The Case Against Compression Stockings

Many patients hesitate to have their spider veins treated during the summer months.  Summer heat makes the idea of wearing  compression stockings unpleasant.

 

After years of experience, I offer the following guidelines on the subject:

• Patients with smaller spider veins may skip compression hose entirely. After sclerotherapy, we wrap the leg in an elastic wrap, to stay on for 24 hours.   Our experience shows patients with small spider veins will do fine without prolonged compression and so we recommend that the only compression would be the 24 hour wrap.
• Patients with larger veins may wear compression stockings for one week.   The initial wrap stays on for 24 hours, followed by up to a week of compression hose. Studies have shown that wearing compression stockings for longer than a week has diminishing returns. One week seems to work just as well as wearing them for three weeks.

• We’ve also found that when treating small spider veins with skin lasers we do not have to use compression wraps.  We offer this method of treatment to patients who do not want to wear compression stockings. This has enabled us to treat many of our patients comfortably during the summer months.

HOW I ADOPTED THIS POINT OF VIEW:

 The use of compression stockings after sclerotherapy is somewhat controversial.  Recommendations vary and a case can be made for both wearing and not wearing compression stockings.

Some doctors feel that studies show that you don’t need to wear compression stockings at all.  This is the accepted standard of care in France:  the recommendation in France being NOT to wear compression stockings for treatment of spider veins.   Yet, other doctors insist on compression hose.

I come down somewhere in between both views.  Every case is, after all, different.   Patients who have larger spider veins and reticular veins need to be treated differently from those who have smaller spider veins.  So, some  patients will do well  without wearing compression stockings and there are others whose veins need to have some compression for a short period of time to prevent refilling of the treated veins.

Don’t put off treatment or evaluation because you assume you will have to wear compression hose.   At your initial appointment, when we are able to look at your veins, we will  make a personalized  evaluation of what you can anticipate.  You may be pleasantly surprised!