Eight Secrets About Varicose Veins That Doctors Don’t Want to Discuss

Eight Secrets About Varicose Veins That Doctors Don’t Want to Discuss

The No BS Guide to Modern Varicose Vein Treatment in Pittsburgh

This “secrets” of vein treatments article is not about varicose vein creams, potions, home remedies or homeopathic medicine. We all suspect these natural do-it-yourself treatments are a waste of time and money.

By the way, they are a waste of time and money. Take it from a board certified vascular surgeon specializing in veins for over thirty years.

Instead, I promise to reveal some fascinating and disturbing secrets about the currently available, medically accepted varicose vein treatments.

I want to help you decide. After reading these hidden truths you will be better informed. You can make better decisions whether varicose vein treatments are for you.

  • No fluff.
  • No soft soaping the truth.
  • No persuasive pseudo-marketing to try to coax or sweet talk you into having a procedure or procedures that you may not need or want.

This article lets the cat out of the bag. That expression came from naval history when they used to keep the cat-of-nine-tails whip hidden out of sight in a bag. The bag protected it away from the salty air. That kept it supple and more effective.

You need the whole truth when making important and effective medical decisions.

Unfortunately, vein websites like webmd.com and mayoclinic.org only mention the positives of modern vein treatment. That won’t bear scrutiny.

That’s right.

I said it.

Medical web sites and individual vein doctor’s web sites don’t give you all the information you need to make a truly informed decision about the care of your veins.

This article discloses in all candor eight of the cons of which you must be aware when you make your written or mental list. Here are some of the pros and cons you need before making a final decision.

Facts About Varicose Vein Treatments Doctors Don’t Want to Admit

#1 Varicose vein disease is incurable.

Because varicose and spider veins are inherited, there is little that you can do except maintain a healthy weight to help keep your veins in check. Even after definitive treatments are done by qualified vein doctors, previously normal veins can enlarge. Although the treated veins should not return, new varicose veins can develop or recur.

That does not imply that your varicose veins should be neglected. If left alone, varicose veins inevitably enlarge. They often become more symptomatic when the size and pressure inside the veins increase.

Complications including phlebitis, bleeding, skin ulcers and skin changes can also occur if you neglect your abnormal veins. Some are debilitating.

#2 Vein doctors in Pittsburgh aren’t always as advertised.

Advertising in this highly competitive and rapidly emerging field proves how popular a career change into treating varicose veins has become.

Doctors are paid in this country largely by doing procedures. Time consuming cognitive interaction is reimbursed poorly.

Everyone knows specialists who do procedures are reimbursed higher than family doctors and pediatricians. On the other hand, the sacrifices and costs of vascular surgical training and education are more brutal than most people can imagine.

So here’s how it works financially.

The higher the volume of procedures done, the higher the doctor’s income.

Cue horrifying cringe-in­duc­ing scream and record scratch.

The vein field is overcrowded in Pittsburgh. It is extremely competitive. Many opportunistic doctors are flocking into treating veins for the wrong reasons.

These doctors who switch into veins have experienced burnout in their chosen fields.

The incentives for untrained doctors switching into treating veins are overwhelming such as:

  • Superior lifestyle
  • Good hours
  • No night call
  • No holidays
  • No weekends
  • Independence
  • No peer review and oversight
  • Avoiding having to going to hospitals

#3 Painless treatments?

There is no magic laser. There is no magic formula for getting rid of varicose veins. You’ll notice that most doctor’s web sites will call the procedures virtually painless.


What does that mean exactly? Some degree of discomfort involving pinches with a needle to numb your veins is necessary.

#4 Stockings are a necessary evil.

You won’t like the support stockings that are prescribed for vein treatments. They are difficult to put on and take off. They are hot. They can dig in over certain areas if you are overweight.

#5 Cost and insurance requirements are becoming very problematic.

With rising deductibles and coinsurance, for many people the cost of treatments is being shifted to you despite rising premiums.

The Happel Laser & Vein Centre is an independent practice devoted exclusively to the treatment of veins.

We are the only accredited vein center in Pittsburgh.

When you have your procedures done in our accredited vein office, there is absolutely no facility fee.

Only vein practices that have been bought by a hospital charge costly and expensive facility fees.

It costs you 3-4 times more if you go to St. Clair Hospital’s outpatient center, UPMC’s outpatient center, Magee-Women’s Hospital of UPMC Hospital Vein Center, Shadyside Hospital, any Allegheny Health Network outpatient facility, Washington Hospital or Jefferson’s cardiology office that only does varicose vein procedures on the side.

Would you rather have a bill of $2,500 or less (with us) or up to $10,000 (with these expensive overpriced hospital outpatient facilities that aren’t even accredited).

That’s because a hospital bills the physician component separately from the facility component.

Therefore, a hospital’s outpatient facility component is additional thousands of dollars that you must pay. These outpatient hospital owned facilities aren’t even vein center accredited.

That facility fee is zero when you have your procedure done in an independent vein office (like Happel Laser & Vein Center that is not owned by a hospital.)

#6 Multiple treatment sessions are often necessary depending on the extent and size of your varicose and spider veins.

Treatment is not effortless or fun. It’s not a day at the spa.

Treatment is complicated because venous disease is complicated. It is quite variable from one person to the next.

That’s why it takes an experienced vascular surgeon to get optimum results that last. There are a lot of unqualified doctors who got disenfranchised in the field in which they trained.

#7 Saphenous vein procedures aren’t enough.

Most web sites advertise that a laser or radiofrequency treatment will take care of your varicose veins in less than an hour. That is purposely misleading.

Although the saphenous veins must be ablated or closed for most people with varicose veins, that is rarely all that needs to be done to complete the treatment.

Usually injections (sclerotherapy) or phlebectomy (removal of the surface veins through mini incisions) are also necessary. Implying that the saphenous vein treatment which is done in less than an hour is the complete treatment is disingenuous at least and false advertising at most.

#8 Unnecessary vein testing and vein procedures are rampant.

I have seen it on a first-hand basis from suspicious patients who seek a second opinion from me on what they rightfully perceive overly aggressive recommendations from other vein centers in Pittsburgh.

Because of the intense competition in this overcrowded field, unscrupulous doctors are resorting to what has to be called abuse.

Vein cognoscenti are aware of the disturbing trend.

It is a nationwide problem growing in scope. There is no easy solution. Awareness of the problem is vital to your best interests.


The purpose of this blog article is to let the cat out of the bag.

As far as I know, this type of list has never been published.

I hope this “inside” information has been helpful.

On Wall Street, people go to jail if they are caught using it. In contrast, this information will really benefit you.

The final question becomes – varicose veins, should they stay or should they go?

This is the takeaway.

As a vascular surgeon in Pittsburgh who specializes in veins, it is my honest opinion and strong belief that modern minimally invasive treatments are the way to go despite these eight undesirable facts.

Full disclosure. I treat veins for a living. As a physician, my job is to educate as well as to treat. Responsible and benevolent non-entrepreneurial doctors must present both sides of the equation.

Weigh the pros as well as the cons.

Here they are summarized:

  1. Venous disease is progressive. Varicose veins will only get worse over time. Neglect them at your own risk.
  2. Complications from neglected veins are not uncommon.
  3. New varicose veins will probably develop over time despite treatment.
  4. Insurance companies are pushing back on paying for varicose vein treatments. Weigh your options carefully. In the future, you will pay more for the treatment you could have received today.
  5. Seek advice only from a qualified vein specialist – preferably a board certified vascular surgeon. Most of the surgeons who specialize in veins in Pittsburgh are really just general surgeons. You know, the kind who were trained to take out gall bladders and fix hernias. They may say they have “an interest” in vascular surgery. Ask what their true specialty really is before they touch you. It really does matter what kind of medical training your vein doctor has. Your treatment experience and outcome will reflect that.
  6. Prepare and ask questions. Only then will you be ready to make an informed decision.

Good luck!

Call the Happel Laser & Vein Centre today at 724-969-0600 to learn more.

About The Author

Dr. John Happel

Dr. John Happel has been in practice as a surgeon since 1986 in the Pittsburgh region. He specializes in vascular surgery and has subspecialized in the treatment of varicose and spider veins since 1999. Dr. Happel is board certified in vascular surgery and recertified in vascular surgery in 2012. He was chosen in 1985 to fulfill the position for the vascular surgical fellowship at the world renowned Mayo Clinic.