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Offices of Michael Kassouf, MD

Non-Surgical Varicose & Spider Vein Therapies

A mainstay of treating varicose veins, compression therapy helps to improve circulation and should be considered by anyone suffering from varicose or spider veins. Compression therapy improves blood circulation by applying controlled pressure to the affected area, constricting the diameter of the veins and thus restoring adequate blood flow. Also anti-inflammatory, such treatment can yield improvement in pain and swelling, reducing symptoms and even retard the progression of varicose and spider veins.

Compression Therapy

There are several options for compression therapy for vein treatment. The two methods most commonly used are compression bandaging and elastic graduated compression hosiery (support stockings).

Compression Bandaging:
Usually used when varicose veins produce symptoms of leg ulcers, compression bandaging utilizes a multi-layer system to bind, pad, and compress. Elasticized bandages provide graduated compression with the highest pressure placed on the ankle where it is most needed. Bandages may be left on or reapplied for several weeks until swelling has dissipated in the affected vein area.

Compression Hosiery/Support Stockings:
Elastic compression stockings are classified into different levels based on the amount of pressure placed on the ankle. Measurements of the lower leg should be taken to ensure proper fitting. Properly fitted stockings will produce an effective graduation in pressure and be comfortable to wear; they should not cause discomfort or trauma.

You should consult a doctor about which type of compression is best for you. Proper measurements are required to ensure the effectiveness of the treatment and inappropriate compression may worsen vein symptoms. We offer a variety of compression hosiery at discounted prices, call today to schedule a consultation, 866.238.0131.

Compression therapy should not be used for arterial leg ulcers and should be used with caution in diabetic leg ulcers.

Nutrition & Diet

Eating a balanced diet high in fiber and low in sugar and fat is crucial to maintaining healthy veins and legs. Many physicians consider the first line of therapy to be a high fiber diet with sufficient fluids. A diet too low in fiber can result in patient strain during bowel movements, which can subsequently increase pressure in the veins of the lower legs. Over time this can deteriorate vascular integrity and even worsen existing conditions.

Aside from a healthy diet, many vitamins and herbal remedies have been found to be helpful in the reduction of symptoms and prevention of venous disease. Below are some of the most common vitamins and herbal remedies taken to treat varicose veins.

You should note that though the information provided is helpful, you should seek the attention of a qualified physician before starting any treatment or therapy. Failure to do so could result in further aggravation of an existing condition.

Vitamin C:
Also known as ascorbic acid and dehydroascorbic acid, vitamin C is essential in the formation of collagen, the main supportive protein of skin, and other fibrous tissue. Because collagen is essential to the growth, development, and repair of tissue, the structural and functional integrity of capillary walls depends on sufficient vitamin C. A prolonged deficiency in vitamin C not only halts construction of collagen-based structures, but also can deteriorate existing structures.

Vitamin C can be ingested in citrus fruits, tomatoes, potatoes, brussel sprouts, cauliflower, broccoli, strawberries, cabbage, and spinach. Although relatively safe, excessive consumption can result in gastrointestinal disturbances, kidney stones, and excess iron absorption. Those who have a history of kidney stones should not take large amounts of vitamin C. Individuals who smoke require an additional 35 mg/d of vitamin C over that of a nonsmoker.

Vitamin E:
Antioxidants such as vitamin E act to protect your cells against the effects of free radicals, which are potentially damaging by-products of energy metabolism. Free radicals can damage cells and may contribute to the development of cardiovascular disease and cancer. It is believed that vitamin E, through its ability to limit production of free radicals, might help prevent or delay the development of such chronic diseases.

Vitamin E can be found in vegetable oils, unprocessed cereal grains, nuts, fruits, vegetables, and meats. While there is no evidence of adverse effects from the consumption of vitamin E that naturally occurs in foods, excess vitamin E from supplements can cause hemorrhagic toxicity in certain individuals. Patients on anticoagulant therapy should be monitored when taking vitamin E supplements.

Herbal Remedies

While the complete reversal of varicose veins is only possible with medical vein treatments, conservative therapies, like the herbal remedies listed below, can help alleviate symptoms and prevent vein problems from worsening. For more information on the best treatment options for you, call 866.238.0131 and set up a consultation today.

Gotu Kola (Centella Asiatica):
Despite its reputation as a tonic herb, gotu kola is used mainly for skin problems and wounds and has been found beneficial in the treatment of varicose veins. Clinical studies have shown that the use of gotu kola enhances vein integrity, aides healing, and improves circulation. Application of the extract locally has also demonstrated improvement in vascular tone, making problem veins less prone to damage. Except for the rare person who is allergic to gotu kola, the only problems encountered are occasional nausea if excessively high doses are used. Should be avoided if pregnant or while breast feeding.

Horse Chestnut (Aesculus Hippocastanum)
Horse chestnut seed extracts are used clinically to relieve symptoms and reduce signs of varicose veins. In clinical studies, the extract has been found to inhibit the activity of damaging enzymes, making veins less permeable and fragile. Horse chestnut therapy should not be undergone by those with bleeding disorders.

Butcher’s Broom (Ruscus Aculeatus)
A traditional folk medicine, butcher’s broom, also known as box or knee holly, has been used to treat varicose veins and hemorrhoids for many years. Increasing scientific literature has supported such uses, having found that the extract has anti-inflammatory and astringent properties. In clinical studies patients who were given the extract maintained venous tone and improved venous emptying in comparison to placebo-treated patients.

Witch Hazel (Hamamelis Virginiana)
Witch hazel extract has a long therapeutic tradition and is used primarily for its astringent, anti-inflammatory, and local hemostatic effects and can be found in most pharmacies. Application of the extract can cause minor skin irritation in some people when applied topically; this herb is not recommended for internal use.


Regular exercise, such as walking, biking, swimming and other low impact exercise, promotes healthy circulation and can help relieve symptoms of varicose and spiders veins, as well as keep existing vein conditions from worsening. While raising your legs and moving on your feet is beneficial, sitting or standing for long periods of time can worsen conditions. If you must stand, make sure to shift your weight from one leg to the other every few minutes. If you find yourself unable to get up and walk around do ankle flexions while seated to help keep blood in your legs pumping. If you are suffering from varicose or spider veins, it is advisable to wear support stockings during any excercise.

When the legs are active, the muscles in your legs contract and help pump stagnant blood back to the heart, limiting the amount of blood left to pool in the legs. Better circulation can relieve symptoms and improve the appearance of varicose and spider veins.

Exercise is also crucial to keeping your weight down. Excess weight puts added pressure on the valves of your legs.The following are some easy movements you can do ease symptoms and maintain healthy blood flow.

Ankle Flexions: While keeping the heel of your foot down, lift and lower your toes. This exercise mimics the movement of walking for your muscles and should be done throughout the day while seated.

Leg Elevation: Raising your legs a few inches above your heart level lets gravity drain your legs of pooled blood. Place 2-3 inches under your ankles while lying down.

For more information on varicose and spider vein treatments through excercise call 212.343.2777 or toll free at 866.238.0131.

Clothing & Apparel

Tight garments can restrict venous blood flow and cause blood to pool, which can aggravate existing conditions. Girdles, pantyhose that are too snug in the groin area, garters, calf-hugging boots, or waist cinching belts should be avoided.

Footwear such as high heels should also be avoided. The contraction of the calf muscles aids the return of blood from the legs to the heart. The wearing of high heels prevents full contraction and can hinder blood flow, causing excessive leg aching and tiredness.