Never have treatment on Leg Thread Veins without seeking advice from a Medical Professional with Vascular experience!!!

Before you embark on treatment for your Leg Thread Veins you must always seek expert Medical advice from a Medical Professional with Vascular experience first.

Thread Veins are NOT just cosmetic. They are the first signs that there maybe a Reflux and a hidden Varicose Vein. I out of 10 people who have Thread Veins will have a Varicose Vein and this needs to be treated first before attempting to treat a Thread Vein.

Leg Ulcers

What are Leg Ulcers?

Leg Ulcers can be either Venous or Arterial. A Venous Leg Ulcer is a Chronic Non Healing Wound that has been present for at least 6 weeks with Broken Layers of Skin and Exposed Tissue. Venous Leg Ulcers are usually found on the inside of the leg just above the ankle. They can be painful especially when they are infected.

What causes Leg Ulcers?

A Venous Leg Ulcer is caused by Poor Blood Circulation due to damaged veins in your legs.

There are two main types of blood vessel:

• Arteries – oxygen rich blood is pumped from your heart through your arteries to the rest of your body.
• Veins – blood is returned to the heart through the veins once the oxygen has been removed.

Vein problems occur when the valves inside the veins stop working properly.

In a healthy vein, blood flows towards the heart. Blood is prevented from flowing backwards by a series of valves that open and close to let blood through. If the valves weaken or are damaged, for example, following a Deep Vein Thrombosis (DVT) the blood can flow backwards.

This may cause Varicose Veins visible on the surface of the leg or the damage may lie in the deep veins hidden from view. Pressure inside these veins is increased and this can damage the Skin.

The constant high blood pressure in your legs causes fluid to leak from the veins. The fluid causes swelling and damages the skin which becomes hard and inflamed leading to a Leg Ulcer.

Symptoms of a Leg Ulcer

• Swollen Ankles filled with fluid that temporarily hold the imprint of your finger when pressed (Oedema)
• Discolouration and Darkening of your skin around the Ulcer (Haemosiderosis)
• Hardened Skin around the Ulcer (Lipodermatosclerosis)
• Small, Smooth areas of White Skin which may have tiny Red Spots (Atrophie Blanche)

The associated symptoms of a Venous Leg Ulcer are caused by blood not flowing properly through your veins. This is known as Venous Insufficiency and can cause the following:

• Leg Pain
• Heavy feeling in the affected leg
• Aching
• Itching
• Swelling
• Varicose Eczema (Itchy, Irritated Skin associated with Varicose Veins)

Diagnosis of a Leg Ulcer

If you have the above symptoms then you need to see a Medical Professional. You may well have a Doppler and a Duplex Ultrasound Scan. A referral to a Consultant Vascular Surgeon is next to determine the next stage and treatment for the Leg Ulcer.

Treatment for Leg Ulcers

Treatment for Leg Ulcers should start with the UNDERLYING vein problems.

• Assessment by a ConsultantVascular Surgeon
• Duplex Ultrasound Scan
• Surgery (approx 60% of patients)
• Long term Compression (40% of patients)

What should be avoided at all costs?

• Patients with Leg Ulcers being condemned to dressings and compression bandages/stockings without assessment by a Specialist Vascular Surgeon (unless patient is immobile, has poor ankle movement, is very unwell for any other reason or has a very short life expectancy).
• Patients with skin changes at the ankle being given creams (particularly steroid creams) before venous causes have been excluded by a Specialist Vascular Surgeon
• Patients with Varicose Veins being told that it is a cosmetic problem only and to "wait until there is a problem before having anything done".
• Patients with skin changes at the ankle or Varicose Veins being given long term support stockings without a cause being found and the possibility of a cure being offered.

(The College of Phlebology)

Deep Vein Thrombosis - DVT

What is a Deep Vein Thrombosis (DVT)?

A Deep Vein Thrombosis (DVT) is a blood clot that has formed in one of the Deep Veins. A DVT usually occurs in a larger vein that runs through the muscles of the calf and the thigh. It can cause pain and swelling in the leg and may lead to complications such as Pulmonary Embolism (PE). This is when a piece of blood clot breaks off into the bloodstream and blocks one of the blood vessels in the Lungs.

DVT and Pulmonary Embolism are known collectively as Venous Thromboembolism (VTE).

What causes a DVT?

A DVT can occur for no reason however, there are certain risks that can increase the risk of developing a DVT. These are:

* Inactivity - Not moving around i.e In Hospital

* Blood Vessel Damage

* Medical and Genetic Conditions

* Pregnancy

* Contraceptive Pill and Hormone Replacement Therapy (HRT)

* Other Causes - Obesity, Smoking, Dehydration

Symptoms of a DVT

In some cases of Deep Vein Thrombosis (DVT) there may be no symptoms at all but possible symptoms can include:

• Pain, Swelling and Tenderness in one of your legs (Usually the Calf)
• A Heavy Ache in the affected area
• Warm Skin in the area of the clot
• Redness of your skin, particularly at the back of your leg below the knee

A DVT usually affects one leg but there have been cases of bilateral DVTs.

Complications of a DVT

If a DVT is not treated, a Pulmonary Embolism (PE) which is a blood clot that has come away from its original site and become lodged in one of the Lungs may occur. If you have a Pulmonary Embolism (PE) you may experience more serious symptoms such as:

• Breathlessness which may come on gradually or suddenly
• Chest Pain which may become worse when you breathe in
• Sudden Collapse

Both DVT and Pulmonary Embolism (PE) are serious conditions that require URGENT investigation and treatment.

Diagnosis of a DVT

If you suspect that you have a DVT then you need to seek Medical Professional attention. You will need to have a specialised blood test called a D Dimer and an Ultrasound Scan. If both of these fail to detect a DVT then you should have a Venogram however, a Venous Duplex Ultrasound Scan from the onset will tell you specifically if you have a DVT or not.

Treatment for a DVT

If you have a Deep Vein Thrombosis (DVT) you will need to take an Anticoagulant.

Anticoagulation

Anticoagulant medicines prevent a blood clot from getting bigger. They can also help stop part of the blood clot from breaking off and becoming lodged in another part of your bloodstream (Embolism).

Although they are often referred to as "blood-thinning" medicines, Anticoagulants do not actually thin the blood. They alter chemicals within it which prevents clots forming so easily.

Two different types of Anticoagulants are used to treat DVT:

• Heparin
• Warfarin

Heparin is usually prescribed first because it works immediately to prevent further clotting. After this initial treatment you may also need to take Warfarin to prevent another blood clot forming.

Your GP or Hospital Consultant will prescribe the Anticoagulant required for you.

Compression Stockings

Compression Stockings help prevent calf pain and swelling and lower the risk of ulcers developing after having a DVT. They can also help prevent Post Thrombotic Syndrome which is damage to the tissue of the calf caused by the increase in Venous Pressure that occurs when a vein is blocked by a clot and blood is diverted to the outer veins.

After having a DVT, stockings should be worn every day for at least two years because symptoms of Post Thrombotic Syndrome may develop several months, or even years, after having DVT.

Compression Stockings should be fitted professionally. They need to be worn all day but can be taken off before going to bed or in the evening while you rest with your leg raised.

Raising your Leg

As well as wearing Compression Stockings you might be advised to raise your leg whenever you are resting. This helps to relieve the pressure in the veins of the calf and stops blood and fluid pooling in the calf itself.

When raising your leg make sure that your foot is higher than your hip. This will help the returning blood flow from your calf. Putting a cushion underneath your leg while you are lying down should help raise your leg above the level of your hip. You can also slightly raise the end of your bed to ensure that your foot and calf are slightly higher than your hip.

Prevention of a DVT

* Smoking and Diet

* Mobilising

* Compression Stockings

* Anticoagulant

Restless Leg Syndrome

What is Restless Leg Syndrome (RLS)?

Restless Leg Syndrome (RLS) is a common medical condition characterised by an uncontrollable urge to move the legs. This can occur during sleep when a person has persistent leg movements. Sensations such as tingling, burning and aching can also be felt.

Sufferers from Restless Leg Syndrome (RLS) can find activities such as sitting for long periods of time impossible because they cannot sit still for long periods of time.

What is the cause of Restless Leg Syndrome (RLS)?

The cause of Restless Leg Syndrome (RLS) is unknown but it appears to have a link to damage to the valves in the Veins. Medical research shows that 22% of patients with Restless Leg Syndrome (RLS) also have venous insufficiency or valve damage with or without visible Varicose Veins.

What is the treatment for Restless Leg Syndrome (RLS)?

The treatment for Restless Leg Syndrome (RLS) can be as a result of treatment for venous insufficiency. Anyone who experiences these symptoms should see a Medical Professional and have a Venous Duplex Ultrasound Scan to see if there are any 'Hidden' Varicose Veins if not seen on the legs or to determine what vein is incompetent if there are Varicose Veins visible on the skin.

Following the Duplex Scan, suitable treatment will be discussed with a Consultant Vascular Surgeon.

Vulval Varicose Veins

What are Vulval Varicose Veins?

Vulval Varicose Veins are found on the Vulva and Vagina. They develop during pregnancy. Women may not have had any symptoms of reflux prior to getting pregnant and had no visible Varicose Veins and were therefore unaware that they had any problems. During pregnancy the veins in the pelvis dilate further causing Varicose Veins in the Vagina, Vulva and then they become visible Varicose Veins on the legs. Out of embarrassment, women rarely mention Vulvar Veins but these veins can be treated.

Diagnosis of Vulval Varicose Veins

The diagnosis for Vulval Varicose Veins is the obvious Varicose Veins on the Vulva and Vagina. A Duplex Ultrasound Scan is required prior to treatment.

Furthermore, a new grading system for Vulval Varicose Veins was published by The whiteley Clinic in 2012 to help Medical Professionals to classify the severity of Vulval Varicose Veins.

	Description	Frequency seen at present
Grade 0	Normal – no varicosities nor venous reflux in vulva	Usual
Grade 1	No visible varicosities in vulva, but ultrasound proven reflux in vulval veins usually with para-vulval varicose veins seen on inner thigh	Common – 1 in 7 females presenting with leg varicose veins (1 in 5 of those post vaginal delivery)
Grade 2	Visible varicosities seen through mucosa of inner labia and lower vagina and ultrasound proven reflux in vulval veins.	Uncommon
Grade 3	Isolated varicosities seen on standing through skin of outer labia majora without a distortion of the general anatomy of the area	Very uncommon
Grade 4	Extensive varicosities of the labia, distorting skin and distorting the gross anatomy of the area on standing	Rare

The Whiteley Clinic 2012

Treatment for Vulval Varicose veins

Treatment is available for Vulval Varicose Veins. If you have any of the symptoms then see a Medical Professional and get the required investigations and treatment required.

Procedures for treating Varicose Veins

There are many different procedures for treating Varicose Veins. The treatment known as 'STRIPPING' is an old and outdated treatment and should no longer be used to treat Varicose Veins. It has been widely researched that 'STRIPPING' can cause the Varicose Veins to grow back and can cause further Thread Veins. 

Furthermore, the patient is also undergoing a General Anaesthetic (GA) and a hospital stay that is unnecessary and can also end up with unsightly scars when newer treatments today offer a Walk in-Walk out service for the successful treatment of Varicose Veins.

These treatments are KEYHOLE procedures and these include:

* Endovenous Laser Ablation (EVLA)

* Radiofrequency Ablation (RFA)

* Ultrasound Guided Foam Sclerotherapy (UGFS)

* Ambulatory Phlebectomy

* Transluminal Occlusion of Perforators (TRLOP)

* Coil Embolisation of Pelvic Veins

* Microsclerotherapy (Thread veins)

Advanced Cosmetic Procedures

Advanced Cosmetic Procedures/Advanced Electrolysis

Advanced Cosmetic Procedures involves using Advanced Electrolysis to remove fibrous and vascular skin blemishes such as Red Veins, Spider Veins, Blood Spots, Skin Tags, Warts, Seborrhoeic Warts, Milia (whiteheads), Pigmentation Patches and many other marks or lumps and bumps on the skin.

Advanced Electrolysis is a technique of passing an electric current through the skin from a needle causing heat to be generated. During an Advanced Electrolysis treatment for Facial Thread Veins, each Vein is treated individually and the heat produced by the current destroys the Blood Vessel. This then heals by fibrosis ensuring the Blood Vessel will never reappear. Although other Facial Thread Veins can form the treated vessel destroyed by heat will never re-open again.

This treatment is used for the treatment of Facial Thread Veins and is NOT used to treat Thread Veins of the Legs.

Claudia McGloin Clinic have introduced this Advanced Cosmetic Procedure into the clinic and currently Claudia McGloin is the only fully trained Advanced Practitioner that will carry out this treatment at the Claudia McGloin Clinic and The Vein Clinic Ireland.

Further details on Advanced Cosmetic Procedures can be found on www.claudiamcgloinclinic.com

Call the Claudia McGloin Clinic on 071 9140728 or email claudia@claudiamcgloinclinic.com

Pelvic Congestion Syndrome

What is Pelvic Congestion Syndrome?

Pelvic Congestion Syndrome (PCS) is a condition caused by Varicose Veins in the Pelvis. The Varicose Veins are caused by incompetent valves in the Veins of the Pelvis. This causes blood to fall back into the Pelvis rather than being taken away from the Pelvis by the Iliac Vein which causes congestion.

Symptoms of Pelvic Congestion Syndrome

The symptoms of Pelvic Congestion Syndrome (PCS) are caused by these Varicose Veins pushing onto the other organs in the Pelvis:

• Pressure of the Varicose Veins onto the Pelvis causes Aching more so during a woman's period
• Pressure on the Rectum causes Bowel symptoms such as Irritable Bowel Syndrome (IBS)
• Pressure on the Bladder causes Irritable Bladder which can cause Stress Incontinence
• Pressure on the Vagina can cause Dyspareunia (Discomfort on Sexual Intercourse)

How is Pelvic Congestion Syndrome (PCS) diagnosed?

If you suffer with any of the symptoms above and have any visible Varicose Veins (bulges) around the Vulva, Groin or Vagina then you need to see a Medical Professional and have a Venous Duplex Ultrasound Scan.

MYTHS about Varicose Veins

Common MYTHS about Varicose Veins

• Women get Varicose Veins more often than men
• Pregnancy causes Varicose Veins
• You should wait until you've had your family before getting your Varicose Veins fixed
• Varicose Veins are only cosmetic and can safely be left alone
• There's no point in operating on Varicose Veins as they always come back
• Standing for long periods of time causes Varicose Veins

(The College of Phlebology)

Varicose Veins

What are Varicose Veins?

Varicose Veins are dilated Veins which you can often see as bulges on the Legs however, you can still have Varicose Veins that have no visible signs on the Legs. These are called 'Hidden' Varicose Veins. This occurs when the valves in these Veins which stop the blood from flowing back down your legs fail and the blood flows back the wrong way down your leg, which causes the Vein to start dilating or bulging. These Veins can become unsightly as time goes on.

While some people with Varicose Veins have absolutely no problems at all others have symptoms such as aching Legs, bulging Veins and swelling. It is important at this point to see a Medical Professional and have investigations such as Doppler, Venous Duplex Ultrasound Scan to determine if you have Varicose or 'Hidden' Varicose Veins.

Diagnosing Varicose Veins

A Venous Duplex Ultrasound Scan is the ONLY way to accurately diagnose Varicose Veins as this Non Invasive Scan can tell which vein is incompetent and where it is.

Some clinics, hospitals and GP's will only offer a Doppler Ultrasound Scan but this is will not be as accurate as the Duplex Scan.

Treatment for Varicose Veins

If Varicose Veins are present then the Consultant Vascular Surgeon will decide on the appropriate treatment required. Treatments available for Varicose Veins include:

•             Endovenous Laser Ablation (EVLA)

•             Radiofrequency Ablation (RFA)

•             Ultrasound Guided Foam Sclerotherapy (UGFS)

•             Ambulatory Phlebectomy

•             Transluminal Occlusion of Perforators (TRLOP)

•             Coil Embolisation of Pelvic Veins

Vein Stripping should not be a treatment option for Varicose Veins as it has been researched that Varicose Veins can grow back and cause more Thread Veins on the legs.

Common MYTHS about Varicose Veins

• Women get Varicose Veins more often than men
• Pregnancy causes Varicose Veins
• You should wait until you've had your family before getting your Varicose Veins fixed
• Varicose Veins are only cosmetic and can safely be left alone
• There's no point in operating on Varicose Veins as they always come back
• Standing for long periods of time causes Varicose Veins

(The College of Phlebology)

Thread Veins of the Face

Facial Thread Veins

THREAD VEINS otherwise known as Spider Veins, Broken Veins, Venous Flares, Broken Capillaries or Surface Veins are extremely common.  On average 40% of women have them on their Legs. Men are not immune from Thread Veins and can also suffer from them. Thread Veins are red or purple in colour and are visible on the skins surface. They can appear in clusters or as individual veins and are usually about 1-2mm. They are also Genetic!

Facial Thread Veins are usually found around the nose but can spread up onto the cheeks. They are very different to the Thread Veins that are found on the legs. Effective treatments for Facial Thread Veins is also very different to the treatment used for Leg Thread Veins.

Although they are called Thread Veins they are Dilated Capillary Networks from your Arteries and not your Veins. (Arteries take blood from the heart to the rest of the body and Veins return blood to the heart). The blood inside them is more oxygenated and therefore appear brighter red in colour.

Treatment for Facial Thread Veins

Effective treatment for Facial Thread Veins can usually be achieved by using one of the following treatments:

* Advanced Electrolysis

* Intense Pulse Light (IPL)

* Laser

All of these treatments work by using heat to destroy the Blood Vessel. Injecting vessels on the face is NOT recommended except in very rare cases.

Claudia McGloin Clinic has introduced Advanced Cosmetic Procedures/Advanced Electrolysis into the clinic. This is currently the only treatment that is used for the treatment of Facial Thread Veins.

For further details on Advanced Cosmetic Procedures please look at the Claudia McGloin Clinic www.claudiamcgloinclinic.com

Thread Veins of the Leg

What are Thread Veins?

Thread Veins of the Leg otherwise known as Spider Veins, Broken Veins, Surface Veins, Broken Capillaries or Venous Flares are extremely common affecting 1 in 4 women and an unknown number of men. 

They are found closer to the skin’s surface and have the appearance of small fine flat red veins or thicker purplish veins which are either isolated or in clusters.

Thread Veins are not just 'cosmetic'. Research performed in 2001 has shown that 89% of people with Thread Veins actually have underlying vein problems. These can either be Minor or Major Varicose Veins. These are very often not visible from the surface and cannot be found without the aid of a specialised Duplex Ultrasound Scan of the legs. If you have Thread Veins, you should have a Venous Duplex Ultrasound Scan before having any treatment to make sure that you don't have LEG PUMP FAILURE underlying the Thread Veins.

On consultation at The Vein Clinic Ireland we use a hand held Doppler to see if there is any evidence of underlying Varicose Veins. If any evidence is found, then the patient will be referred to a Consultant Vascula Surgeon for a Duplex Ultrasound Scan to examine every Vein in the Leg from the Deep Veins right the way through to the Thread Veins of the skin. This scan will show the exact cause of the Thread Veins in the Leg and will show any hidden Varicose Veins.

Following a Duplex Ultrasound Scan the best treatment suited will be discussed with a Consultant Vascular Surgeon. The Varicose Veins will be treated first and then the Thread Veins will be treated.

If the Doppler does not show any signs of underlying Venous Reflux, then we can proceed to treat the Thread Veins by Microsclerotherapy.

The Vein Clinic Ireland Contact Details

The Vein Clinic Ireland and the Claudia McGloin Clinic

First Floor,

Millennium House,

Stephen Street,

Sligo,

Co. Sligo,

Republic of Ireland

Phone: 071 9140728 or International 00353 71 9140728

Email: claudia@claudiamcgloinclinic.com Facebook: Claudia McGloin Clinic - https://www.facebook.com/pages/Claudia-McGloin-Clinic/302059066494084

Facebook: The Vein Clinic Ireland - https://www.facebook.com/pages/The-Vein-Clinic-Ireland/145909002197141

Twitter: @ClaudiaMcGloin

LinkedIn: Claudia McGloin Clinic

Blog: http://claudiamcgloinclinic.blogspot.com/

Website: www.theveinclinicireland.com

Website: www.claudiamcgloinclinic.com

Microsclerotherapy

What is Microsclerotherapy?

Microsclerotherapy is a technique of injecting Thread Veins with a substance through a very small needle. Using a large magnifying light, a chemical called a "Sclerosant" is injected into the Veins. This destroys the Vein making the walls of the Veins fibrose (''stick'') together. After treatment on the Legs, you will need to wear compression stockings for 2 weeks day and night.

As Microsclerotherapy closes the Veins by inflammation of the wall, most patients get a patch of inflamed skin over the site of the injection which lasts for up to two weeks. This inflammation is actually very good - it is the body’s way of removing the dead Vein. The area then settles down but the full benefit can take up to 12 weeks to be seen. After that you will find that the Veins often continue to improve for up to a year after the treatment. Depending on the number of Thread Veins on the Legs, several sessions may be needed to get the required results, but usually two will be enough.

How effective is Microsclerotherapy?

Compared with other treatments, Microsclerotherapy gives the best results. It is the Gold Standard for treatment of Thread Veins, with 95% of patients seeing an improvement with a good or very good result.

Some clinics use Laser, Intense Pulsed Light (IPL) or Electrolysis type treatment of Thread Veins on the Legs. Laser and Intense Pulsed Light (IPL) are more likely to damage the skin. This does not happen on the face where the skin is more resilient to radiation. As far as the needle-type treatments such as Electrolysis that are used that heat the Vein and destroy it, this is very slow and laborious compared to Microsclerotherapy. In addition, one injection of Microsclerotherapy not only takes away a whole patch of Thread Veins but also treats lots of little Thread Veins that are hidden under the skin that may well be feeding into this patch. Using one of the techniques that employ heat being transferred to the Vein via a needle, each visible vein has to be treated individually every couple of millimetres along its whole length and any Vein that is deep enough to not be visible from the surface cannot be treated.

In a very few cases, Thread Veins of the Legs are too small for treatment by Microsclerotherapy. An alternative is to leave the Veins for six months in which case they often get large enough to treat with Microsclerotherapy.

The Vein Clinic Ireland do NOT use laser treatments for the removal of Thread Veins from the LEGS.

Are there any side effects to Microsclerotherapy?

As with any medical procedure, there are some risks involved, but complications with Microsclerotherapy are very rare and are generally of a very minor nature.

Some 4-5% of people can get brown marks – usually very mild and usually fading over several weeks or months. Very occasionally the brown stains can be dark. At the Claudia McGloin Clinic we check anyone who has brown stains as many can be improved by releasing any trapped blood in the Veins that were treated.

Approximately 1% (1 in 100) people can get a little break down of the skin. This is called a Chemical Ulcer. This can be very tender for a few weeks and then usually heals with a small scar. This scar can be permanent but such a small scar is usually better then the Thread Veins that were there before the treatment. This is rare. Allergies are often quoted as a problem but they are exceptionally rare.

Contact the Claudia McGloin Clinic for further details on Thread Veins and procedures available.