Today, many plastic
surgeons are treating
spider veins with
sclerotherapy. In this
rather simple procedure,
veins are injected with
a sclerosing solution,
which causes them to
collapse and fade from
view. The procedure may
also remedy the
bothersome symptoms
associated with spider
veins, including aching,
burning, swelling and
night cramps.
Although this procedure
has been used in Europe
for more than 50 years,
it has only become
popular in the United
States during the past
decade. The introduction
of sclerosing agents
that are mild enough to
be used in small veins
has made sclerotherapy
predictable and
relatively painless.
If you're considering
sclerotherapy to improve
the appearance of your
legs, this brochure will
give you a basic
understanding of the
procedure - when it can
help, how it's performed
and what results you can
expect. It won't answer
all of your questions,
since a lot depends on
your individual
circumstances. Please
ask your doctor if there
is anything about the
procedure you don't
understand.
What are spider
veins?
Spider veins-known
in the medical world as
telangiectasias or
sunburst varicosities -
are small, thin veins
that lie close to the
surface of the skin.
Although these
super-fine veins are
connected with the
larger venous system,
they are not an
essential part of it.
A number of factors
contribute to the
development of spider
veins, including
heredity, pregnancy and
other events that cause
hormonal shifts, weight
gain, occupations or
activities that require
prolonged sitting or
standing, and the use of
certain medications.
Spider veins usually
take on one of three
basic patterns. They may
appear in a true spider
shape with a group of
veins radiating outward
from a dark central
point; they may be
arborizing and will
resemble tiny
branch-like shapes; or
they may be simple
linear and appear as
thin separate lines.
Linear spider veins are
commonly seen on the
inner knee, whereas the
arborizing pattern often
appears on the outer
thigh in a sunburst or
cartwheel distribution.
Varicose veins differ
from spider veins in a
number of ways. Varicose
veins are larger -
usually more than a
quarter-inch in
diameter, darker in
color and tend to bulge.
Varicose veins are also
more likely to cause
pain and be related to
more serious vein
disorders. For some
patients, sclerotherapy
can be used to treat
varicose veins. However,
often surgical treatment
is necessary for this
condition.
The best candidates
for sclerotherapy
Women of any age may be
good candidates for
sclerotherapy, but most
fall in the 30-to-60
category. In some women,
spider veins may become
noticeable very early on
- in the teen years. For
others, the veins may
not become obvious until
they reach their 40s.
If you are pregnant or
breastfeeding, you may
be advised to postpone
sclerotherapy treatment.
In most cases, spider
veins that surface
during pregnancy will
disappear on their own
within three months
after the baby is born.
Also, because it's not
known how sclerosing
solutions may affect
breast milk, nursing
mothers are usually
advised to wait until
after they have stopped
breastfeeding.
Spider veins in men
aren't nearly as common
as they are in women.
Men who do have spider
veins often don't
consider them to be a
cosmetic problem because
the veins are usually
concealed by hair growth
on the leg. However,
sclerotherapy is just as
effective for men who
seek treatment.
What to expect from
sclerotherapy
Sclerotherapy can
enhance your appearance
and your self
confidence, but it's
unrealistic to believe
that every affected vein
will disappear
completely as a result
of treatment. After each
sclerotherapy session,
the veins will appear
lighter. Two or more
sessions are usually
required to achieve
optimal results.
You should also be aware
that the procedure
treats only those veins
that are currently
visible; it does nothing
to permanently alter the
venous system or prevent
new veins from surfacing
in the future.
Before you decide to
have sclerotherapy,
think carefully about
your expectations and
discuss them with your
doctor.
Risks related to
treatment
Serious medical
complications from
sclerotherapy are
extremely rare when the
procedure is performed
by a qualified
practitioner. However,
they may occur. Risks
include the formation of
blood clots in the
veins, severe
inflammation, adverse
allergic reactions to
the sclerosing solution
and skin injury that
could leave a small but
permanent scar.
A common cosmetic
complication is
pigmentation
irregularity - brownish
splotches on the
affected skin that may
take months to fade,
sometimes up to a year.
Another problem that can
occur is "telangiectatic
matting," in which fine
reddish blood vessels
appear around the
treated area, requiring
further injections.
You can reduce the risks
associated with
treatment by choosing a
doctor who has adequate
training in
sclerotherapy and is
well versed in the
different types of
sclerosing agents
available. A qualified
doctor can help you
select which type of
sclerosing medication is
most appropriate for
your needs.
Planning your treatment
During your initial
consultation, your legs
will be examined. Your
doctor may draw a simple
sketch of your legs,
mapping out the areas
affected by spider veins
or other problems.
During the examination,
you will be checked for
signs of more serious
"deep vein" problems,
often indicated by
swelling, sores, or skin
changes at the ankle. A
hand-held Doppler
ultrasound device is
sometimes used to detect
any backflow within the
venous system.
If such problems are
identified, your surgeon
may refer you to a
different specialist for
further evaluation.
Problems with the larger
veins must be treated
first, or sclerotherapy
of the surface veins
will be unsuccessful.
Your doctor will ask you
about any other problems
you may have with your
legs, such as pain,
aching, itching or
tenderness. You will
also be asked about your
medical history,
medications you take, or
conditions that would
preclude you from having
treatment. Individuals
with hepatitis, AIDS or
other blood-borne
diseases may not be
candidates for
sclerotherapy. Patients
with circulatory
problems, heart
conditions, or diabetes
may also be advised
against treatment.
It's important to be
open in discussing your
history and treatment
goals with your doctor.
Don't hesitate to ask
any questions or express
any concerns you may
have. Your doctor should
explain the procedure in
detail, along with its
risks and benefits, the
recovery period and the
costs. (Medical
insurance usually
doesn't cover cosmetic
procedures.)
Preparing for the
procedure
You will receive
specific instructions
from your physician on
how to prepare for your
treatment. Carefully
following these
instructions will help
the procedure go more
smoothly.
You'll be instructed not
to apply any type of
moisturizer, sun block
or oil to your legs on
the day of your
procedure. You may want
to bring shorts to wear
during the injections,
as well as your
physician-prescribed
support hose, and slacks
to wear home.
When scheduling your
procedure, keep in mind
that your legs may be
bruised or slightly
discolored for some
weeks afterward. You
probably won't be
comfortable wearing
shorts, a swimsuit or a
mini skirt until after
your legs have cleared
up a bit.
Where your treatment
will be performed
Sclerotherapy of spider
veins is a relatively
simple procedure that
requires no anesthesia,
so it will be performed
in an outpatient
setting, most likely
your doctor's office.
The procedure
A typical sclerotherapy
session is relatively
quick, lasting only
about 15 to 45 minutes.
After changing into
shorts, your legs may be
photographed for your
medical records. You
will be asked to lie
down on the examination
table and the skin over
your spider veins will
be cleaned with an
antiseptic solution.
Using one hand to
stretch the skin taut,
your doctor or nurse
will begin injecting the
sclerosing agent into
the affected veins.
Bright, indirect light
and magnification help
ensure that the process
is completed with
maximum precision.
Approximately one
injection is
administered for every
inch of spider vein -
anywhere from five to 40
injections per treatment
session. A cotton ball
and compression tape is
applied to each area of
the leg as it is
finished.
During the procedure,
you may listen to music,
read, or just talk to
your practitioner. You
will be asked to shift
positions a few times
during the process. As
the procedure continues,
you will feel small
needle sticks and
possibly a mild burning
sensation. However, the
needle used is so thin
and the sclerosing
solution is so mild that
pain is usually minimal.
After your treatment
In addition to the
compression tape applied
during the procedure,
tight-fitting support
hose may be prescribed
to guard against blood
clots and to promote
healing. The tape and
cotton balls can be
removed after 48 hours.
However, you may be
instructed to wear the
support hose for 72
hours or more.
It's not uncommon to
experience some cramping
in the legs for the
first day or two after
the injections. This
temporary problem
usually doesn't require
medication.
You should be aware that
your treated veins will
look worse before they
begin to look better.
When the compression
dressings are removed,
you will notice bruising
and reddish areas at the
injection sites. The
bruises will diminish
within one month. In
many cases, there may be
some residual brownish
pigmentation which may
take up to a year to
completely fade.
Getting back to
normal
Although you probably
won't want to wear any
leg-baring fashions for
about two weeks, your
activity will not be
significantly limited in
any other way from
sclerotherapy treatment.
You will be encouraged
to walk to prevent clots
from forming in the deep
veins of the legs.
However, during the
period of time to
complete your treatment
program, prolonged
sitting and standing
should be avoided, as
should squatting, heavy
weight lifting and
"pounding" type
exercises, including
jogging.
A one-month healing
interval must pass
before you may have your
second series of
injections in the same
site. After each
treatment, you will
notice further
improvement of your
legs' appearance. |
