Medical Super Glue for Varicose Veins

In today’s Daily Mail, there is an article on the use of medical “Super Glue” called VenaSeal to treat varicose veins.  I commented on this in a previous blog posting. I believe that the Sapheon “super glue” Closure system for varicose veins is one of the most interesting and promising developments in the treatment of this condition for many years. The procedure is very fast and there is no need for local anaesthetic injections, so the procedure really is pain-free. In addition, there is no requirement to wear compression stockings afterwards, which many people in my clinic find uncomfortable or difficult to put on. However, the use of medical super glue for veins is at a very early experimental stage. The results of this clinical study and others are needed in very large numbers of people (to identify rare but serious complications) and for at least 5 years (to be sure that this technique stands the test of time). Nevertheless, the Sapheon Closure System is an exciting new treatment option.

The article in the Daily Mail is very interesting. However I would caution readers not to rush out asking their vein specialist to have VenaSeal for their varicose veins until we have the results of this trial and the results of other trials comparing it to established, tried and tested treatments such as endo-venous laser, Radiofrequency (VNUS Closure) and Ultrasound-Guided Foam Sclerotherapy. Will I be performing it next week? Well perhaps, as part of a research trial.

Contact me today for a confidential chat

If you’re worried about your veins and would like a confidential chat please do get in touch. I am happy to offer simple advice by telephone and email for free and without obligation.

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Varicose Eczema is not a dermatological or skin condition and it should not be treated by dermatologists or with creams. In fact steroid creams only mask the condition which can continue to deteriorate to the point of causing a leg ulcer. The underlying problem is superficial vein reflux and this should be treated by a vein specialist (phlebologist).

Early Treatment gives better results and reduces the risks of complications. If caught early, varicose eczema can be cured. However if varicose eczema is neglected, the skin may be damaged beyond repair and may not recover.

Contact me today for a confidential chat
If you’re worried about your veins and would like a confidential chat please do get in touch. I am happy to offer simple advice by telephone and email for free and without obligation. You don’t need a referral letter from your GP. If you want a full consultation and duplex ultrasound scan, you can call direct to make an appointment – 01935 873 951

In published scientific trials, sclerotherapy always comes out tops for the removal of thread veins on the legs and most vein specialists regard it as the “gold standard”. In this treatment, a prescription medicine called a sclerosant is injected directly into the thread veins using very fine needles, slightly bigger than a human hair. As the clear solution enters the thread vein, the blood within it is displaced and they look as if they disappear. In fact, the sclerosant removes the lining of the vein instantly (surprisingly this is not painful) and then the vein responds over the course of 6 weeks by shrinking and becoming much less apparent. Usually, 3 treatment sessions separated by 6 weeks are needed to achieve the desired improvement. Initially after each injection session, the veins look temporarily worse.

Let me show you how I do these injections.

If you are affected by Varicose Veins and Thread Veins, there are 7 things you must know.

1. Heredity is the most important factor that determines whether you are likely to develop varicose veins or thread veins. It’s not your fault, you probably inherited a weakness of your veins from your Mother or Father.
2. Pregnancy doesn’t cause varicose veins or thread veins. These vein problems may appear for the first time during pregnancy, but pregnancy is not the cause, it merely aggravates an underlying weakness of the vein valves.
3. Early treatment gives better results. There is no point putting off treatment. Don’t wait until you have had your children, lost weight or changed jobs!
4.  Superficial Vein Reflux (SVR) is the underlying problem that leads to varicose veins and thread veins. SVR is the flow of blood in the wrong direction. Flow should be upwards in the veins, from the foot, back towards the heart. Where there is SVR, the valves do not work properly and gravity can pull blood downwards in the wrong direction.
5. You shouldn’t have anything done to your veins until you have had a full duplex ultrasound scan. Only an ultrasound can identify where the reflux is coming from and which veins are unhealthy.
6. All vein treatments are best done under local anaesthetic. Under local, you will get a better result with less risk of complications and without the costly need for treatment in hospital.
7. Thread Veins really are not just cosmetic. Most thread veins are caused by SVR

The Treatment Susan had her left leg treated by VNUS Closure under a local anaesthetic as a walk in, walk out procedure at the VeinCare Centre at the Melbury Clinic in Dorset. She was in and out the door in less than 4 hours and can now get on with her life as normal.

The Results have been dramatic. The pain and discomfort have gone, Susan has not had any more phlebitis and the varicose eczema has cleared up completely. Usually varicose eczema indicates severe damage to the skin and sometimes it does not resolve completely even after successful closure of the refluxing veins. Happily, Susan is young with good healing powers and only 6 months after VNUS Closure, the eczema has disappeared as you can see from today’s clinical photograph (photograph on the right).

Early Treatment gives better results and reduces the risks of complications. If varicose eczema is neglected, the skin may be damaged beyond repair and may not recover.

Contact me today for a confidential chat
If you’re worried about your veins and would like a confidential chat please do get in touch. I am happy to offer simple advice by telephone and email for free and without obligation. You don’t need a referral letter from your GP. If you want a full consultation and duplex ultrasound scan, you can call direct to make an appointment – 01935 873 951

Before VNUS Closure

After VNUS Closure

Dr Charlene Scicluna and Dr Johanna Ward are congratulated by Dr Haroun Gajraj

I have just returned to Dorset having spent the day in London training two doctors in the treatment of thread veins (known medically as telangiectasia). Dr Charlene Scicluna (middle) is a General Practitioner and Specialist Cosmetic Doctor from Malta and Dr Johanna Ward (right) is a General Practitioner and Cosmetic Specialist who has her own clinic in Kent, the Skin Clinic Sevenoaks. Both doctors completed my intensive one day course today in London and they demonstrated a thorough understanding of the condition, how it is managed and they showed that they are competent in the treatment of these unsightly veins.

Charlene and Johanna see many patients who are concerned about thread veins on the nose and cheeks as well as on the neck, chest and legs. Both have had variable success with treatment options such as laser and intense pulse light (IPL) so they were keen to receive training in the most effective methods of removing these sorts of thread veins.

In published scientific trials, sclerotherapy always comes out tops for the removal of thread veins on the legs and most vein specialists regard it as the “gold standard”. In this treatment, a prescription medicine called a sclerosant is injected directly into the thread veins using very fine needles, slightly bigger than a human hair. The sclerosant removes the lining of the vein instantly (surprisingly this is not painful) and then the vein responds over the course of 6 weeks by shrinking and becoming much less apparent. Usually, 3 treatment sessions separated by 6 weeks are needed to achieve the desired improvement.

For the face, neck and chest, an electrical treatment called Short Wave Diathermy gives excellent results. After numbing the affected area with local anaesthetic cream applied to the skin, a very fine needle is used to conduct a medical electrical current into the veins which are heated and instantly sealed. Usually only one treatment is needed and the veins disappear after 4 weeks.

The course that I run in London in association with Wigmore Medical is supported by a comprehensive course manual that delegates receive in advance to study and then the theoretical aspects are summarised by intensive lectures in the morning. After a short lunch break, the delegates are instructed on the treatments. The techniques are demonstrated and then the delegates get to do the treatments themselves under my careful scrutiny and supervision. I am always very grateful to the volunteers with thread veins who allow the delegates to inject their leg thread veins by sclerotherapy and allow their facial thread veins to be removed by Short Wave Diathermy. Both delegates today were able to have “hands-on” experience over several hours.

I wish Charlene and Johanna great success in their own clinics and I look forward to hearing from them.

Nevertheless, varicose veins are unsightly, they ache, throb and itch, particularly after prolonged standing and in hot weather. Untreated, they usually get worse and spread. Treatment at an early stage gives better cosmetic results, it relieves symptoms and it reduces the risks of complications.

Recently Julie from Taunton who has severe varicose veins and a family history of leg ulcers asked me whether she is at risk of ulcers herself. I was able to reassure her and here is my advice to those who are concerned about a leg ulcer.

If you’re worried about your veins please do get in touch. I am happy to offer simple advice by telephone and email for free and without obligation.

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1. Inadequate surgery

Venous Reflux may still persist after the surgery either because the wrong operation was performed or the correct operation was performed but incorrectly. For these reasons,  treatment should always be based on full pre-procedure duplex ultrasound scan, the procedure itself should be monitored by ultrasound and at the follow up clinic check, another ultrasound scan should be performed.
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2. Neovascularization

Even when the correct veins have been stripped, it is still possible to have a similar varicose vein come back a few years later.  After surgical stripping, the “raw ends” of the veins that have been tied regrow and re-join. Ultrasound scans have shown us that this re-growth of veins occurs after nearly every stripping operation and that neovascularisation is a major cause of recurrent varicose veins. The latest research shows that modern treatments such as VNUS Closure, Endo-Venous Laser and Foam Sclerotherapy do not cause neovascularisation and so they are treatments which are less at risk of being complicated by recurrent varicose veins.
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3. Progression of the disease

Most people with varicose veins have a genetic predispositon or inherited weakness of their veins. Heredity is in fact the major risk factor for the development of varicose veins and thread veins.  Like the colour of your eyes, this predisposition or inherited weakness cannot be “cured”, so even after the most appropriate and modern treatment, expertly performed and checked by ultrasound, people are at risk of new varicose veins. Therefore, many vein experts advise regular check ups to detect early development of varicose veins and reflux which can be treated before they become a problem. Life style changes and the wearing of good quality compression hosiery are very important in minimising progression.

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If you have been affected by recurrent veins, do please leave your comments below or if you’re worried about your veins and would like a confidential chat please do get in touch. I am happy to offer simple advice by telephone and email for free and without obligation.

Another Health Benefit of Chocolate

A recent study showed that frequent chocolate consumption was associated with lower body mass index (BMI), even when adjusting for calorie intake, saturated fat intake, and mood.

Beatrice A. Golomb, MD, PhD, associate professor of medicine at the University of California, San Diego, and colleagues described their findings in a research letter published in this week’s issue of the prestigious medical journal – Archives of Internal Medicine.

The authors used data from 1018 patients already being screened for inclusion in a widely sampling clinical study looking at the benefits of statin medications. Of the 1018 participants, 1017 answered the question, “How many times a week do you consume chocolate?” BMI was calculated for 972 participants (95.6%); and 975 (95.8%) answered a Food Frequency Questionnaire.

Here’s the Science:

The investigators performed analyses with and without adjustment for calorie intake, saturated fat intake and mood. Fruit and vegetable intake was not associated with chocolate consumption. The amount of chocolate consumed was examined, in addition to the frequency of chocolate consumption. Activity (number of times in a 7-day period the participant engaged in vigorous activity for at least 20 minutes) and mood were also examined.

The relationship between chocolate consumption frequency and BMI was calculated in unadjusted models, in models adjusted for age and sex and in models adjusted for activity, saturated fats and mood. Study participants consumed chocolate on average twice a week and exercised between three and four times per week. Frequency of chocolate consumption was associated with greater intake of calories and saturated fats. Chocolate consumption frequency was not associated with greater activity, but it was associated with lower BMI.  This association remained with and without adjustment for age and sex, as well as for calories, saturated fats and depression.

Although chocolate consumption frequency was associated with lower BMI, the amount of chocolate consumed was not, so it appears that how often you eat chocolate is more important than how much you eat.

The connection of higher chocolate consumption frequency to lower BMI is opposite to associations presumed based on calories alone, but in agreement with a growing body of medical literature suggesting that the type — as well as the quantity — of calories has an impact on weight.

This is good news for chocolate lovers, particularly with Easter round the corner. It seems that a little of what you fancy does you good and that we can all enjoy chocolate in moderation.

Reference Arch Int Med. 2012;172:519-523.

Thread Veins Before Treatment

Although thread veins are considered to be a minor issue, the majority of thread veins are caused by reflux and faulty vein valves. So, successful treatment relies on a careful assessment of the cause and upon the correction of any reflux, as well as a very precise injection technique. Sclerotherapy – injection of a prescription medicine directly into the thread veins – is the best way to banish thread veins. Today,  I met Sally from Dorset who has just finished  treatment.

Sally’s Story

I am so glad I had my thread veins treated. They were very unsightly and prevented me from going swimming with my children and even in the summer I had to keep covered up. Dr Gajraj injected them and after 2 visits, they gradually disappeared. I now have my confidence and I went swimming with my family for the first time recently. I am thrilled. One more thing – everyone at the VeinCare Centre is so kind and understanding. It’s difficult to show people your legs when you are as embarrased as I was, but they made me feel so comfortable and I was treated with respect at all times.

Sclerotherapy for Thread Veins

The thread veins are injected directly using a very fine needle. A medical solution called a sclerosant is injected and it works by removing the lining of the vein (this doesn’t hurt). Over the next few weeks the veins gradually fade. As you can see from the before and after photographs, the results in Sally’s case are impressive. The important thing to remember is that the process of fading takes several weeks, so now is a very good time to start thread vein treatment if you hope to have nice legs for summer. My team and I have treated many people who are happy to provide testimonials.

Don’t leave it too late. Contact me today for a confidential chat
If you’re worried about your veins and would like a confidential chat please do get in touch. I am happy to offer simple advice by telephone and email for free and without obligation.

You don’t need a referral letter from your GP. You can call direct to make an appointment – 01935 873 951

After Sclerotherapy