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vein services

Varicose Veins and Chronic Venous Insufficiency


Varicose veins appear in the legs often as blue bulging or twisted lumps under the skin. The condition affects the veins that lie closest to the skin known as superficial veins. As many as 20 million Americans are affected by the condition. Heredity is a common factor. Age, pregnancy, obesity and lifestyles that require prolonged standing also increases the likelihood of varicose veins.

Healthy veins have valves that keep blood flowing to the heart. Sometimes these valves stop working properly. This allows blood to flow backwards and pool in the lower leg veins. Left untreated, these symptoms can worsen over time. This condition is known as chronic venous insufficiency.

Signs of Chronic Venous Insufficiency:

  • Presence of Varicose veins
  • Aching
  • Leg swelling
  • Leg cramping
  • Heaviness or tiredness
  • Itching
  • Restlessness in the legs
  • Open skin sores on the legs

Chronic venous insufficiency is a medical condition covered by most insurance plans, including Medicare. Seeking treatment for veins is not simply for cosmetic reasons. Left untreated, other symptoms may arise such as skin rashes, ulceration, blood clots or bleeding.

To see if your veins are functioning properly, a painless ultrasound scan is preformed in office by a registered technician. A map of your veins in made and discussed in detail with you. If unhealthy vein reflux or enlargement is found, an appropriate treatment plan is made. If 6-8 weeks conservative therapy fails to bring relief, most all insurances will approve more advanced, minimally invasive vein treatments.

Dr. James Tidwell has been specially fellowship trained and is board certified by the American Board of Venous and Lymphatic Medicine. There are various, minimally invasive techniques he may recommend for you based on your medical needs.


(Click each treatment method below to read more)


Endovenous laser ablation is a minimally invasive method for treating large varicose veins. In this method a small laser catheter is inserted in the damaged veins. The laser causes the vein to close on itself allow for blood to flow to healthier veins deeper in the leg. This method has replaced painful venous stripping that left large scars and eliminates the need for costly hospitalizations, general anesthesia, and incisions.


Endovenous chemical ablation is helpful for medium sized veins. Using the map of your veins made during the consultation, a small needle is used to gain access to the damaged vein under ultrasound guidance. Topical numbing maybe applied to the leg so you do not feel with needle is desired. Once the vein is accessed, a detergent is used to cause the vein to close. Blood is then diverted to health veins other areas in the leg improving circulation.


Sclerotherapy is used for smaller more superficial veins (spider veins). No ultrasound devices are needed as these veins can be easily seen and accessed. In this process, a chemical detergent is injected into veins closing them. Aftercare is simple requiring compression socks and light walking. Although after performed in cosmetic dermatology, this treatment is sometimes covered in insurance plans as a part of a larger vein treatment program is extensive damage is found in your veins.

schedule a consultation

If you are suffering from varicose veins or are experiencing symptoms of chronic venous insufficiency, contact us to schedule a consultation with Dr. Tidwell.

What Our Patients Say

Wonderful team! I had basal cell carcinoma removed from the bridge of my nose and, as you can imagine, was concerned about all the cancer being removed but also about it being right in the center of my face. Dr. James Tidwell did an excellent job! He was able to remove all the basal cell and did minimal scarring to my nose. It’s been two weeks today and I can easily say that by the time it completely heals the scar will barely be noticeable. Amazing. Thank you Dr. Halden Ford and Dr. James Tidwell, for a job well done. Dr. Tidwell, thank you for your kindness and understanding. I would recommend you to anyone.

Lynda P.

"My boyfriend was treated for a skin cancer.  We knew exactly what to expect on the day of the procedure.  What we didn't know was how courteous and caring the staff would be.  We were impressed with Dr. Tidwell as well.  He was compassionate, personable, knowledgeable, and completely put my boyfriend at ease during the procedure."

Susie C.

"Dr. Tidwell was great and very efficient . He took his time and explained what was going to take place. I would highly recommend his services.  His assistants were very caring also."

Connie M.

"Dr. Tidwell and staff are fantastic!  Informative, quick, easy, painless appointments for a small skin cancer.  Paducah should be proud to have a great dermatologist like Dr. Tidwell.  I trust him so much that I sent my daughter to see him. "

A. Guhy

"Through removal of a cancerous lesion and a skin graft on my 91 year old mother,  Dr. Tidwell was impressive.  He and his staff were caring, compassionate, and considerate on the day of the surgery as well as all of the follow-up visits."

Cindy P.

"When Dr. William James Tidwell walked into the examining room, it was obvious within just a couple of minutes that he was truly interested in my concerns and eager to do the best job possible to take care of me. He was professional and personable and put me very much at ease as a patient.  At age 62 and an avid fan of the outdoors, I have had more than a handful of experiences with dermatologists and plastic surgeons over the years. I will definitely go back to Paducah Dermatology for checkups or any other skin care needs -- which by the way, I learned that Dr. Tidwell also does some 'age-reversing' procedures!"


Steve M.

make an appointment today

Call today to have your skin care questions answered and make a convenient appointment for you and your family.



3101 Parisa Drive
Paducah, KY 42003
(270) 444-8477

Office Hours
Monday – Friday
8:00 a.m. – 4:30 p.m.




619 Old Symsonia Road
Benton, KY 42025
(270) 444-8477

Office Hours
Monday Only
8:00 a.m. – 4:30 p.m.



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