Sclerotherapy for Superficial Leg Veins

Superficial leg veins, also known as spider veins, telangiectasias, or starburst blemishes are small, dilated surface veins that can be pink, red, or purple and appear as lines or clusters on the thighs, lower legs, or ankles.

What causes these vessels and can they be prevented?

Dysfunction of the valves within veins contributes to spider veins, and several factors may play a prominent role to their development, including heredity, pregnancy, hormone replacement therapy, oral contraceptives, obesity, and trauma. Although exercise, weight loss, and support hose may limit the number of new vessels, they will not prevent their development.

What is Sclerotherapy?

Performed on an outpatient basis, sclerotherapy involves the injection of a sclerosing solution such as hypertonic saline into the dilated vessels. This procedure causes the lining of the vessels to swell or close, resulting in both a lighter color and improvement in appearance, or complete disappearance, of the vessels.

What can I expect during treatment?

Most people experience mild discomfort similar to a mosquito bite. The injected veins completely disappear for a few minutes as blood is pushed out by the solution, but they reappear when the blood flow returns. Since many vessels are interconnected, one injection may eradicate several dozen vessels at once by washing over the cells that line the inner wall of the vessels, causing them to shrink. They will slowly disappear, as your body’s natural response to injury clears them. Up to three treatments spaced at six to eight week intervals may be necessary for clearance of the vessels. Some patients are satisfied with the results after only one treatment.

Are there any side effects associated with Sclerotherapy?

Serious side effects from this procedure are extremely rare; however, some temporary side effects may occur.
* Local swelling and bruising may occur at the injection site and along the vessel. Swelling usually lasts no more than 24 hours; bruising fades within 1 to 2 weeks. Brown discoloration may infrequently develop. This usually lasts approximately three months, slowly fading away.
* Tenderness may occur at the injection site and along the vessel and may persist for a few days.
* Immediately following injection, a hive-like reaction may develop at the site, usually lasting no longer than 30 minutes.
* Following injection of the ankle or the calf, cramping similar to a “charley horse” may occur. Massage usually eases discomfort.
* Occasionally, formation of new blood vessels resembling a blush (telangiectatic matting) may occur at the treated site. If this side effect occurs, the redness usually fades over the next three to six months.

What are the post-treatment instructions?

* Pressure bandages will be placed over the treated veins and remain for one to two days after treatment. You should avoid contact sports, aerobics, and leg weights for the first three to four days after treatment. A 30-minute, moderately paced walk may be substituted for your regular workout.
* Medium-weight compression support hose such as Jobst are recommended for daytime wear during the one to two weeks following treatment. These are nonprescription, fitted by height and weight, and are available in several colors at various medical supply stores.

Do other treatment options exist?

Yes! Sclerotherapy remains the treatment of choice for spider veins but if sclerotherapy does not fade veins appreciably, if the veins are too small to be treated by sclerotherapy, or if you are fearful of needles, lasers and light sources are effective treatment options. The pulsed dye laser (V-Beam) and the long pulsed Nd:YAG lasers are effective in treating red, superficial, fine veins and also some bigger, deeper blue veins. These options will be discussed during your consultation.

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