Most patients that come to see me for their varicose veins and leg pain have small to moderate sized surface veins and relatively normal color and texture to the skin around the lower calf and ankle. These patients often have what is termed C2 in the CEAP Classification of venous disease. However, other patients who developed varicose veins and not undergone treatment for many years progress to a more severe form of disease, often classed as C4 in CEAP, with pigmentation of the ankle skin, thickening of the skin and even what termed medically as lipodermatosclerosis.
These skin changes occur as the elevated venous pressures target the lower leg with gravity forcing the blood back down the leg. Small blood cells may leak from the capillaries, and as these cells are broken down and resorbed, the iron pigment is deposited in the tissues, leading to the permanent color changes.
Once patients develop this lipodermatosclerosis, and if they go untreated, venous stasis ulceration can form. This is an open sore, usually on the inner ankle area due to varicose veins.
Because the progression from uncomplicated varicose veins to these advanced stages is hard to predict, we often advise patients to seek evaluation early in the phase of the problem instead of waiting for complications, such as blood clots and skin changes.
Evaluation consists of an evaluation with Dr. Rosenberg, usually followed by a venous duplex scan and treatment based on the scan results. The Venefit Procedure is highly effective in treating saphenous vein reflux, and occasionally micro-phlebectomy or sclerotherapy is needed as well. These procedures help normalize venous flow and reduce the pressure in the lower leg.
As venous insufficiency is a legitimate medical problem and not cosmetic, most insurance providers cover varicose vein treatment. For more information on this condition, please see us at the CVL Lansdowne vein center in Leesburg.
