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What are spider veins?
Spider veins or telangiectasias of the legs are a common problem that
particularly affect women. Small purple, blue or red veins can form anywhere
on the leg, from the top of the thigh to the ankle, and can sometimes
occur on the face as well. These veins appear as connected lines resembling
a sunburst or spider web pattern or as short, unconnected lines. On many
people, they are relatively inconspicuous, because they are confined to
a small area; however, some people become distressed when larger areas
of skin are affected and the veins become more noticeable.
Varicose veins are larger, sometimes raised veins
which are often blue in color. They can become quite painful, producing
a burning or throbbing sensation. Although these superficial varicose
veins and spider veins carry blood, neither are necessary to the circulatory
system.
Today, both telangiectasias and superficial varicose
veins can be treated through a procedure called sclerotherapy. Sclerotherapy
is a technique which involves the use of a very fine needle to inject
a solution directly into the veins. The solution injures the lining of
the vessels, casuing it to seal off and become less obvious.
Before treatment
Prior to treatment, a complete medical history is taken and a thorough
examination made in order to determine, among other things, how long the
problem has existed, the severity of the symptoms, whether or not the
condition is affected by physical activity and if there has been prior
surgery or treatment of the veins. Dr. Binstock determines if the deep
venous system is affected, in which case surgery may be recommended before
sclerotherapy is undertaken. Preoperative instructions may include the
elimination of certain drugs which contain aspirin in order to minimize
the possibility of excess bleeding. The veins are usually marked while
the patient is in a standing position.
Sclerotherapy treatment
- New Foam Technique
Larger veins are usually treated first. After the skin is thoroughly cleansed
with alcohol, Dr. Binstock uses a syringe with a tiny needle to inject
a small amount of foam sclerosing (irritating) solution directly into a vein.
The foam solution displaces the blood within the vein, causing it to blanch
or turn white. The solution then causes the vessel to become irritated
and swell shut, prohibiting the blood from reentering the vein. When the
needle is withdrawn, pressure is immediately applied to the area. The
skin may be massaged to help disperse the solution and reduce bruising.
Each vein may require several injections and most disappear in two weeks
to two months. Smaller veins are treated with a glycerin solution.
Following treatment
Patients who have had sclerotherapy have reported little discomfort. Some
experience a slight to moderate burning sensation immediately after the
injection, but this disappears within a few seconds. An ointment to soothe
the skin and relieve the burning may be used, and a pressure bandage may
be applied to prevent post-injection bleeding. Elastic stockings or compression
bandages will be applied.
Patients are usually advised to resume normal activity
immediately, although vigorous activity is discouraged for twenty-four
hours. Walking is encouraged because it increases the blood flow through
other veins. Elevation of the legs is usually not recommended unless large
veins have been treated.
What are the side effects of sclerotherapy?
Most patients experience little adverse effects; however, some minor side
effects have been reported. These include slight blistering which occurs
when small amounts of the solution seep into the surrounding areas, or
from the friction of the tape holding cotton balls in place over the vein.
These spots usually resolve in time or respond to treatment with bleaching
agents.
Bruising around the treated area, which eventually
disappears, can result if the veins are unusually weak. Bruising and skin
discoloration tends to last longer in people of olive or dark complexion.
Clots sometimes develop at the site of the injection. Although not a major
cause for concern, it may be necessary to remove these clots within two
weeks in order to allow the healing process to progress normally.
A small percentage of patients develops a network
of tiny, pink vessels that turn white when pressure is applied. This condition,
referred to as "matte telangiectasia" usually disappears without
treatment; however, injection treatment may be necessary in some cases.
Occasionally, there are allergic reactions to the solution which are treated
immediately with antihistamines and other medications. Ulceration and
scarring have also been reported.
In some cases, spider veins recur and new spider veins
present themselves. When large veins are treated, wearing support hose
is recommended to prevent their recurrence.
What causes spider veins and
varicose veins?
No one has determined for certain why some people are affected with spider
veins and varicose veins and others are not; however, some families seem
predisposed to the condition. Trauma to the leg in the form of blows or
falls may contribute to the formation of these veins, and long periods
of standing or sitting may also be causative factors. More women than
men seem to develop this condition, perhaps as a result of pregnancy or
because or hormones. Scientists have not discovered any clear-cut methods
to prevent the onset of these telangiectasias, although some authorities
believe that the use of support hose, weight control and exercise may
be beneficial.
Today, thousands of people who have felt self-conscious
or embarrassed by unsightly veins are delighted with the results they
are getting from sclerotherapy treatment. Most patients experience from
60% to 80% improvement, although final results may not be apparent for
several months.
What about
laser therapy?
Other treatments using the argon and carbon dioxide lasers have not proven
particularly successful; however, recent development of the VersaPulse®,
a laser that is used to treat blood vessels, is sometimes effective in
the treatment of smaller telangiectasias of the leg.
Will insurance pay for sclerotherapy
treatment?
Insurance companies do not pay for sclerotherapy treatment.
If you are interested in learning more about sclerotherapy,
please call Dr. Binstock and he will be happy to answer your questions.
** Benefits depicted are actual and
not retouched.
Patient results may vary. Each set of photos reflects the benefit realized
by the person in that set of photos, and not necessarily the viewers final
results.
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