Do high heels cause varicose veins?

January 18, 2014Mainhigh heels, Varicose veinsJohan Blignaut

The simple answer is NO.

There has been no verified scientific study to show that wearing high heels will cause varicose veins. Recently researchers from Preto Medical School in Sao Paulo conducted a trial comparing the effect of wearing high heels vs. barefoot on venous return in the legs.

Venous return is your body’s ability to return blood from your feet and legs back to your heart. The most important aspect of venous return is the function of the calf muscle pump. Every time your calf muscle contracts, it squeezes the veins in your legs and blood is pumped upwards in the leg. The blood moves upwards, because there are one way valves in the veins, directing the flow. These valves will close when the calf relaxes, and prevent blood from returning all the way to the foot. In this manner a column of blood is pumped towards the heart with every muscle contraction.

When wearing high heels, especially 7cm stilettos, this calf muscle is rendered almost useless, since you are walking on your tippy toes all the time. So back to the researchers, they compared 7cm stilettos, 7cm platform / wedges, 3.5cm medium heels and going barefoot and found that wearing 7cm heels impaired venous return in the leg with an associated impaired pump. The 3.5cm heel did not do much better either!

The conclusion was that the continuous use of high heels tends to provoke venous hypertension and may represent a causal factor of venous disease symptoms.

Having venous hypertension is only part of the puzzle, this needs to be combined with failing venous valves to cause venous reflux and varicose veins.

My advice to my patients is that the occasional use of high heels will not be detrimental to the health of your leg veins. Patients with symptoms of venous reflux – heavy legs, swelling, pain, large varicose veins, should be assessed for treatment, rather than worry about high heels and crossing your legs.

Varicose veins in the printed press

Comprehensive vein treatment in South Africa – Johannesburg – Durban – Cape Town

Varicose veins in the Highway Mail Durban

September 30, 2013Varicose VeinsVaricose veinsJohan Blignaut

Highway Mail article – click to read this article about radio frequency ablation and varicose veins.

The article has been posted on the web here

Frequently asked questions about spider veins and sclerotherapy

September 29, 2013Spider Veinssclerotherapy, spider veinsJohan Blignaut

This is a very typical email enquiry that I often receive :

I am enquiring about sclerotherapy. I have spider veins on my lower and upper legs. They are fine but visible (red-blue in colour)

1. How much do the sessions cost and how many would I need?

Every patient is unique. We charge according to the amount of veins needed to treat. You will undergo a thorough examination and scan and will then be presented with a treatment plan and costs involved. On average, patients spend R2000 – R5000 on sclerotherapy to achieve desired results.

2. I have sensitive skin and am rather needle phobic – would you be able to give me something to dull the pain during the procedure?

We don’t routinely do this. Sclerotherapy injections are done using an ultra fine needle. There is a burning sensation afterwards. EMLA (R) cream may be used at times in selected cases.

3. Could you explain what the procedure would involve eg. would I have to wear stockings after the procedure and would I be able to drive?

Compression is sometimes indicated.
There is no restriction on driving afterwards.
4. What about exercise and sun exposure? How long should I wait before returning to gym and how long do I need to be careful of the sun?

Avoid exercising on the same day and having a hot bath. This will cause the burning sensation to return. ALWAYS wear the maximum protection for your skin when out in the sun.

5. How long does the bruising and swelling last after a session of sclerotherapy?

The acute reaction that involves redness and tenderness will last 2-3 days. There after you might have some staining (Caramel coloured fine lines), which is the iron that leaks from the blood in the vessel, this is temporary and may take months to fade completely.

6. How do I know that the veins won’t reoccur or what do I do to minimise their recurrence?

The same veins would not return. It is important to always have your veins treated by a medical professional that specialises in vein treatments. All vein patients always require a complete medical workup of their vein problem, prior to any treatment. Often patients would attend salons and have treatments for their veins. These patients are often disappointed with the results.

The usual story is “I had my veins treated at XXX and now they are worse!” The problem here is the presence of venous reflux in the larger veins, that require treatment first, before the spider veins are treated.

If you are prone to develop spider veins, and you don’t have an underlying cause for it, then it is best to have them treated once a year at the beginning of fall/winter.

New vein centre opens in Durban

September 22, 2013MainVein Centre DurbanJohan Blignaut

Vein Centre Durban

Holistic vein care requires a dedicated practice, and to achieve this, I’ve decided to close my rooms at Life Entabeni Hospital in Berea, Durban from 30 November 2013.

The exciting news is that my newly renovated Vein Centre will open on 1 December 2013.

These rooms are situated in Umhlanga, next to the Netcare Umhlanga hospital. Follow medigate road to Medigate No 2.

This world class Vein centre features two state-of-the-art procedure rooms. The overall design and waiting room has been tastefully appointed by well known interior specialist Frans Alexander. Although situated in the busy heart of Umhlanga, you will be able to relax prior to your procedure. Gateway Shopping is a quick 1 minute’s walk down the road.

The world of veins

September 21, 2013MainJohan Blignaut

I was privileged to attend the UIP 2013 congress in Boston last week. This is the biggest gathering of vein care specialists in the world. More than 1800 delegates attended lectures by over 300 world class speakers.

What was apparent is the fact that vein stripping surgery should be something of the past. Thermal ablation procedure like endovenous radio frequency and laser are the standard of care in most places worldwide. Foam sclerotherapy has drawn much attention. It is a excellent treatment option for many types of veins.

Radio-frequency ablation and ultrasound guided foam sclerotherapy is currently a very good way of managing most vein patients. This has been validated by a number of studies presented this year.

There are many new treatment options on the horizon, like Venaseal by Sapheon which is a type of sterile superglue that is injected into the offending varicose vein. Clarivein is another new treatment method, where a rotating device damages the lining of the vein while glue is injected into the vein. It does not use any heat.

Steam vein sclerosis is a treatment method of injecting steam into the vein, unfortunately results have been poor after one year of follow-up.

The new treatment options would have to stand the test of time, before acceptance by most doctors. For now, thermal / heat ablation with radio frequency or laser are the best treatment for varicose veins.

During my stay in Boston, I was fortunate enough to meet world removed vein specialists Mark Whiteley from the UK, Nick Morrison from Phoenix and Nicos Labropoulos. Mark founded the Whiteley Clinics in the UK and Nick is currently president of the UIP.