May 7, 2012 -- Brett Peaks, a former college baseball player and lawyer, began to notice that his legs were "tired and achy" after he would exercise. And he was only 28.
"Then I started to notice the veins in both legs got progressively worse," said Peaks, now 35, who now runs a dental office in Nashville with his wife Anne. "They were very noticeable."
He was surprised to learn that even though he was young and male, he had varicose veins, a condition that had afflicted his grandmother.
With summer around the corner-- the season for shorts and short skirts -- Peak's story busts a lot of myths about varicose veins: They don't just affect women; they can trigger medical problems, not just embarrassment; and treatment, unlike the past, is painless and relatively easy.
More than 40 million Americans suffer from varicose veins and, surprisingly, 25 percent of them are men. As in Peaks' case, the condition tends to run in families.
These swollen, twisted veins appear just under the surface of the skin. Usually they occur on the legs but can also form in other parts of the body.
As unsightly as they are, varicose veins are not just a cosmetic problem. Not only are they painful and can impede a person's ability to walk or run, but they can also cause more medical issues.
According to the National Institutes of Health, varicose veins can lead to skin ulcers and even blood clots, if left untreated.
Veins are blood vessels that carry blood from the body's tissues to the heart, up from the legs. But in varicose veins, the valve malfunctions and blood tends to flow backward, swelling the vein and pooling in the leg.
Peaks didn't seek treatment right away. Doctors say men are more reluctant to seek medical help in general, especially if they think it will take time away from work and recreational activities.
But eventually, fed up with the pain, Peaks sought out a new treatment: a jacket-tipped laser fiber that seals the varicose vein from the inside, preventing the backward flow of blood. And the procedure comes with no bruising, no pain.
Cunningham uses ultrasound to see the vein and guide the procedure in his Brentwood, Tenn., clinic. Peaks was numbed with a local anesthetic and a tube was fed into the vein like an IV.
Then a small fiber optic laser was inserted and numbing fluid was put around the vein. The fluid helps absorb the heat of the laser as it closes the vein and compresses it to get a good seal.
Varicose veins are like tree trunks, according to Cunningham. After treating the "trunks," he uses an image-guided procedure on the "branches," injecting a foam liquid and air to form soap-like bubbles to chemically seal the veins.
A simple shield at the end of the laser fiber keeps the laser off the vein walls so the vein cannot be accidentally poked or burned.
Cunningham said the new procedure has a 98 percent success rate.
Varicose Veins Cause Aching, Burning
"What causes varicose veins are bad valves," he said. "You should have a one-way vein going out of the leg. But when these valves fail, they don't close properly, and the blood goes back down the leg."
The backward flow of blood allows pressure and inflammation to develop in the leg and patients feel an aching, itching or burning sensation.
Varicose veins can also cause restless leg syndrome, but after treatment, "75 percent of the symptoms go away and you can sleep," he said.
In a worst-case scenario, untreated varicose veins can cause deep vein thrombosis, which can be life-threatening.
"The veins can get so big that they put so much pressure on the surface of the skin that it breaks down and you get venous ulceration," he said. "The skin can't heal properly and a surface accident can cut them and they can bleed profusely. Some are so bad you need blood transfusions."
Many patients avoid treatment because they know family members who underwent old-fashioned stripping methods.
"You would go under general anesthesia and a surgeon would make a cut in the leg and take a metal rod with an acorn on the tip and insert it and pull out the other end, ripping the vein out of the leg," he said.
Cunningham, who has been using VenaCure 1470 since December, said it has been a "game-changer for me and my patients."
"I can use less energy to target the water in the vein to feel it close," he said. "Less energy means less inflammation in the vein wall, less pain and less bruising."
This was especially important to Brett, who wanted to return to running and his golf game.
"I really didn't have a lot of pain or anything and a pretty good recovery," said Peaks. "I was back at work an hour later and walking around."
"I'm feeling good today," he said, only a week after the outpatient procedure, which was covered by insurance. "And every day gets better."