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Sclerotherapy
Spider Veins
Diminishing unsightly 'spider veins'
Millions
of women are bothered by spider veins - those small yet unsightly
clusters
of red, blue or
purple veins that most commonly appear on the thighs, calves and ankles.
In fact, it's estimated that at least half of the adult female
population is plagued with this common cosmetic problem.
Today, many
Doctors 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.
If you're
considering sclerotherapy to improve the appearance of your legs, this
information 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 the consultants, or nurses, 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; or they may be simple linear and appear as thin separate lines.
Linear spider veins are commonly seen on the inner knee.
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 legs. 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. Three 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 our certified consultants.
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.
PLANNING YOUR TREATMENT
During your
initial consultation, your legs will be examined. The consultant 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.
The consultant
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 our
consultants. Don't hesitate to ask any questions or express any concerns
you may have. The consultants 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 our consultants 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 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.
Sclerotherapy for
the treatment 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, the 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 the nurse.
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 recommended 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.
YOUR NEW LOOK
Most patients are
pleased with the difference sclerotherapy makes. The skin of your legs
will appear younger, clearer and more healthy-looking. If you've been
wearing long skirts and slacks to hide your spider veins, you'll now be
able to broaden your fashion horizons. Often, patients are surprised at
the dramatic difference in appearance between a treated leg and an
untreated one.
Although
sclerotherapy will obliterate the noticeable veins for good, it's
important to remember that treatment will not prevent new spider veins
from emerging in the future. As time passes, you may find that you need
"touch-ups" or full treatments for new veins that surface. But even if
you choose not to have further sclerotherapy, your legs will look better
than if you never had treatment at
all.
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