Sclerotherapy

About
Sclerotherapy

Veins become enlarged when they are congested with blood. These enlarged veins are commonly called spider veins or varicose veins. Spider veins are small red, blue or purple veins on the surface of the skin. Varicose veins are larger distended veins that are located somewhat deeper than spider veins.

Abnormal leg veins can cause considerable pain. Symptoms include feelings of fatigue, heaviness, aching, burning, throbbing, itching, cramping, and restlessness of the legs. They are often made worse by prolonged standing. Leg swelling can occur. Severe varicose veins can compromise the nutrition of the skin and lead to eczema, inflammation or even ulceration of the lower leg.

Sclerotherapy can be used to treat spider veins. A tiny needle is used to inject the veins with a medication that irritates the lining of the vein. In response, the veins collapse and are reabsorbed. The surface veins are no longer visible. Sclerotherapy relieves symptoms due to varicose and spider veins in most patients. With this procedure, veins can be dealt with at an early stage, helping to prevent further complications.

You may need anywhere from one to several Sclerotherapy sessions for any vein region. Depending on the type and number of veins being treated you may have one to many injections per session. Thanks to this treatment methods, spider and varicose veins can be treated at a high level of effectiveness and safety.

What are Spider Veins?
The highly visible, very fine, blue or red blood vessels on the thighs, legs and ankles of women and men are unsightly and a cause of concern in most people who have them. Most of the persons having them feel very self-conscious. Many woman with visible “spider veins” or “sunburst” “varicosities” even refuse to wear shorts and many haven’t worn shorts for years. Remarkably, some of these women are less than twenty-five years old.

What causes Spider Veins?
The causes for these vessels are many, and in any given person, more than one factor may be playing a role in causing “spider veins.” The major factors causing “spider veins” on the legs are:

  • Genetic
    In these cases, there is usually a strong family history, including an affected mother, sister(s), and/or daughter(s).
  • Hormonal
    There is frequently a worsening during times of heightened estrogen levels, as during pregnancy, during adolescence, or while taking some estrogen-containing medication (such as birth control pills).
  • Physical Trauma
    There is usually a history of a well remembered blow, or fall, or cut, or surgical procedure at or near the affected sight. Other factors are known to cause “spider veins “, but are much less commonly associated with the veins than the three factors listed above.

What can be done about Spider Veins?
Because these vessels are such a nuisance, many different techniques have been developed through the years in order to eliminate them. The major techniques tried on the legs have been electrosurgery and laser surgery, and injection of sclerosing solutions (sclerotherapy). While electrosurgery and lasers work nicely on facial vessels, sclerotherapy has proven to be the best treatment for “spider veins ” on the legs.

Electrosurgery causes an unacceptable amount of visible scarring. While scarring can occur with sclerotherapy, it happens rarely, and if it does occur, it is usually only at the injection sight. Pulsed-dye lasers may be helpful to reach those vessels that are too small to be injected.

What do you use for Sclerotherapy? Why?
We use hypertonic saline (23.4 sodium chloride, containing no preservatives and no heparin) because of its safety and effectiveness. Allergic reactions cannot occur and it does not cause permanent staining of the skin at the injection sight. Hypertonic saline does cause stinging and short-term (minutes) discomfort in some persons, but it is very safe and very effective. We also use Sotradecol which is a detergent type of sclerosing agent.

What size spider veins can be treated?
Vessels from less than 1/2 mm to as large as 2 mm can be treated. Pressure over the larger vessels after sclerotherapy causes them to respond better to treatment. Larger vessels can also be treated, but may need surgery, and vascular studies prior to treatment.

What are the side effects?
Side effects are uncommon. They include brown spots or small crusts or ulcerations at the injection sights. If a brown streak occurs along the course of the treated vessel, it will fade without treatment. Some vessels may require two to four treatments before responding completely. Ankles frequently swell for a few days after they are treated.

Thrombophlebitis of the treated vessel occasionally occurs. It’s always superficial and responds well to aspirin (or other similar anti-inflammatory drugs), heat, and antibiotics (infrequently needed). Infrequently tiny new vessels develop at treatment sights. They are treated the same way the original vessels were. Rarely, an ulcer may need to be excised in order to speed-up healing.

How many treatments will be needed?
The frequency of treatments is determined by the severity of the problem. Treatments are usually done at four to six week intervals. Most patients achieve about a 50% clearing with each treatment.

How much improvement can I expect?
We expect our patients to get a 75-80% improvement with two treatments. Most do better than that. Sclerotherapy is a very pleasing answer to a nuisance-type problem that will not go away by itself.

When can I expect to see results?
Although some people see results almost immediately, it may take weeks for the veins to resolve completely. With spider vein treatments the veins will often turn red, and bruising will occur at the injection site. This initial reaction usually goes away within seven days and then the veins slowly disappear over the next two to eight weeks. When larger veins are treated by injection, it is normal to also see some discoloration and bruising at the injection site and along the vein. Redness and slight soreness are also common, but not worrisome. Over several weeks the larger vein will scar down and appear as a black, slightly raised ridge. This will be progressively absorbed by the body over approximately 6-8 weeks. Occasionally longer periods of time are needed for the full effect.

How long must I be out of work?
Generally patients go directly back to work. No work should be missed.

What about spider veins on the face?
Those spider veins can also be treated with very good results with Intense Pulse Light (IPL). Please see our (IPL) section of the website.

Price
30 minute treatment $450.00

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Varicose Vein Treatment