News & Articles

Skin Rash of the Ankle

inner ankle reddened scaly rashSkin changes of the lower leg may be the first sign of vein disease. These vein disorders originate from the superficial or from the deep vein system and are called venous insufficiency or venous reflux.  While lower leg and ankle skin rash may be caused by other conditions, such as arterial disease, superficial venous disease is the common culprit.

An ankle rash related to venous disease occurs when superficial veins become dilated due to vein valve damage from a higher source in the vein.  This allows backward blood flow, pooling and eventually local inflammation.  The inflammation which is due to the chronic venous insufficiency often leads to a skin rash which causes intense itching and redness.  A skin rash caused by vein disorders is called venous stasis dermatitis and is often overlooked.  It affects the lower legs usually starting with small patches of tiny red bumps that cluster into a diffuse red rash covering the ankles and lower legs.  The rash is usually quite itchy, red and misdiagnosed as a skin infection called cellulitis.

Following a rash, the chronic venous insufficiency causes the surrounding skin area to become dark.  This is called hyperpigmentation and it is due to prolonged inflammation which damages tiny blood vessels and capillaries.  Initially fluid and then red blood cells are able to leak from the damaged vessels and eventually causes swelling and skin discoloration.  The red blood cells contain hemoglobin which carries oxygen to the skin.  Hemoglobin is an iron-based pigment and as it leaks into the subcutaneous tissue and  skin, the brown, iron-base substance is deposited in the skin.  This deposit causes the area, once a small rash, to now appear brown or rust-colored starting at the ankle and progressing up the lower leg.

An untreated venous stasis ankle rash will usually advance and the underlying inflammation process undergoes scarring and fibrosis, damaging the subcutaneous tissue.  This causes the tissue and skin below the calf to shrink and harden. The dark-red or brown plaque-like skin thickening is called lipodermatosclerosis and can be painful.   The patient may notice the decreasing size in diameter of the affected leg or legs.

Skin rashes and skin changes which are actually caused by venous insufficiency are often misdiagnosed as a dermatological problem.  Patients often self-treat or seek dermatological care which delays venous treatment and may allow the condition to progress over time.  Left untreated a patient with venous stasis dermatitis or skin rash may be at risk for skin breakdown and stasis ulcerations.

If you have questions regarding ankle or lower leg skin concerns, call Minnesota Vein Center (651-765-8346) for consultation.

Free Vein Screening: October 2017

Hiker announcing August 7 and 8th free vein screening North Oaks, St. Paul Minnesota Vein Center

October 23 and 24, Monday & Tuesday, 9-5  at Minnesota Vein Center.   651-765-8346

You are invited  to join us for our Fall Screening Event.  As expected, we’re enjoying the beautiful fall we all anticipated; it is only now that we are donning our sweaters.  Soon, the leaves will be gone!  Here, in the office, we are informing folks that now is the time to plan for treatment.  Proper fall planning will optimize the use of health care accounts,  insurance benefits but will also ensure that you are prepared for 2018 Spring/Summer season.

Join us for our final 2017 Free Vein Screening Event which includes a  brief history, a modified ultrasound evaluation and the provision of vein health information.  If you have aching, heaviness, leg fatigue or restless legs, ankle swelling or bulging veins, call 651-765-8346 or schedule now below for a 20 minute Complimentary Vein Screening.  Plan for the years end!  Remember, venous disorders are most often a hereditary issue:  Please share our message and this invitation with your family and friends.


This event has ended. Thank you to everyone who made this screening a success. Check back often for more vein screening opportunities.  Follow updates through our newsletter.


Minnesota Vein Center Offers Scholarship Award

Minnesota Vein Center Scholarship Minneapolis grads throwing caps in airMinnesota Vein Center, a trusted medical leader in venous health, understands the importance of healthy lifestyle and healthy living across the lifespan.   Dedicated to overall health, we understand the importance of incorporating wellness beliefs and behaviors in young adulthood, especially in the college years.

Affording college, though, can be a challenge.  With the increasing cost of tuition, books, housing, food, etc. students need all assistance available.  Sometimes balancing financial needs and maintaining healthy living and lifestyle goals becomes difficult for students.  For this reason, we are pleased to offer the “Healthy Living Scholarship Award” fund.

Minnesota Vein Center is offering this scholarship to students in the United States who write an essay related to healthy living and lifestyle choices.   Minnesota Vein Center believes it is never too early to begin healthy living, healthy lifestyle attitudes and a preventive healthcare mindset.


Can Running Cause Varicose Veins?

st paul minnesota male running at sunset near minnesota vein center

Compared to many states, Minnesotans are a pretty active bunch.  After all, Minnesota is ranked #6 and #7 out of 50 for the best U.S. cities for biking and running,  respectively, in these sports activities.  We love the opportunity to exercise,  especially when it means enjoying the natural beauty of sites near the Mississippi River Road or the Minnehaha Parkway.  Running in particular is the exercise of choice for thousands of Minnesotans.  But, do those runners with varicose veins have to shy away from running?

What is the Cause of Varicose Veins?  Watch this info video.

There is a misconception about running and varicose veins.  Some athletes are worried that running may actually cause varicose veins to develop, but this is not true.  Actually, running can help prevent varicose veins by building the calf pump muscle which improves circulation and blood return..

If bulging veins are beginning to form, though, varicose veins might keep you from running.  The common symptoms of varicose veins include swelling heaviness and leg fatigue.  These can make running less than enjoyable or even cause pain.  If you wish to continue running at the onset of varicose veins, you should consider the following:

  • Running is a high-impact sport that may aggravate swelling, so reduce the impact by avoiding hard pavement. You might instead, choose softer, more shock-absorbent surfaces to run on like dirt, grass or a thick surfaced athletic track.
  • Wearing compression stockings while you run.  This may not be your most favored option, but the pressure helps increase blood flow, blood return and prevents fatigue.
  • Monitor your vein health, and stop running if bulging veins become acute  or significantly worsen, becoming more painful.  If your varicose veins are now at this stage, it is best not to run.  Until treatment, in this case, continue exercise through walking, swimming, or engaging in any other low-impact physical activity.

To return to your regular running or other high impact activity and lifestyle, it’s important to seek treatment for your varicose veins.  At Minnesota Vein Center, Dr. Pal offers five non-invasive or non-surgical varicose vein treatments.

If you would like to learn more about the procedures and treatments by Minnesota Vein Center Specialist, Dr. Pal, contact us at 651-765-8346.

Is it safe to remove veins?

Dr. Pal discussing it is safe to remove veins with the staff in St Paul , Blaine and Minneapolis

Have you talked with relatives or searched the internet for safe vein treatment for your spider or varicose veins?  Do you now have even more questions?  Do you feel you need treatment but the thought of having a vein removed is causing you added concern?  You are not alone.  A common patient question here at Minnesota Vein Center is whether the veins being treated are safe to remove.  Patients worry that removing a varicose or spider veins will cause problems with their health or that they may cause an issue later in life.  We are pleased to let you know, this is not the case.

Will I need these veins?

If you do have varicose or spider veins these are veins which are not functioning properly and they are affecting your circulation.  These damaged veins act as reservoirs, holding blood instead of moving it for proper circulation. The answer is no, since they don’t perform properly they are not needed.  Instead these veins pose a risk to your health.

How can circulation improve if you remove veins?

Unhealthy veins allow blood to flow in the wrong direction and then nearby veins have an increase in work load.  The surrounding veins now work to move blood effectively back towards the heart.  When the unhealthy or damaged veins are removed the surrounding veins are relieved of the additional burden.

What if I need my veins for open heart surgery in the future?

In cardiovascular surgery today, when grafts might be needed for coronary bypass surgery,  Dr Pal explains, “the Internal mammary arteries are the most common bypass grafts.”  These arteries have the best long-term results.  While healthy saphenous leg veins are still used as grafts, an unhealthy, thin varicose saphenous vein would not be harvested for use in cardiac bypass surgery.

What are the benefits to having veins removed?

There are many benefits to having your varicose or spider veins removed.  By eliminating improper functioning veins the pressure on your venous system will decrease, returning to normal.  Treatment also alleviates the symptoms related to unhealthy veins.  These may include:

  • Itchy legs
  • Rash, skin discoloration and scarring
  • Ankle swelling
  • Achiness, heaviness and leg fatigue
  • Throbbing or leg cramping

If you have concerns or would like more information, call 651-765-8346, schedule a consultation here or sign-up for upcoming free vein screening events.

Health & Fitness Expo | TC in Motion, 2017

Medtronic TC Marathon 2017 Logo October 1, 2017 Minnesota Vein Center Presentation

Medtronic Twin Cities Marathon, held Sunday, October 1, 2017.  Minnesota Vein Center will be present at Twin Cities in Motion events connected to the Marathon including the Health & Fitness Expo and Finish Line festivities.

“Contributing as a strong member of our community continues to be very important to our practice.  The Medtronic Twin Cities Marathon provides us, in 2017,  an opportunity to participate in one of the most important yearly athletic events,  as well as provide valuable information to participants about leg health, varicose veins, venous disease but also prevention and treatment.  We are honored to be included in such an important event, “said Primepares Pal, MD., Minnesota’s Vein Centers’ Medical Director.

Minnesota Vein Center will be at the Health & Fitness Expo (Booth 256/258) on September 29th and 30th at St. Paul’s RiverCentre.  Staff from Minnesota Vein Center will distribute information about the practice as well as demonstrate digital office and procedural videos about venous disease and treatments We will also conduct  two special (Garmin Watch) giveaways for attendees and we will offer on- site Free Vein Ultrasound Screenings during the Health and Fitness Expo.

Staff from Minnesota Vein Center will also be present at the 2016 Medtronic Twin Cities Marathon Finish Line.

Sudden Bleeding from Varicose Veins

Surface bulging varicose veins susceptible to sudden bleeding. Minnesota Vein Center, St. Paul treatment methods.

As vein problems first develop, people are somewhat concerned of their appearance or their vague symptoms such as end-of-the-day leg achiness.  However, no one likes the bulging or obvious leg veins or the webbed discoloration of spider veins.   For the most part, concerns end here until varicose vein problems progress.  As blood back flow and pooling increases, veins can become engorged and become exaggerated and distended surface veins.  While such veins don’t immediately affect overall health, one potential problem we see in our clinic is patients who have sudden bleeding from a surface varicose or spider vein.  This can be quite alarming.

The untreated varicose veins have a higher than usual risk of a spontaneous rupture and bleeding.  Varicose veins, over time, grow larger, and as the vein wall stretches out, they weaken.  These weakened veins are also under high pressure due to back flow (or reflux which is the underlying problem).  The result of this high pressure condition can be a spontaneous burst and heavy bleeding.  Patients often worry they have ruptured an artery because of the forceful pulsating-like high blood flow from the vein.

We often hear of these incidents when a new patient contacts our office the day after a bleeding incident.  A patient will describe that a sudden bleed occurred during a warm shower.   The dilation or relaxation of the vein with warm water allows more blood to pool in the veins.  Patients also report bleeding incidents at night while sleeping.  They are awakened when they feel sudden, warm moisture around an ankle.  Those patients on blood thinners can lose a significant amount of blood, especially if it occurs during sleep.

In a state of near panic, patients or family members often call emergency services that transport the individual to the emergency room.  Bleeding has usually subsided with elevation and external pressure during transport.  We commonly see these patients the day following their emergency room visit.  With duplex venous ultrasound we are able to locate the refluxing or incompetent saphenous vein leading to the problem or surface varicose or spider vein.  We then provide our patients individualized  treatment plans and recommendations.

Patients with sudden varicose vein bleeding, usually require scheduling of procedures such as a thermal vein ablation with or without microphlebectomy to treat the problem. Patient instructions on managing bleeding, were it to recur before an upcoming vein treatment, are emphasized.  Placing a wrap, applying pressure and elevating the leg will, most often, stop the sudden bleeding.

If you or someone you know has experienced bleeding from a superficial varicose vein, it is important to see a vein specialist.  Prevention is key; through  appropriate diagnosis and treatment, sudden bleeding from a bulging varicose or spider vein can be avoided.  This is a familiar occurrence with varicose veins and is one we commonly manage at Minnesota Vein Center.


Free Vein Screening: August 2017

Hiker announcing August 7 and 8th free vein screening North Oaks, St. Paul Minnesota Vein Center

We’re in the midst of another beautiful Minnesota summer, but the best weather, in our opinion, is yet to come. When the humidity clears, the leaves start to turn, and the sun isn’t as strong, being outdoors in Minnesota is idyllic. Before those days come, stop in for a visit to get your varicose and venous disease questions answered and get on the path to less pain, swelling, and throbbing in your legs.

You’re invited to our August Free Vein Screening Event.

Request an appointment from 9 a.m. to 5:00 p.m. on Monday, August 7 or Tuesday, August 8 at Minnesota Vein Center. Remember, varicose and venous disease are hereditary conditions; left untreated they may result in more serious problems. Please share this Free Vein Screening Event with your friends and family who may also seek relief.

Free vein screenings include a history, exam, and ultrasound. Screenings are approximately 20 minutes. To request your free vein screening appointment, please complete the form below or call us at 651-765-8346. We look forward to seeing you in August!


This event has ended. Thank you to everyone who made this screening a success. Check back often for more vein screening opportunities.


6 Tips for Choosing a Vein Specialist

If you are searching for the right physician and facility to have vein treatment or wondering what to consider when choosing a vein specialist, you may have several questions to answer.  You will want a highly qualified doctor and a specialty vein clinic and staff to perform all of your vein procedures. In your search, you will discover that veins are treated by dermatologist, internists, interventional radiologist, surgeons and others specialists. How do you find the best doctor – the right fit for you?   Here are important factors to consider.

Find a vein specialist who:

  • Is a board certified physician but who also specializes in varicose vein and spider vein treatment
  • Has experience treating patients with your specific condition and all leg vein conditions
  • Accepts your insurance. The physician is credentialed through major insurance companies
  • You feel comfortable talking with and one who listens and answers your questions
  • Has a vein practice and the clinic  is solely dedicated to vein care.  The physician is also credentialed by a local hospital
  • Provides a comprehensive evaluation and treatment plan and is also able to treat the more complicated vein conditions. 


Six Tips for Choosing a Vein Specialist:

1. Review Recommendations:

You may start by creating a potential list of specialists.   Friends, family and co-workers may be an excellent source of information when it comes to recommendations because they often have first- hand experience with someone in whom they have developed trust.  Sites that show patient satisfaction ratings, which may give you insight into their experience can be helpful. Your private physician or nurse practitioner may rely on their own referral system but often they will share with you reports of their patient experiences. 

2. Confirm Credentials and Experience

Take time to research the doctor’s credentials and their experience.  Look for a physician who is board certified in internal medicine, dermatology, vascular medicine or surgery and is also certified as a Phlebologist (Venous and Lymphatic Medicine Physician.) You will want to know the doctor treats varicose veins and spider veins on a regular basis.  How long have they been treating veins and how many procedures do they perform each month.   Does the physician have special credentials in ultrasound (RPVI, RVT or RPhS) and is he/she recognized by the American Board of Venous and Lymphatic Medicine.

Confirm the physician is in good standing with state and federal agencies and that the physician has no history of malpractice claims or disciplinary actions.  A hospital affiliation means a higher level of physician credentialing.

3. Evaluate the Clinic/Center:

Do you feel comfortable with the clinic’s physical layout and is it clean and comfortable.  Does the center have a stable and dedicated staff that is very familiar with venous disease?  Do you speak with the same staff each visit?  Does the staff have a dedicated registered vascular ultrasonographer (RVT) full-time employee who specializes in venous ultrasound and diseases?  Is the clinic accredited by the Intersocietal Accreditation Center (IAC) which ensures best practices in venous diagnostics and care?  Does the clinic have additional staff such as nurse practitioner, specializing in venous disease (RPhS), who can thoroughly answer questions, guide your care and help you with pre- and post- procedure issues or questions?

4. Look for Current Technology:

Lower extremity vein conditions or disorders do require a specialist.  The venous anatomy of the legs, pelvis and abdomen has variations that require an experienced hand and eye.   Ultrasound equipment is ever- advancing, this improves the diagnosis of venous conditions.  Treatment modalities also improve over time.  A high quality vein center should offer many alternative techniques and technologies to manage venous conditions and complicated cases including incompetent perforator veins.

Ablation treatment options should include thermal (laser and radio frequency) and non-thermal (Clarivein and VenaSeal.)  To treat tributary varicosities, the specialist should be highly skilled at phlebectomy and also ultrasound- guided (chemical) sclerotherapy.  Superficial (spider vein) sclerotherapy and non invasive Veinwave or VeinGogh technology should be available.  As a patient consumer, you should feel free to ask the staff about the diagnostic and treatment options offered by their facility.

5. Interview the Vein Specialist:

During your first visit, take the time to go over the questions you have listed and take note of how comfortable you feel talking with the physician.  Does he/she seem to respect your opinion and answer your questions in a way you can comprehend?

You might ask these questions:

  • Do you often see or treat patients like me?
  • How many treatments, like the one I need, do you do in a month/ in a year?
  • What is the usual outcome with a procedure for someone like me?
  • Have you ever had a procedure you could not complete? (This answer should be ‘no’.)

6. Explore Insurance Benefits:

Learning from your insurance provider or the clinic about your insurance coverage is a practical matter.  Vein procedures/surgeries are typically covered under insurance.  The type of coverage, of course, depends upon the plan you have selected from your employer.  Often times a vein treatment facility may state that your insurance policy does not cover your procedure.  Such facilities or physicians may not possess credentialing through one or more insurance companies (often for complicated reasons.)   Be certain to clarify with an alternative clinic or your insurance provider if this occurs.

Make the Wise Choice

We are very fortunate today in that treatment of vein disorders are minimally invasive and they are easily performed in the office setting.  Patients do walk out following their treatments and they do return to their normal activity very soon thereafter.   The best outcomes occur when you chose your vein specialist wisely.

Not all vein care is equal.  Take advantage of our tips for choosing a varicose vein specialist as you begin your search.  A little homework can mean dramatically better treatment options and treatment outcomes.   At Minnesota Vein Center you’ll find that high quality setting and vein specialist  you seek. Contact us and we can assist in your search.


May 2017, Free Vein Screening Event

Minneapolis May Free Vein Screening 2017

You’re invited to a May Free Vein Screening Event. Request an appointment from 9 a.m. to 5:00 p.m. on May 1-4 and May 8-11 at Minnesota Vein Center.

Varicose and venous disease are hereditary conditions; left untreated they may result in more serious problems. Please share this event with your friends and family.

Free vein screenings include a history, exam, and ultrasound. Screenings are approximately 20 minutes. To request your free vein screening appointment, please complete the form below or call us at 651-765-8346. We look forward to seeing you in May!


This event has ended. Thank you to everyone who made this screening a success. Check back often for more vein screening opportunities.