Are you interested in learning about medical treatments for varicose and spider veins? Dr. Greg Martin shares his expertise on vein health with LoveToKnow Seniors in this exclusive expert interview.
About Dr. Martin
Dr. Martin earned his undergraduate degree at Clemson University, followed by medical school at the Medical University of South Carolina in Charleston. He completed his residency at Northwestern University of Chicago, where he served as Chief Surgery Resident. He has since been in private practice in Georgia. Dr. Martin is a Fellow of the College of American Surgeons and certified by the American Board of Surgery. The American Board of Phlebology's inaugural board certification was in 2008, when he was one of 256 doctors worldwide to earn certification, including eight in Georgia. He is the author of Say Goodbye to Varicose & Spiders Veins Now!
LoveToKnow (LTK): Please tell us about your experience with varicose and spider veins.
Dr. Greg Martin (GM): I had performed the traditional treatment for varicose veins and spider veins in years past, including performing several dozen of the traditional old vein stripping operations, as well as the hypertonic saline sclerotherapy for spider veins. These treatments could be beneficial to patients, but had substantial limitations.
I worked in a traditional surgery practice for 22 years. I began doing the new state-of-the-art spider veins and varicose vein treatments in 2003 and dedicated my practice full-time to treating vein disease in 2005.
LTK: Why did you dedicate your practice to varicose and spider veins?
GM: I met Dr. Ron Bush of Midwest Vein Center in the Dayton, Ohio area, who became my mentor and friend. He was among the pioneers in new vein treatments. These were a dramatic improvement and advancement in treating both varicose and spider veins. The old era of vein stripping and hypertonic saline injection treatments left a lot to be desired; recurrent disease was really a hallmark of the old therapies, even though they would often temporarily help patients to some degree. Now we are learning how to treat the root causes of varicose vein and spider vein disease. I performed essentially what was a mini-fellowship under Dr. Bush and spent a couple years absorbing as much information as I could about vein disease. I originally intended it to be a subspecialty in my surgery practice, but vein treatment has been very rewarding in its own ways compared to traditional surgical practice.
Spider and Varicose Veins
LTK: What are spider veins and varicose veins?
GM: Spider veins are the smaller red or purple veins on the skin surface that look like a spider legs illuminating from a central source. With time and enlargement, they can take on a more blue and beaded appearance. Varicose veins are just any of the abnormal veins that actually bulge outward from the skin surface in the legs.
LTK: How many people have varicose and spider veins? What percentage seeks treatment?
GM: A conservative estimate by the American College of Phlebology is that at least 80 million American adults have varicose or spider veins, and many have both. I have never seen data that indicates what percentage of those patients seek treatment. I can state that of those patients, about 70 percent are women and 30 percent are men. I would also say that probably more than half of American adult women have varicose or spider veins. In fact the majority of women actually have spider veins or varicose veins by retirement age.
LTK: When does vein disease usually start?
GM: Varicose and spider veins can actually develop very early, often even in late childhood or early teenage years. Our median age for our patients would be in the fifties. Varicose vein disease, spider veins, and I would say chronic venous insufficiency, generally is progressive. It only gets worse with time, making it a serious senior health issue. We have an old joke of "time and gravity are the enemies." That is true of a few things in life, especially leg veins. One of the beauties of our current varicose and spider vein treatment is we are treating the root causes for the varicose and spider veins, which we had difficulty doing with older techniques. Thus, not only can we clear the majority of varicose and spider veins that the patient currently has, but we can also prevent the great majority of future varicose veins and spider veins.
New Vein Treatments
LTK: What new treatment methods are there and how do they work?
GM: The most exciting new technology for varicose veins is the development of endovenous laser ablation and radiofrequency ablation techniques to destroy the large veins that have valve leakage resulting in high vein pressures in the legs due to prolonged standing or sitting. These are veins that we used to take out surgically in the old days of vein stripping. Now the techniques are performed in the office under local anesthesia and are virtually scarless. With minimal recovery, the patient can be immediately lightly active and often back to work in two to four days. The idea is that instead of removing the veins, we close and seal the veins right where they are using ultrasound guidance and local anesthesia, working through very small catheter tubes and using laser filaments or radiofrequency probes.
Another major development has been the use of foam sclerotherapy, which is dramatically more effective, more comfortable and has a better safety profile as compared to previous agents. We also can use ultrasound or other trans illuminating light guides to inject deeper veins, which we really did not have the ability to do until the past decade. We also use microphlebectomy and surface laser treatment and other adjunctive techniques in combination with the above for a customized treatment plan on each patient.
The key thing to know is that these treatments are all minimally invasive and scarless, involve very little recovery time, and have dramatically better safety profiles, long-term results and keep us away from the need for hospital stays or the need for general anesthesia. The majority of expense even for the biggest varicose vein cases is eliminated by at least 80 to 90 percent, as there are no hospital fees, nor any anesthesia fees by doing these techniques in the office setting.
LTK: Are these treatments covered by health insurance?
GM: We often battle the perception that treating leg veins is just a cosmetic issue and that the patients will need to pay for treatment out of pocket. In fact, 85 percent of our practice revenues are from health insurance. I should note that Medicare, for example, covers the majority of treatments that we do and commercial insurance policies will cover the majority of cases of varicose vein techniques. Sometimes spider vein disease is deemed as cosmetic, though that is not always medically accurate. At the initial consultation with a vein specialist physician, you should be informed if there will be insurance coverage for your pattern of leg vein disease, and whether or not your policy will cover it.
For patients who are paying for spider vein treatment because it has been deemed cosmetic, it is actually an excellent value if you are in the hands of experts. I sometimes joke with my wife about how people spend what seems to me like exorbitant amounts of money for hair styling, clothing, jewelry, makeup, and especially shoes, but for somewhere in the range of $500 to $2,000 you can have a series of spider vein treatment sessions. This treatment dramatically changes your legs, in both health and appearance, actually preventing most future abnormal veins from occurring.
Benefits of Treatment
LTK: What are the benefits of treating varicose and spider veins?
GM: There is some risk from having varicose vein and spider vein disease. We do not have good quality medical studies to demonstrate it, but it is thought that treatment may well reduce this future risk for patients. What the patients will usually notice is dramatic improvement in symptoms, which may include leg pain, heaviness, aching, fatigue, restless leg type symptoms, cramps and swelling. A lot of patients actually report that their legs feel lighter, fresher and have more energy and durability. In addition, as a side benefit, there is always the cosmetic or visual aesthetic clearing of the veins. Many of our patients enjoy substantially improved quality of life as they enjoy their summer clothes. I have had hundreds of patients who have told me they have gotten back into shorts and skirts for the first time in 15 to 20 years after our treatment was completed. They have often been able to resume activities such as gardening, long car trips or plane travel, which their leg pain and swelling did not allow them to do previously.
Learn More from Dr. Martin
For even more helpful information from Dr. Martin, pick up a copy of his book Say Goodbye to Varicose & Spiders Veins Now! In doing so, you not only improve your vein health, but also rediscover some of your favorite summer clothing and activities.