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woman holding ankle showing spider veins in calf

How to Recognize and Treat Early Onset Vein Disease in Illinois

Corona phlebectatica is much more common than most think. According to Johns Hopkins Medicine, venous disease affects approximately 15% of the United States population. Fortunately, treating vein disease has never been easier. When you choose Gilvydis Vein Clinic, you’re choosing passionate vein specialists who care about your health, comfort, and well-being. 

Let’s take a look at how you can detect early-onset vein disease and how Gilvydis Vein Clinic can help get you back on your feet.

Schedule a Free Vein Screening

Types of Vein Disease

Vein disease is a type of medical condition that causes a person’s veins to improperly return blood to the heart. This disease can stem from numerous types of serious venous issues, like:

  • Varicose veins
  • Spider veins
  • Pulmonary embolism
  • Deep vein thrombosis
  • Chronic venous insufficiency

Stages of Vein Disease & Corona Phlebectatica

No two individuals will experience the progression of vein disease the same. However, there are seven stages of vein disease that can typically be predicted among patients as a whole. If you believe you are in the beginning stages of vein disease, schedule a free screening at Gilvydis Vein Clinic. 

Stage 1

The first stage of vein disease is most likely invisible to you—however, you may be experiencing painful leg aches and cramps despite not being able to see any visible varicose veins. Your legs may also throb, itch, burn, swell, and feel heavy or restless. 

Stage 2

Have you been noticing blue, purple, or red veins branching out on your legs? These web-like spider veins appear on the surface of your legs and can cause painful itching, aching, or burning sensations.

Stage 3

Enlarged varicose veins are often dark blue or purple. These swollen veins will become much more prominent to the eye as they swell and bulge at the surface of your skin. These painful veins can feel heavy and may bleed or form ulcers.

Stage 4

If you have swelling in your legs and ankles, you may be experiencing edema. This is caused by the blood of leaky valves pooling underneath the surface of your skin. Swelling can become more severe the longer you are on your feet.

Stage 5

Do you have abnormally visible blood vessels around your ankles? You may have corona phlebectatica. Corona phlebectatica is a complex medical term used to describe signs of chronic venous insufficiency. Common symptoms include painful itching, swelling, and burning sensations.

Stage 6

Skin changes are a sign of a damaged vein. When a vein is damaged, it can cause fluid and blood to build up under the surface of your skin. These progressive skin changes can lead to leg ulcers. Symptoms include skin color changes and painful hardening of the skin.

Stage 7

Leg ulcers typically form in the final stages of vein disease. Watch out for wounds on your legs. These wounds are caused by abnormal or damaged veins, which can lead to venous hypertension and a breakdown of your tissue. 

Schedule a Free Vein Screening

What Causes Corona Phlebectatica?

Corona phlebectatica is a sign of chronic venous insufficiency. People with chronic venous insufficiency often experience the presence of fanned-out discolored veins around the ankle area.

Those with chronic venous insufficiency have damaged veins that prevent blood from flowing backward. This causes blood to swell and pool within the leg veins. The most common cause of chronic venous insufficiency is high blood pressure—however, factors like diabetes, age, obesity, and family history can play a big part in your diagnosis.

What Are the Dangers of Vein Disease?

 Even though vein disease is common, serious complications can occur down the road. If left untreated, vein disease can cause ulcers, bleeding blot clots, and life-threatening deep vein thrombosis.

Deep vein thrombosis is a condition characterized by a blood clot deep within a leg or arm vein. This condition can be fatal if not treated immediately due to the high chance of the clot breaking off and traveling to the lungs. 

What Are the Symptoms of Vein Disease?

Symptoms of vein disease typically start within your legs and ankles.

  • Aching
  • Burning
  • Cramping
  • Heaviness
  • Itching
  • Swelling
  • Throbbing
  • Restlessness

If you’re experiencing one or more of these symptoms, especially with the presence of discolored veins, then you may be suffering from the early stages of vein disease. Schedule a free screening with the vein experts at Gilvydis Vein Clinic to tackle your symptoms with today’s most innovative vein technology.

How Is Vein Disease Treated? 

Vein disease treatment no longer has to hurt. Instead, Gilvydis Vein Clinic has turned to non-invasive vein treatments like ultrasound vein mapping, endovenous laser ablation (EVLA), and sclerotherapy. 

Ultrasound Vein Mapping

Also called a vascular ultrasound, ultrasound vein mapping is a safe and effective non-invasive technique used to create a visual roadmap of your veins. Ultrasound vein mapping is perfect for gauging the size, depth, and flow of your blood to reach a diagnosis.

Endovenous Laser Ablation (EVLA) 

Endovenous laser ablation is an FDA-approved outpatient treatment that destroys the walls of a diseased vein through the use of laser heat. Our clients have a 97% success rate after one EVLA treatment.

Sclerotherapy

Sclerotherapy is an effective treatment for eliminating varicose and spider veins. The vein experts at Gilvydis Vein Clinic will inject a saline solution into your vein, which will cause it to collapse and force blood to run through healthy veins instead. The only discomfort you might experience after sclerotherapy is mild cramping. 

Treating your veins shouldn’t end at the vein clinic. Practice healthy home remedies like changing your diet, exercising more, and quitting smoking. Contact our vein specialists for more information about how you can create a positive impact on your veins at home.

What Are the Risk Factors of Vein Disease?

Venous insufficiency affects millions of Americans every year. Even though vein disease can be linked to family history, other risks like an unhealthy diet and tobacco use play a role in the development of vein disease.

Risk factors for vein disease include:

  • Age
  • Obesity
  • Smoking
  • Cancer
  • Lack of exercise
  • Muscle weakness
  • Various trauma

Schedule a Free Screening With a Trusted Vein Specialist

Don’t let your vein disease get out of hand. Take control of your vein health and schedule a free screening with a vein specialist at Gilvydis Vein Clinic. With leading vein technology, there’s no reason to repeat scary and painful invasive vein treatments. Get back to the life you love and contact Gilvydis Vein Clinic today.

 Schedule a Free Vein Screening

evla

Get Your Legs Spring-Ready!

Even before winter releases its icy grasp, our minds shift to spring. We begin dreaming of days at the park, lazy afternoons lounging around the pool, and evenings spent firing up the barbecue. Retailers stock their shelves with shorts, tops, sundresses, swimsuits and sandals. While most of us look forward to the warmer months, those who suffer with vein disease are often filled with a sense of dread. Bulging veins and leg ulcers make wearing the fashions of the season an embarrassing affair, leading many to swelter in long pants all spring and summer. The pain and swelling of vein disease also makes it difficult to enjoy warm weather activities, like softball, hiking, bicycling or swimming. Even a simple stroll around the neighborhood may be too painful to bear.

At Gilvydis Vein Clinic, we offer a variety of minimally-invasive treatments, like Endovenous Laser Ablation (EVLA), which uses a laser catheter to close off bad veins, which then redirects blood to healthy veins. There’s no scarring and recovery time is minimal, with many patients returning to their normal activities the same day. In addition to getting rid of ugly, gnarled veins, EVLA eliminates the pain and swelling, giving patients healthier, lighter, younger feeling legs.

During your initial consultation, we’ll talk about your vein-related symptoms, along with your medical history, including what medications you take, past or present diagnoses, any prior medical procedures you’ve had, and whether your parents had varicose veins. If we determine any tests are necessary, rest assured they will be painless and noninvasive. Wear comfortable clothes, as you may undergo an ultrasound, which uses sound waves to create an image. Don’t forget your ID and be sure to bring your insurance card, as our treatments are covered by nearly all plans. We can also help you navigate insurance so you can get the help you need. You can save time by completing your paperwork in advance or simply arrive 15 minutes early to fill it out in the comfort of our office.

With spring just around the corner – and summer waiting in the wings – why wait any longer to address your vein health issues? Contact us today to schedule a free consultation and we’ll help you get your legs spring-ready, so you can enjoy everything the warmer months have to offer.

Treating Varicose Veins from pregnancy

Treat Varicose Veins Between Pregnancies

Your risk of developing vein disease – especially varicose veins – increases if you have a family history of them or if you spend long periods of time standing or sitting.

Varicose veins affect both women and men, and a common risk factor for women is pregnancy. More than 40% of pregnant women experience varicose veins during pregnancy.

These bulging, twisted veins can cause legs to feel heavy, restless, painful, and achy, and increase the risk of developing blood clots.

Pregnancy causes a woman’s body to work harder than normal, leading to the development of varicose veins. Here’s why:

  • The body produces higher levels of progesterone, which are linked to varicose veins.
  • These increased hormone levels relax veins and promote blood to flow in the wrong direction.
  • More blood is flowing through the body, causing the veins to work harder, resulting in weakened valves that can lead to pooling of blood within the veins.
  • The pressure of an enlarged uterus on the pelvic veins can obstruct the veins from draining into lower extremities and lead to the backflow of blood.

For many women, varicose veins will be less noticeable (although still present) after pregnancy once progesterone levels return to normal. For others, vein disease will progress after pregnancy, worsening the look of and pain associated with varicose veins.

The good news? In both cases, a thorough evaluation and noninvasive treatment can help. And a consultation can be scheduled between your second and third trimesters.

During the consultation, we will assess your level of vein disease, explain the condition and answer your questions, and fit you for compression stockings (insurance requires these to be worn prior to treatment). Modern technology allows for vein disease to be treated in between pregnancies.

Our founder Dr. Rimas Gilvydis, a board-certified vascular and interventional radiologist, has spent his career treating vein disease and educating patients, individuals, and the medical community that vein disease – including varicose veins – is not purely cosmetic and that painful vein stripping (which your mother or grandmother might have experienced) is a thing of the past.

The Gilvydis Vein Clinic team has performed more than 24,000 successful laser vein treatments, delivering innovative treatment with minimal downtime and discomfort. We are known for excellence in vein care and for always providing the highest-quality, individualized care with the best possible outcomes for our patients.

If your varicose veins appeared during or after pregnancy, call us at 815-981-4742 to schedule a consultation or contact us right here on our website. Don’t let the debilitating pain often associated with vein disease take time away from your pregnancy or time with your children.

family history and risks for varicose veins

Family history increases risk for developing varicose veins

It’s important to know our family history for various medical issues, from cancer to vein disease.

A visit to the doctor’s office is a frequent reminder of this need-to-know information every time we have to fill out a form or confirm details with a nurse during a checkup.

Another question to ask your immediate and/or extended family members is for their history with vein disease, be that varicose veins, spider veins, or deep vein thrombosis (DVT). It’s common to assume these issues are just cosmetic, but vein disease is serious and will worsen over time if left untreated.

Study links varicose veins, DVT

How serious are varicose veins? A 2018 study in the Journal of the American Medical Association (JAMA) found that among adults with the condition, there is a significantly increased risk of developing DVT, when a blood clot (thrombus) forms in one or more of the deep veins in your body, usually in your legs.

A blood clot is a life-threatening complication, so treating varicose veins before they get worse is critical. There are real health risks associated with vein disease.

Symptoms can be debilitating

The look of varicose or spider veins can be annoying and embarrassing. They can appear as red and blue spidery lines on our legs or bulging, twisted veins that make us choose long pants over shorts or a bathing suit every time (or be grateful for added layers during the winter months).

But clothing doesn’t cover up the symptoms of vein disease, which can feel unbearable and interfere with everyday activities like sleeping, standing, and walking. The most common symptoms of varicose veins include:

  • Aching or throbbing pain in the legs
  • Slightly swollen legs, ankles or feet
  • Itchy legs
  • Hot or burning sensation in the legs
  • Heaviness in the legs or feet
  • Restless legs
  • Skin that looks discolored or thick along the legs or feet

Talk to your doctor if you’re experiencing any of these symptoms. Or you can contact us anytime for a consultation, and we can determine what next steps are needed.

 Ask Your Parents

Nearly 55% of women will develop varicose veins, and 45% of men, too. That’s why it’s critical to understand your family history on both your mother’s and father’s sides. Vein disease affects both men and women.

The earlier vein disease is treated, the better, and women no longer need to wait until after they’re done having children. Vein disease can be treated between pregnancies, and we can do consultations for women in their second and third trimesters.

Men are less likely to seek treatment for vein disease. Men tend to wait on treatment and ignore the early symptoms, allowing the disease to advance. Men will seek treatment when they start experiencing the more debilitating symptoms of the disease. Vein disease affects individual lifestyle activities and quality of life. Today’s treatment is safe, with little or no downtime allowing men to get treatment without having to miss work.

One of your parents or grandparents may be reluctant or hesitant to talk about varicose veins because they were previously treated with painful vein-stripping procedures. Those are outdated treatments. At Gilvydis Vein Clinic, our founder Dr. Rimas Gilvydis performs minimally invasive sclerotherapy and endovenous laser ablation that produce minimal pain and offer little-to-no downtime.

Our team has performed more than 24,000 successful laser vein treatments. Don’t wait to schedule a consultation for varicose or spider veins. Act now to stop the progression of vein disease, which, if left untreated, can debilitate your quality of life and limit your active lifestyle.

Leave us a review at Gilvydis Vein Clinic

We Prioritize Your Experience

Living with the symptoms of varicose veins or other vein disease can be debilitating and disrupt your quality of life.

Taking steps to talk to your doctor about your symptoms or start researching options for care can also feel intimidating. The information can seem overwhelming and reading about a potential online diagnosis can cause anxiety.

Our founder Dr. Rimas Gilvydis and our team here at Gilvydis Vein Clinic (GVC) work to remove the stress and fear from seeking treatment for varicose veins, spider veins, and other leg vein issues.

Patients are some of our strongest advocates, regularly leaving five-star reviews and feedback on Google, Facebook, and other health care platforms. We take great pride in knowing our patients leave our clinic with a good experience and great results.

Here are some of the most common comments we hear from patients.

“I wish I would have come in sooner.”

You will hear us frequently say that vein disease is progressive if left untreated. Many people suffer in silence or live with the debilitating pain from varicose veins for years before talking to their doctor about their symptoms or coming to see us for a consultation.

That’s why we work hard to teach people about the signs and symptoms, as well as the stages of vein disease.

Another reason people delay treatment is because they think it still involves the painful vein stripping procedures that were common many years ago (maybe your mother or grandmother went through that). Today’s varicose vein and spider vein treatments are minimally invasive, and our patients experience little-to-no downtime.

Though the risks of vein disease increase as we get older, it can develop in your 20s or 30s, especially after pregnancy and/or if they run in your family. The good news is you can treat these painful, bothersome veins at any age, including between pregnancies.

“My experience was easy.”

This is feedback we’re especially proud of. It’s our goal to make vein treatment as seamless as possible, whether you start with a free screening or consultation or are referred by your doctor.

Vein disease in most cases is a medical condition, not just a cosmetic issue. Our staff will work with your insurance to secure coverage whenever possible to help reduce your out-of-pocket costs.

Patients say treatment is painless or they experience minimal or temporary pain. It’s minimally invasive and delivered in the comfortable setting of our clinic by our accredited staff.

“The team was friendly and helpful.”

Yet another point of pride! Vein disease is common, but not commonly understood. Patients tell us our staff makes them feel comfortable by explaining their condition and all the available treatment options, as well as clearly outlining the next steps for their care.

Learn more about our awesome team – including their education, training and why they love working at GVC – here.

At the end of the day, we’re happiest when patients tell us they are pain free and able to get back to everyday activities that had been disrupted by vein disease. That could be something as simple as taking the dog for a walk without leg pain or hitting the gym again to stay healthy rather than be sidelined by bulging, achy varicose veins.

Call us at 815-981-4742 to come see us at our Geneva or Sycamore clinic or request a free screening online. We look forward to delivering the same five-star experience our patients have come to expect.

Vein Doctor in Illinois

Ask Your Podiatrist about Varicose Veins

Varicose veins are a common condition, affecting up to 35% of the U.S. population by some estimates. That shared experience means people seek us out here at Gilvydis Vein Clinic in a variety of ways.

Individuals can contact us directly for a screening or consultation if they’re experiencing symptoms of vein disease. Those symptoms include burning, itchiness, and achiness in the legs, or visible/unsightly varicose and spider veins.

Many patients also are referred to us by their primary care or family practice doctors, which is why we work with many Geneva- and Sycamore-area hospitals and health systems to educate physicians about the progression of vein disease and what that looks like.

Another specialty that’s often familiar with vein disease is podiatry. A podiatrist is a physician or surgeon who treats the foot, ankle, and other parts of the leg.

Because podiatrists already observe and treat the feet and legs, they can also refer individuals to us for further consultation and treatment. That means if you talk to them about your symptoms and they understand and recognize vein disease, you can then come to us directly for an ultrasound and to determine the next steps for treatment.

Signs that vein disease may have progressed include if you have ulcers on your legs that aren’t healing or reappear. Doctors will sometimes close or repair these ulcers and then they come back, which could be a sign of venous hypertension/insufficiency. That means the valves that help blood flow through the legs aren’t functioning properly.

Progressive vein disease also could look like darker clusters of varicose or spider veins along the inside of the ankles with associated symptoms of itching or burning, or if the skin feels leathery.

Here’s what we strive to do when educating podiatrists and other physicians (as well as patients):

  • Identify the symptoms of varicose veins.
  • Recognize the progression of vein disease, which will worsen over time if left untreated.
  • Explain that minimally invasive treatment is available and effective (long-gone are the days of painful vein-stripping procedures you may have heard about from your mother or grandmother).
  • Make an appropriate referral to a board-certified vein expert like Rimas Gilvydis at Gilvydis Vein Clinic.

As a reminder, you can reach out to us anytime for more information about vein disease and to request a screening. Don’t hesitate to also ask your existing health care team – a nurse, family doctor or podiatrist – about varicose veins and be honest and open about your symptoms.

Image Credit: Getty/wutwhanfoto

Insurance can help to cover vein treatment

Eliminating Health Insurance Confusion

Varicose veins, spider veins and other conditions cause tremendous suffering for people from all walks of life. Women and men, old and young, active and sedentary – no one is immune from vein disease. Sadly, many people don’t seek relief from these issues because they don’t realize vein treatment is typically covered by insurance. Often, that’s because they falsely believe vein disease is merely cosmetic, yet nothing could be further from the truth.

Those bulging, gnarled veins are caused by venous stasis, a condition in which old, stagnant blood pools in the legs. They can be the sign of chronic venous insufficiency (CVI), a serious disorder, which can progress to cellulitis, scar tissue, ulcers, bleeding, blood clots, and even deep vein thrombosis, a potentially fatal condition.

At Gilvydis Vein Clinic, we accept insurance from most major providers and Medicare. Our effective, minimally invasive treatments such as endovenous laser ablation and ultrasound-guided sclerotherapy are covered by nearly all plans. Just because a procedure is covered, though, that doesn’t eliminate the headaches and hassles of dealing with an insurance provider.

Navigating insurance coverage can be confusing, leaving you overwhelmed and frustrated. Don’t let that keep you from getting the treatment you need for those aching, swollen legs. Our team has the knowledge and expertise to help you obtain insurance authorization and certification. We’ll work with your insurance company to eliminate any barriers that might prevent you from getting screened and charting a path to happier, healthier legs.

Isn’t it time you sought treatment for those unsightly, painful legs? Contact us to schedule a free consultation and let us help you navigate the complicated insurance landscape, so you can focus on getting back to your favorite activities. More active time, less downtime.

Healthy Legs without Varicose and Spider Veins

Treat yourself to healthy legs this holiday season

The holidays are a time of giving, spending time with family and friends, and preparing for a New Year.
Taking care of yourself and treating yourself to better leg vein health should also be on the to-do list this season.

It’s understandable that the busyness of the holidays means commitments such as health screenings and doctor appointments get put on the backburner. Here are a few reasons to keep them top of mind this month and heading into 2020.

Symptoms don’t need to persist

Common vein diseases include varicose veins, spider veins, deep vein thrombosis (DVT), a pulmonary embolism and chronic venous insufficiency.

Vein disease is progressive and if left untreated can develop into potentially life-threatening complications such as blood clots.

Let’s take a step back, though, and talk about symptoms. You might not know you have one of these conditions, but consider these symptoms:

  • Bulging veins that are excessively visible
  • Heavy feeling in the legs
  • Calf pain and cramping
  • Discolored skin
  • Fatigue
  • Aching
  • Burning
  • Throbbing
  • Itching
  • Restlessness of the legs

If you’re experiencing any of these symptoms, they could be the result of leg vein issues. A simple first step is to call us to schedule a free screening or request an appointment online.

Veins issues aren’t just cosmetic

One of the most common concerns we hear is that treatment for issues such as varicose veins won’t be covered by insurance. Our team will help you eliminate insurance barriers by assisting with insurance authorization and certification.

Treatments such as endovenous laser ablation and ultrasound-guided sclerotherapy procedures for varicose veins are covered by almost all plans. We also offer procedures for cosmetic purposes that are typically not covered, though we have third-party financing options available.

As we noted, vein disease should be taken seriously and treatment works. There’s no need to be embarrassed about the appearance of varicose veins, to cover them up, or to put up with the discomfort from pain, swelling and other symptoms.

Treat yourself to healthy legs this holiday and instill confidence, eliminate downtime and improve your overall health.

Leg vein treatment helps Batavia man rebuild strength after stroke

As a project manager working on a multimillion-dollar deal, Shawn Samii knew his health was taking a backseat.

Still, no one was as surprised as Shawn when he suffered a stroke at the age of 45.

The married father of two went from a busy travel schedule packed with high-stress meetings to being unable to talk, walk or even swallow. It was a humbling time as he learned basic life skills once again, but Shawn came out of it more determined than ever to regain his independence.

Just months after the stroke, Shawn began working with a personal trainer. He was lifting weights, building his strength and seeing results.

After a while, however, his right leg would ache at night after his workouts. He got a tattoo on his calf and it took twice as long as it should have to heal. Eventually, the pain in his leg was significant enough that he couldn’t lift weights like he used to – and that wasn’t OK with Shawn. He needed the exercise if he wanted full mobility to return.

With his leg clearly swollen, he visited a doctor who didn’t have many answers. Worse, he didn’t have a treatment. Shawn knew the doctor’s suggestion of wearing compression socks for months wouldn’t heal him quickly enough to achieve his stroke recovery goals. He needed more.

That’s when he visited Dr. Rimas Gilvydis at Gilvydis Vein Clinic and had a vastly different experience.

“Not only did they do the ultrasound that day, they explained exactly what happened and came up with a treatment plan,” he said.

What happened was that the valves in Shawn’s veins were leaking blood, and that caused his pain. The solution was a two-part procedure – one on the lower leg and one on the upper leg. Dr. Gilvydis noted that Shawn’s stroke history had no effect on the development of varicose vein disease. The condition is inherited and only affects veins in the legs.

The stroke also didn’t affect his ability to receive treatment. Shawn had endovenous laser ablation (EVLA) performed on the varicose veins in his right leg. Multiple catheters were inserted into the varicose veins, through which a laser fiber was inserted into each catheter separately, Dr. Gilvydis explained. Once the varicose vein to be treated was numbed in its entirety, energy transmitted through the laser was slowly retracted (along with the catheter), and the vein was permanently sealed (ablated).

The first procedure happened within a month of Shawn’s initial visit to the clinic, and he appreciated the aggressive timeline that would get him back to a healthy life.

“I found the right team to help me,” Shawn said. “Anything I needed, they provided. They were fantastic.”

Legs without visible spider or varicose veins.

Met your deductible? Come see us

Vein Treatment Options

If unsightly leg veins kept you from enjoying summer fun, now’s the time to take action.

Vein disease is a serious medical condition where our veins don’t properly return blood from the legs back to the heart. It’s progressive and will worsen over time if left untreated.

Fall is a great time to come see us, as we accept insurance from most major providers and Medicare. If you’ve already met your insurance deductible for the year, you will likely have lower out-of-pocket costs for the effective, minimally invasive treatments we offer. These treatments are covered by almost all plans.

Vein disease presents in several different ways, the most common diagnoses being varicose veins, spider veins, deep vein thrombosis (also known as a blood clot) and chronic venous insufficiency. Vein disease is not just a cosmetic issue, so it’s important to keep track of your symptoms and talk to your doctor.

Common symptoms include:

  • Visible bulging veins
  • Restless legs
  • Itching, burning, aching and/or throbbing
  • Fatigue
  • Heavy feeling in the legs
  • Calf pain and cramping
  • Discolored skin

You can contact us anytime for a free vein screening, but today – or any day – is a good time to prioritize your own health.

With fall on its way, our wardrobes will also shift, with more layers, jeans, sweaters and warm clothing. If varicose veins are severe enough, compression therapy (wearing compression socks or stockings) may be recommended as part of treatment. These stockings support the legs, improve circulation and prevent excess fluid from accumulating. They can easily be worn under pants or other layered clothing.

Schedule Your Appointment

Talk to your doctor about vein disease or contact us today. Vein treatment can be a life-changing solution that resolves both the appearance and physical symptoms of conditions such as varicose and spider veins, improving your quality of life.