We now offer treatment for unwanted, unsightly leg veins. We have added this service to the Aesthetic Laser & Cosmetic Surgery Center because of the number of requests from our patients. Above all, our approach emphasizes safety. We use only agents for injection with an excellent record of safety and effectiveness. Older sclerosing agents are not used because of their incidence of skin ulcerations and scarring as well as residual pigmentation.
After an evaluation, an estimate of potential improvement and number of treatment sessions are discussed. We generally treat a specific area once every four weeks, although patients can schedule treatments of other areas on a weekly basis as needed.
Unwanted leg veins (spider veins), known medically as telangiectasias or superficial varicosities, are dilated skin capillaries. These may become unsightly with time and may also lead to a dull aching of the legs after prolonged standing.
Sclerotherapy is the technique of instilling a specific solution into these vessels (tiny capillaries or larger varicose veins), using a small needle. The solution irritates and destroys the inner lining of the blood vessels so it ceases to carry blood. The body then replaces this damaged vessel with an imperceptible scar tissue. This does not harm the circulation ? it improves it by eliminating the abnormal, unnecessary vessel. Several injections may be needed for a specific area of telangiectasia. The procedure is virtually painless. Fading of the vessels is a slow process which takes I to 6 months. The goal is to produce a 75% to 90% improvement.
There is a one-time purchase charge for compression stockings. The stockings cost from $25.00 to $30.00 depending on the type required. Appointments are required in advance. Payment is required at the time of the procedure. Results of treatment cannot be guaranteed, but most patients are pleased with the cosmetic and functional improvement.
Common Questions about Sclerotherapy
What causes spider veins?
No one is totally sure. Certain families are predisposed to this condition particularly female relatives. Certain things make spider veins worse: Estrogens, pregnancy and birth control pills, tight girdles and garter belts, prolonged standing or sitting, and trauma.
How does sclerotherapy work?
The solution destroys the tiny cells, which line the blood vessels without damage to the surrounding tissues.
How soon will the vessels disappear?
Each vessel usually requires one to three treatments. The vessels disappear over a period of 2 weeks to 3 months. Recurrences may rarely occur over a period of I to 5 years. This treatment does not prevent new telangiectasias from developing.
Are there certain vessels, which tend to recur more commonly?
Yes. They are the types of vessels, which occur in a mat of very fine radiating vessels.
How often can I be treated?
The same area should not be injected for 3 to 4 weeks to allow for complete healing. Additional different areas may be treated every week.
How many times does it have to be done?
This varies with the number of areas that have to be injected, as well as the response to each injection. It usually takes one to three injections to obliterate any vessel and 10 to 40 vessels may be treated in any one session.
Are there certain kinds of spider veins that cannot be treated?
Certain types of large varicose veins may not respond readily to sclerotherapy alone. These vessels may require a minor surgical procedure followed later with sclerotherapy. You may be referred to a vascular surgeon for complete or partial treatment of these types of large varicose veins.
Are there other methods of treating these vessels?
Four other methods are used.
Laser surgery: To date, this method has only been effective for tiny facial blood vessels. The present laser systems tend to produce a greater risk of scarring. The laser is an expensive device and treatment is thus, more costly.
Electrodesiccation: This method produces non-specific destruction of both the vessels and overlying skin thus, resulting in a greater incidence of scarring.
Ambulatory phlebectomy: This operation procedure is often recommended for veins larger than 6.0 mm in diameter. It results in minimal or even unnoticeable scars along the course of the extracted vein. It is usually performed under local anesthesia and has few complications. It may be recommended that this procedure be performed before sclerotherapy. In this case it will minimize the side effects of sclerotherapy and enhance the results. The procedure is usually performed by a general surgeon.
Surgical ligation and stripping: This operative procedure always result in a scar, although modern techniques limit the extent and number of scars. It is best reserved for large varicose veins. The procedure may be required before other cosmetically noticeable veins are treated by sclerotherapy to limit the side effects and enhance the results of sclerotherapy. This is also done by a general surgeon.
Is there any one way to prevent them?
The use of support hose may be helpful. Reducing your weight and regular exercise may also be of help.
What are the side effects of sclerotherapy?
The follow side effects have been observed in some patients.
Slight blistering may occur around the injected vessels which will resolve in a day or so.
10% to 30% of patients develop a small freckle-line, tan-to-brown spot around the injected vessel. This usually resolves in 80% of these patients within 3 to 6 months. A few patients will have a persistent freckle for up to a year.
Slight stinging or burning may occur with injection of certain types and concentrations of solutions in certain areas.
Sometimes a clot develops at the injection site (especially if the recommended pressure stockings are not worn for the proper amount of time). This clot will never cause internal problems, but its removal within 2 weeks of the injection will speed the healing process and decrease the incidence of “freckling”.
Swelling over the injection site may rarely occur. It is particularly common when patients have jobs in which they stand for long periods of time or when vessels in the ankles are injected. The swelling is never dangerous but occasionally must be treated with elevation and compression dressings.
A small superficial ulceration of the skin overlying the injected vessel may occur. This does not usually leave a scar but needs to be seen as soon as possible by Dr. Edds.
Superficial thrombophlebitis, an irritation of the injected vessel, occurs in less than I per 1,000 patients. It may have to be treated with anti-inflammatory agents and compression stockings.
If you are interested in learning more about this procedure, please call our office at (270) 926-9033 and we will be happy to answer questions about the procedure itself or about procedure cost and financing.