasn’t disappeared or it has kind of gone down, but it has popped up again in the same location, then there’s a high likelihood that that vein wasn’t treated in the first place. There could be multiple reasons why that’s happened, and I’ve always told patients that if this happens to you or if it’s happened with me, I often want to be the first person to know about it so I can have a look at it.
But more importantly, I think if you’ve had treated with someone and it’s come back, you may want to get a second opinion and here at Doctor Vein, we’re quite happy to have a look and let you know whether or not that vein has been treated. Part of my practice, is that I actually make sure that I follow up every patient to ensure that vein that we’ve treated is gone. Because if I haven’t done my job, I’m completely transparent in patients that it hasn’t closed, and we may have to do a different form of treatment to close it because it may be a little bit resistant. But oftentimes the most important thing to ensure is to make sure that the vein that would be where we’re actually targeting and treating is treated. Hope this gives you an idea about veins coming back after treatment. And more importantly, if you’re having a dinner meeting with a whole bunch of friends, you can kind of tell them that it’s not true. Varicose veins can get treated and they can be gone forever.