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Channel: David Ian Rosen, MD – Advanced Dermatology Blog

Facts to Battle Leg Vein Fictions, Winter/Spring 2016 Newsletter

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Women and men who come to see me in consultation regarding their varicose and spider veins have been living with those nagging, annoying things for years…decades in many cases. Aside from aesthetic concerns, such veins are often painful and associated with other symptoms such as leg swelling, cramps, “restless legs” and legs that feel tired and heavy.

While there are certain barriers that kept most patients from wanting to deal with this issue, technology has finally “caught up” to vein disease and has answers for every concern. I’m here to shed some light and battle Fiction with Facts:

• Fiction: “Procedures are very invasive and risky.”

• FACT: State-of-the-art, minimally invasive procedures I provide are very safe and have very low risk. They are all performed in the office while we chat and listen to music!

• Fiction: “Procedures are very uncomfortable.”

• FACT: Procedures such as Endovenous Laser Ablation, Clarivein®, Sclerotherapy and VenaSeal® all require only local anesthetic and are very well tolerated. Post-procedure discomfort is minimal.

• Fiction: “There is a lot of down time and restrictions after procedures.”

• FACT: Such minimally invasive procedures allow patients to resume most routine activities IMMEDIATELY after treatments. Drive yourself to & from procedures. Rather than limited, activity is encouraged after procedures.

• Fiction: “Procedures are ineffective; veins just come back.”

• FACT: Procedures are very effective at permanent closure of veins. However, healing often takes time. Similar factors may lead to formation of new spider/varicose veins over time. Often times being proactive about treatments today may prevent or slow progression of future issues.

• Fiction: “Insurance/Medicare never covers vein treatments.”

• FACT: The biggest surprise to many patients is that commercial insurance and Medicare may cover many of the procedures I provide. Determination of coverage eligibility requires a consultation visit. Such visits are also typically covered by insurance/Medicare. Eligibility, when possible, often requires months to achieve due to individual insurance policy rules. The sooner you are evaluated, the sooner we can get your treatment process started.

Winter…or “pants season” is the perfect time to get treated so you can be ready to go for “shorts season” next spring and summer. I look forward to meeting you and helping your legs to feel and look better than they have in years!


Ask Dr. Rosen: Exercise & Leg Veins, Spring/Summer 2016 Newsletter

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Beautiful Female LegsEach consultation with a new patient is an opportunity for patients to get answers to their questions…ones that have been at the back of their minds…and at the front & back of their legs…for years.

One question I commonly get is: “Will exercise help my legs?”

Yes, but… Exercise won’t fix varicose veins, spider veins nor the underlying issues that often lead to them. In many cases, veins we see at the skin surface are just the “tip of the iceberg.”

The underlying problem often stems from faulty valves that become leaky and allow flow to move downward with gravity. This pooling of flow leads to increased pressure in veins that, over time, causes them to become stretched out, twisty and bulge from the surface (varicose veins). Unfortunately, such broken valves can’t be fixed. But there are things that my patients and I can do to help alleviate the problem.

While exercise doesn’t fix valves, engaging in activity that involves moving your legs…walking, running, biking, zumba-ing (it’s a word)…all help to make your calf muscles more fit. Your body uses the calf muscles as a “peripheral heart”: when they contract, they pump flow upwards and return it to the “real” heart. The more fit the muscle, the more efficient the “pump”, the more outflow from the legs and the less pooling of flow in veins.

Graduated compression stockings also help to allow flow to leave the legs more efficiently and make it harder for pooling to occur. But, like exercise, stockings don’t definitively deal with the underlying valve problem.

Definitive solutions used to involve surgery. Nowadays, state-of-the-art vein care is minimally invasive, maximally comfortable and has no downtime. Rather than stripping veins with faulty valves, I am able to instantly reroute flow to properly functioning veins by using endovenous (inside-the-vein) closure techniques such as Endovenous Laser Ablation & Clarivein®.

To learn if these procedures are right for you, schedule a consultation with me today. I’m here to answer questions and help your legs feel and look better than they have in years!

Love Your Legs Again Fall/Winter Newsletter 2016

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Autumn is a great time to “fall” in love with
 your legs again! Oy… I know, I know…awful pun…
but it’s true: once it starts getting cooler outside and we transition from “shorts season” to “pants season”, it’s a perfect time to finally take care of those nagging varicose and spider veins. There are 3 really good reasons why:

The Treatments: All of the treatments that I
 offer are comfortable, safe, effective and state-of-the-art. They are minimally-invasive, have no down time and have minimal bruising. But, because there is some bruising and because it’s better, as a rule, to avoid sun exposure, “pants season” is a great time to check this off of your to-do list.

The Healing Process: All of the minimally-invasive techniques I use encourage your body to make the bothersome veins disappear over time without having to physically remove the veins. The key word is time: in order to have legs that are ready for next “shorts season”, your body can use the fall, winter and early spring to heal. In addition, I recommend that patients use compression stockings after treatments in order to encourage safe and effective healing. Many patients prefer to wear them during the cooler months.

The Insurance Coverage: For many, but not all patients, some treatments may be coverable by insurance carriers, including Medicare. However, authorization for coverage can often take weeks to months to achieve, depending on your insurance carrier. The sooner we see you this fall, the more likely we may be able to get the coverage you deserve during this deductible year. For most patients, the deductible year ends December 31st. It’s crucial for you to be seen for your consultation visit as soon as possible to determine your eligibility and the likelihood of coverage during this calendar/deductible year.

During the hour-long consultation visit, I have plenty of time to learn more about you, your medical history and your particular concerns. In many cases, an ultrasound exam is warranted; this painless, but highly informative test allows us to tailor a treatment plan that suits your needs and goals. 
I also have time to teach you a bit about vein disease and give you as much information as you require to make the best, most informed decisions about your own care.

I look forward to meeting you and helping you learn more about the exciting and new procedures I offer to treat chronic superficial vein disease, including Endovenous Laser Ablation, Clarivein®, liquid & foam sclerotherapy and more!

What are Varicose Veins & Spider Veins?

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What are Varicose Veins & Spider Veins?
• Varicose Veins are enlarged, often twisty veins that bulge from the surface of the skin. Most commonly on the legs & thighs.
• Spider Veins are smaller, web-like collections of veins. They can be varying shades of red or blue. Although mostly isolated abnormalities, they can also be the “tip of the iceberg” of significant underlying venous disease.

What causes Varicose Veins & Spider Veins?
• Frequently issues in larger, deeper veins which live unseen beneath the surface can be the root cause of surface abnormalities
• The “job” of leg veins is to help channel flow back up to the heart. Since they have to work against gravity, leg muscles are used to “pump” the flow upward. This flow is kept moving in a one-way, upward direction by means of venous valves.
• Valve malfunction can lead to wrong-way, downward flow or reflux. Chronic reflux stretches veins living at the surface; often to the
point of bulging. Chronic reflux can also lead to chronic leg symptoms. Symptoms are often worse after prolonged standing/sitting.

What are some common symptoms of chronic venous disease?
• Heaviness
• Tired legs
• Swelling
• Cramps
• “Restless” legs
• Chronic red/brown discoloration, mainly at the lower legs

How common are Varicose & Spider Veins?
• Extremely! About half of men and women in the US will have some form of venous disease in their lifetime.

What are risk factors for developing Varicose & Spider Veins?
• Genetics: If one/both parents have significant vein disease, you are more likely to develop superficial venous issues. Vein disease affects both Men & Women.
• Pregnancies: Each pregnancy can increase the risk of developing worsening vein issues due to extra pressure on vein valves and increased stretching of veins.
• Other factors, such as increasing age, obesity and lack of exercise can also play a role.

What are some of the treatments for Varicose & Spider veins? Is surgery required?
• No, surgery is no longer the mainstay of superficial vein treatments. State-of-the-art care of underlying significant superficial vein disease includes minimally-invasive procedures such as Endovenous Laser Ablation, Clarivein® and VenaSeal™ procedures.
• Varicose and Spider veins are safely, comfortably and effectively dealt with using sclerotherapy or surface lasers.

How do I know which treatments are right for me?
• The way to tailor a treatment option that is optimized for your particular issues is to schedule an initial consultation with Dr. David Rosen. Dr. Rosen is certified by the American Board of Venous & Lymphatic Medicine and is an expert at diagnosing and treating chronic superficial vein disease.

Stuck Wearing Pants This Summer?

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Whether or not Global Warming is an issue at the forefront of your consciousness or whether math was your strong subject in school, there’s an equation that is undeniable and easy to comprehend: Summer=Warm=Less Comfortable to Wear Pants.

For some of my patients, the discomfort of wearing pants in warm weather is outweighed by their apprehension about wearing shorts or shorter skirts. For some of those patients, their reason relates to having varicose and spider veins on their legs.

Many patients are not only troubled by the aesthetics of chronic vein issues, but they are plagued with chronic, nagging symptoms in their legs: heaviness, fatigue, cramping, swelling and “restless legs”.

My medical specialty, Phlebology, deals with diagnosing and treating the causes and effects of chronic superficial vein disease. The evaluations I provide take place during an hour-long initial consultation. I spend that time doing a thorough medical history: you are more than just a pair of legs…it’s important for me to learn about you in order to give you the best advice. In addition, I spend a great deal of time teaching patients about their issues. Since you, as the President of your body, are the ultimate decision-maker, you need as much “intel” as possible to make the best decisions for yourself. If necessary, we also spend some time doing an ultrasound evaluation for potential underlying causes of symptoms and surface issues.

Initial consultations and many procedures may be covered by commercial insurance and Medicare. Coverage depends on what we discover as well as patients’ individual policies. Coverage may also take weeks to achieve, so here’s another equation for you: Scheduling consultations sooner = Quicker coverage approval = Quicker time to resolving your issues in an efficient and affordable way.

The state-of-the-art treatments I offer are:
• Non-surgical. Techniques include Endovenous Laser Ablation, Clarivein® and Sclerotherapy.
• Safe.
• Comfortable. Only some local anesthetic is required.
• Convenient. There’s no downtime: you can resume most normal activities immediately
• Effective.
I look forward to meeting you and helping you to love the look and feel of your legs again! See you soon!

Veins: They Take Time, Effort and Patience. But It’s So Worth It!

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You have to hand it to the daffodils: though there’s still frost on the ground on these early April mornings, they are still determined to make the world a bit more beautiful. Unlike in cartoons, flowers don’t actually instantly sprout out of the ground…it takes time, effort, patience. But ultimately it’s so worth it!

Dealing with one’s varicose and spider veins are quite similar experiences.
There is no magic eraser in the medical arsenal to wipe those annoying things away instantly. However, with proper diagnosis, a carefully tailored treatment plan and optimal time to allow for the body to heal…ultimately, it’s so worth it!

Allowing optimal time means starting the process as soon as possible. We do this with an initial consultation appointment. I do a thorough medical history and focused exam. I learn about your goals. The information you share with me helps to determine whether an ultrasound examination is warranted: such an exam helps to uncover underlying issues that may lurk beneath the surface of those varicose and spider veins.

If such underlying issues are uncovered, patients are surprised to learn that many treatments may be covered by insurance, including Medicare. However it may take time for us to obtain coverage, which makes it so important to start the process as soon as possible. Initial consultation appointments may be scheduled for Wednesdays between 9am and 8pm.

The state-of-the-art treatments I provide are all performed at our comfortable office here at Advanced Dermatology in Lincolnshire…soon to be double its size after the remodeling! Treatments are comfortable, safe and effective. Treatments include Endovenous Laser Ablation, Clarivein® and Sclerotherapy. You can drive yourself to & from appointments and there is no downtime!
I look forward to seeing those daffodils bloom, but I’m even more excited to meet you and help your legs feel and look better than they have in years!

Fall in Love with Your Legs Again!

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Autumn is a great time to “Fall” in love with your legs again! I know, I know…awful pun…but it’s true: once it starts getting cooler outside and we transition from “shorts season” to “pants season”, it’s a perfect time to finally take care of those nagging varicose and spider veins.

There are 3 really good reasons why:

1. The Treatments: All of the treatments that I offer are comfortable, safe, effective and state of-

the-art. They are minimally-invasive, have no downtime and have minimal bruising. But, because there is some bruising and because it’s better, as a rule, to avoid sun exposure, “pants season” is a great time to check this off of your to-do list.

2. The Healing Process: All of the minimally-invasive techniques I use encourage your body to make the bothersome veins disappear over time without having to physically remove the veins. The key word is time: in order to have legs that are ready for next “shorts season”, your body can use the Fall, Winter and early Spring to heal. In addition, I recommend that patients use compression stockings after treatments in order to encourage safe and effective healing. Many patients prefer to wear them during the cooler months.

3. The Insurance Coverage: For many, but not all patients, some treatments may be coverable by insurance carriers, including Medicare. However, authorization for coverage can often take weeks to months to achieve, depending on your insurance carrier. The sooner we see you this Fall, the more likely we may be able to get the coverage you deserve during this deductible year. For most patients, the deductible year ends December 31st. It’s crucial for you to be seen for your consultation visit as soon as possible to determine your eligibility and the likelihood of coverage during this calendar/deductible year.

During the hour-long consultation visit, I have plenty of time to learn more about you…your medical history…your particular concerns. In many cases, an ultrasound exam is warranted; this painless, but highly informative test allows us to tailor a treatment plan that suits your needs and goals. I also have time to teach you a bit about vein disease  and give you as much information as you’d need to make the best, most informed decisions about your own care.

I look forward to meeting you and helping you learn more about the exciting and new procedures I offer to treat chronic superficial vein disease, including Endovenous Laser Ablation, Clarivein®, liquid & foam sclerotherapy and more!

Leg Veins

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The new year is a classic time for making resolutions. If one of your resolutions involved doing something about those varicose and spider veins that have bothered you for years, I’m here to be the “easy button”.

Unlike a few decades ago, nowadays the state-of-the- art treatments for chronic superficial vein disease are all non-surgical, minimally-invasive and maximally comfortable. There is no downtime: you can resume most normal activities immediately. Most people are also surprised to learn that many procedures may be coverable by insurance, including Medicare.

It isn’t just about aesthetics, chronic superficial vein disease commonly leads to symptoms such as legs that feel heavy, tired, and uncomfortable. At times, some patients also experience leg cramps, “restless legs” and swelling. If left untreated, the underlying factors that lead to superficial vein disease may lead to significant medical issues, including chronic leg discoloration, skin damage/ulceration, clots, and bleeding. Unfortunately, many doctors and patients fail to recognize the connection between such symptoms and chronic vein disease.

The road to legs that feel and look better begins with a consultation appointment. During this visit, we often decide to do an ultrasound to determine whether underlying issues are contributing to symptoms and signs of superficial venous disease. This painless, informative ultrasound study is typically covered by most insurers and Medicare. The results of the ultrasound will determine if your particular issues may be coverable by insurance. You should be aware that insurance coverage may take weeks or even months to achieve (no worries…we do all the “legwork”, including dealing with insurers!); that’s why  it’s important to start the process as soon as possible.

So, let me help you make 2019 the year you learned to love your legs again! Wishing you a happy and healthy new year, Dr. David Rosen, MD.


Leg Veins

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Now that spring has finally sprung, it’s time to set our sights on doing all of the fun things we love to do outdoors. Many of my patients are reluctant to head into “shorts season” because of chronic varicose and spider veins. It’s not merely for the fact that patients often feel such veins are unsightly, they often have a number of symptoms that make their legs less fun to use:

• Heaviness

• Tiredness

• Swelling

• Cramping/”Charlie horses”

• Restless Legs

• Itching

Most of my patients have never made the connection between such symptoms and chronic vein disease. In fact, patients’ other physicians are often unaware of the subtle signs and the potential impact of chronic vein disease. Providers at Advanced Dermatology often recognize such subtle cues and recommend patients to see me for a consultation. I spend an hour during my initial consultation appointments getting to know your medical history and particular concerns. I spend a great deal of time teaching about vein disease and the methods of diagnosis and treatment. Patients are excited to learn that the latest, state-of-the-art treatments I can provide are:

• Non-surgical. Minimally-invasive endovenous

techniques are safe and effective.

• Comfortable. There is no downtime. You can resume

most activities immediately after treatments. Drive yourself in, drive yourself home!

• Affordable. Diagnosis and many treatments may be covered by insurance, including Medicare. Treatment plans are tailored to an individual’s needs and overall goals.

Such exciting, effective treatments include:

• Endovenous laser ablation (EVLA)

• Clarivein®

• Ultrasound-guided Sclerotherapy

• Veinlite® guided Sclerotherapy

Don’t let another “shorts season” pass you by without exploring the newest opportunities to have legs that may feel and look better than they have in years. See you soon!

Fall in Love with Your Legs Again

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Autumn is a great time to “Fall” in love with your legs again! I know, I know… awful pun… but it’s true: once it starts getting cooler outside and we transition from “shorts season” to “pants season,” it’s a perfect time to finally take care of those nagging varicose and spider veins.

There are 3 really:

1. The Treatments: All of the treatments that I offer are comfortable, safe, effective and state-of- the-art. They are minimally-invasive, have no downtime, and have minimal bruising. But, because there is some bruising and because it’s better, as a rule, to avoid sun exposure, “pants season” is a great time to check this off of your to-do list.

2. The Healing Process: All of the minimally-invasive techniques I use encourage your body to make the bothersome veins disappear over time without having to physically remove the veins. The key word is time, in order to have legs that are ready for next “shorts season,” your body can use the Fall, Winter and early Spring to heal. In addition, I recommend that patients use compression stockings after treatments in order to encourage safe and effective healing. Many patients prefer to wear them during the cooler months.

3. The Insurance Coverage: For many, but not all patients, some treatments may be coverable by insurance carriers, including Medicare. However, authorization for coverage can often take weeks to months to achieve, depending on your insurance carrier. The sooner we see you this Fall, the more likely we may be able to get the coverage you deserve during this deductible year. For most patients, the deductible year ends December 31st. It’s crucial for you to be seen for your consultation visit as soon as possible to determine your eligibility and the likelihood of coverage during this calendar/deductible year.

During the hour-long consultation visit, I have plenty of time to learn more about you… your medical history…your particular concerns. In many cases, an ultrasound exam is warranted; this painless, but highly informative test allows us to tailor a treatment plan that suits your needs and goals. I also have time to teach you a bit about vein disease and give you as much information as you’d need to make the best, most informed decisions about your own care.

I look forward to meeting you and helping you learn more about the exciting and new procedures I offer to treat chronic superficial vein disease, including Endovenous Laser Ablation, Clarivein®, liquid & foam sclerotherapy and more!





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