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  • Dr. James Geuder M.D.

Varicose Veins and What to do About Them.

What are the symptom of Varicose Veins?

Varicose veins frequently cause heavy, aching legs. Swelling or edema is common. The veins may feel warm, itch or cause pain. Restless legs are common. Prolonged sitting or standing usually worsen symptoms.

How are Varicose Veins and circulation problems diagnosed?

Most varicose veins are visible and easily diagnosed. However, they are not always the cause of the problem. It is important to see an experienced doctor, preferably a vascular surgeon. They have the knowledge and experience to perform a thorough exam and determine the clinical condition. Further studies, such as Doppler or ultrasound imaging may be helpful.


Conservative treatment i.e support stockings, elevation, exercise and sometimes weight loss are always beneficial. Further treatment may include treating the deeper refluxing veins (laser, radio frequency ablation, VenaSeal, ClariVein, Varithena, sclerotherapy or surgery), varicose vein removal (phlebectomy), or injection treatments (sclerotherapy). These procedures are usually performed in the office using local anesthesia if necessary.

What happens when the veins are removed? “Don’t I need my veins?”

These veins are abnormal and usually have no important function. Removing those varicose veins redirects the blood flow back into the normal veins and improves circulation.

Will the veins come back?

Varicose vein treatment is very effective. The treated veins should not come back. However, people with varicose veins often have a predisposition toward forming new varicose veins. This highlights the importance of proper diagnosis and treatment by a skilled doctor. Better initial treatment will lessen the chance of reoccurrence.

How do I choose a vein doctor?

Board certification is important. The board should be listed by the American Board of Medical Specialties e.g. Surgery, Radiology, Internal Medicine. Many doctors list society or organization membership as “board certified”. This may indicate additional training or experience but does not meet the criteria of the ABMS. IAC-International Accreditation Commission certifies Vein Centers. The can be located on the IAC website.

Patient review sites such as Healthgrades, Patient Choice or Google may be helpful. Facebook groups c e.g. Bergen County Moms frequently comment on patient’s experiences. Castle & Connolly provided lists of top doctors. Vein screening is an opportunmity to visit the office/vein center. It provides an opportunity to meet the doctor and staff as well as see the facility.

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