Sclerotherapy

Millions of people are bothered by spider veins. Spider veins appear as red or purple sunbursts on the skin surface, and can occur on the face, legs or ankles. They can itch, burn or ache, and can be found alone or in combination with varicose veins. They are not a health risk alone, but are often a cosmetic concern. Most spider veins are treated with a combination of sclerotherapy and laser ablation. These combined treatments offer the best long term results.

Today, sclerotherapy, a minimally invasive treatment, can be used to treat varicose and spider veins. The procedure may also remedy symptoms like aching, burning, and swelling. A tiny needle is used to inject a gentle solution into the involved vein, causing it to close down and be absorbed by the body. There is little discomfort with the procedure. Elastic compression hose are worn after each treatment. The duration depends upon the size of the vessels and may vary from two days to two weeks. Several treatments are usually required.

What is injection sclerotherapy?

An FDA-approved solution called Sotradecol® is injected into the vein through a microneedle, to induce an inflammatory reaction which causes the vein to seal shut and gradually shrink away and disappear. Once the vein is sealed, blood is forced into healthier veins. Sotradecol® gives much better results and is far less painful than the traditional hypertonic saline injections.

Why not just inject all the veins?

That method alone results in a higher chance of varicose veins returning. We do not use injection sclerotherapy for very large veins. We will offer the best treatment for each individual's vein problem, which can sometimes require minor surgery to get the best long-term result.

Who are candidates for treatment?

Any individual who has unsightly spider or varicose veins is a candidate, and both large and small veins can be treated effectively. Best results with spider veins are seen in fair skinned individuals. Tanning or prolonged sun exposure should be avoided both before and after treatment.

How many treatments are required?

The number of treatments to provide you with the results you want to achieve will be determined during your initial consultation session, at no cost, where a personalized treatment plan will be developed. For most large bulging veins, one treatment is all that is needed. Spider veins do require several treatments. The average person requires 3-5 sessions spaced 4-6 weeks apart in order to get resolution.

Will it hurt?

Most patients experience little or no pain, and any discomfort lasts only a fraction of a second. Topical anesthesia or ice packs can be applied for pain sensitive patients. While the amount of post treatment pain varies from one patient to another, most require only Tylenol or ibuprofen for any discomfort.

What about side effects?

Most treatments have minimal side effects and recovery time. Patients often experience slight redness or bruising following treatment, but this goes away within a few days.

What about Post-Procedural care?

The overwhelming majority of patients treated for varicose veins or spider veins walk out and return to normal daily activities including work within two days. While the amount of post treatment pain varies from one patient to another, most require only Tylenol or ibuprofen for any discomfort. Complete recovery, including resolution of bruising, takes from 4-6 weeks. Detailed written and verbal instructions will be provided to each patient both before and after treatment.

Are there any restrictions to my activity after sclerotherapy?

There are usually no restrictions on physical activity after spider vein sclerotherapy and, in fact, light exercise is encouraged. We do discourage direct sun exposure to treated areas for a couple weeks after each treatment (sunscreens are adequate protection during this time).

What results can I expect from my spider vein treatments? Realistic expectations are important when one undertakes any cosmetic procedure. That is why we never promise perfection or "beautiful legs" after treatment. (And, any clinic that does is being less than honest.) We set a goal of 80% improvement and can achieve that goal in most people. Every patient is different, and the number of sessions needed varies depending on the severity of your condition. Most cases require three to five treatments. However, this is only a guideline and your individual case may be different. Your legs may begin to show improvement in as little as a few weeks, but the best results are usually seen after several treatment sessions.You will be the one to decide when your unsightly veins have cleared to the point that you are no longer self-conscious about your legs. You may want to come back for a touch-up treatment every year or two.

Is laser not the best treatment for spider veins? Laser is the treatment of choice for spider veins of the FACE. The legs are a different story. In the legs, the spider veins are larger and under higher pressure. And the skin is thicker. Sclerotherapy is the most effective treatment.

How do I begin treatment?

During the initial consultation, your legs will be examined, and any questions you may have will be answered. You may also discuss your expectations and anticipated results. At this point, an estimate of the number of treatments, affiliated costs, and payment will be covered which will vary depending upon the size and extent of your problem. You should then be able to schedule an appointment for treatment.

What is Vein closure by laser?

This is an exciting new laser procedure that involves placing a thin laser filament into the vein through a needle puncture in the lower leg and uses laser energy to heat the vein from inside, causing it to close down. Closure by laser has a 98% rate of completely closing down the vein. The laser procedure can be performed on most patients whose varicose veins are due to an incompetent saphenous vein.

Does this replace vein stripping?

Surgically removing veins, or "vein stripping", is sometimes needed, but the method currently used is much different from many people's idea of vein stripping. The ambulatory micro-incisional phlebectomy procedure is done under local anesthesia in our office and is much less traumatic to the leg than traditional stripping, and leaves minimal to no scarring. Patients walk out of the office, and most are able to resume work and their normal activities within just a few days.