Home Page Saturday - July 31, 2010
Spider Veins

What are spider veins?
Spider veins are abnormally dilated blood vessels in the skin. They usually appear on the legs but can also occur on the face and less commonly the chest, arms, and back. Contrary to what many physicians are taught, spider veins can cause the same symptoms as much larger varicose veins including itching, burning, heaviness, and fatigue in the legs. Although they may be symptomatic, spider veins usually do not lead to serious complications. In rare cases they can bleed profusely after being injured, but otherwise they are treated mostly as a cosmetic problem.

What causes spider veins?
Spider veins develop in two ways. First, tiny pre-existing veins can enlarge and become dilated over time.  Secondly, your body actually grows new veins where it doesn’t need them…in the skin.  Pregnancy, hormone-containing medications, and hormonal fluctuations may stimulate their appearance, thus, spider veins are more common in women.  They are not caused by crossing legs or by years of prolonged standing or sitting at work.  The tendency to develop abnormal veins is largely hereditary, and there is not much you can do to prevent them.  Support hose, exercise, and dietary supplements are helpful for symptoms, but the veins keep growing. In some cases, the appearance of spider veins may be an indication that there are larger diseased veins underneath.  The physician may use ultrasound to search for any larger diseased veins that may be causing your spider veins.  If larger diseased veins are found, they need to be treated first and eliminated or else spider vein treatment will be ineffective.

How are spider veins treated?
Sclerotherapy is the treatment of choice for spider veins.  Sclerotherapy is an injection treatment used to eliminate small to medium size varicose veins and spider veins.  Although these superficial fine veins are connected with the larger venous system, they are not an essential part of it, so eliminating them will not affect your circulation.  The majority of these veins present as a cosmetic problem.  In this rather simple procedure, veins are injected with a sclerosing solution, which causes them to collapse and fade from view.

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. We treat both legs, front and back, during each session.  This results in a gradual cosmetic improvement all over rather than treating one area at a time.   Initial treatments will focus on the most heavily involved areas or the most symptomatic areas.  The average patient usually requires 3 to 6 treatment sessions.  Significant cosmetic improvement can usually be expected near the end of the prescribed treatment course.  In most cases it has taken years for these veins to develop.  They will not go away over night.  It will take weeks or months to eradicate them.

What are the risks related to sclerotherapy?
Serious medical complications from sclerotherapy are extremely rare when a qualified practitioner performs the procedure.  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 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.  Common side effects include itching, hyperpigmentation, telangiectatic matting, pain and bruising.  Rare side effects include ulceration at injection site, allergic reaction and pulmonary embolus/deep vein thrombosis. 

How to prepare for sclerotherapy?
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, sunblock 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 (also available for purchase in the office), and slacks to wear home.  Discontinue Aspirin and Ibuprofen for ten (10) days before injections to reduce bruising.  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 mini skirts until after your legs have cleared up a bit.  Sun exposure and tanning bed use are discouraged the first two weeks after each treatment.

Will insurance pay for sclerotherapy?
Sclerotherapy is considered a cosmetic procedure; therefore your insurance company will not cover this service.  As such, payment is due in full prior to procedure.  We will not file your insurance for sclerotherapy due to its cosmetic nature.