Other Associated Terms: Sclerotherapy, Microsclerotherapy, Telangiectasia, Sunburst Varicosities.
Overview:
For the millions of women who suffer from the negative effects of spider vein appearance, help can be sought through a procedure known as sclerotherapy.
Spider veins are smaller groupings of purple, red or blue veins that appear, most commonly, on the thighs, ankles or calves. Although they create an undesirable appearance, they are not usually painful, unlike varicose veins. Spider veins can appear for a number of reasons related to; weight gain, obesity, changes in hormone levels, heredity, medications, activities that require extensive standing or sitting and pregnancy.
They can appear in both women and men, but they appear far more frequently in women. This is partly due to the role that female hormones can play in their development and can be directly related to changes in those hormone levels during pregnancy, use of birth control pills and hormone replacement treatments.
Sclerotherapy is a common and effective means of treating spider veins and there are two basically different methods of spider vein treatment – but both are relatively simple and non-invasive.
Spider veins usually fall into one of 3 pattern types:
“Spider Shaped”; which is a web-shaped pattern with veins extending out from a darker, central point.
“Branch Shaped”; which resemble the branches seen on trees and can usually be found on the outer thigh.
“Line Shaped”; which may manifest as separate, thin lines and are usually found on the inner knee.
Spider veins differ from varicose veins insofar as spider veins are smaller, don’t tend to “bulge” and are not likely to be painful.
Benefits:
The effects of spider vein removal are permanent (although it isn’t able to prevent the appearance of new vein visibility). Other benefits include the fact that it is relatively non-invasive compared to standard surgical techniques and doesn’t have general anesthesia complications or issues associated with incisions.
There is no actual downtime – just some slight activity limitations for a short period of time. The procedure is performed on an out-patient basis (usually in the doctor’s office) and is virtually pain-free. It can provide excellent cosmetic results which can lead to increased self-confidence and self-esteem.
Sclerotherapy treatments will often cure other spider vein symptoms such as swelling, cramping or persistent burning or aching sensations.
Patient Characteristics:
There is no age limitation for adult women, however the average ages for patients range between 30 and 60. Pregnant women are advised against the procedure as are women who are breastfeeding (injection procedures), since the injected solution may affect breast milk. Men can also be procedure candidates, but the condition is far more rare for that gender.
Patients should also be in good health, both physically and psychologically. They should also be non-smokers (or be able to refrain from smoking during the recovery period). Candidates need to understand the procedure and have realistic result expectations. They should also not have any vascular system-related medical issues.
Procedure:
Spider veins can be treated through either laser or injection therapy. During an initial consultation, it will be determined which of these two procedures is the most appropriate for the patient’s particular situation.
Laser Light Therapy:
With this form of spider vein treatment, the doctor will first identify the veins that are to be treated. Larger veins will usually be singled out to be treated at the beginning of the procedure. An anesthetic may be applied (topical) but no sedation will be used.
Intense laser light is then administered to each vein, which in turn, absorbs the light’s energy through a series of pulses. The energy absorption will cause coagulation of the blood which causes the vein to close down.
Cooling of skin may be performed throughout the treatment, as well. Self-cooling lasers are now available that can assist with this aspect of the treatment. Very little discomfort will be felt during the procedure and only a slight swelling or redness will be apparent (possibly some crusting or blistering, if a vein is close to the surface of the skin). The patient will notice the improvement in either 1 or 2 treatments.
Injection Sclerotherapy:
With this form of spider vein treatment, the doctor will identify the condition of the veins using a hand-held ultra-sound device. This will detect backflow within the veins. The injection treatment, itself, will usually last 15 – 45 minutes. At first, the patient will be prepped while lying on the examination table.
The treatment site will be cleaned and a material known as a sclerosing agent will be injected into the designated vein areas (the ratio is usually one injection per inch). Anywhere from 5-40 injections will be administered during each treatment. No sedation is required and very little discomfort will be felt.
Once the process has been completed, the patient will have compression tape and a compression stocking applied to the treated area. A follow up injection treatment may be scheduled for a month later.
Recovery:
Since sclerotherapy procedures are relatively non-invasive, recovery is usually quick and uneventful. For injection sclerotherapy, once you leave the doctor’s office, a special compression stocking (possibly in conjunction with an ace bandage) will be worn. In the event of a vein hooking procedure (used to treat varicose veins and may be performed in conjunction with sclerotherapy), you might have some pink to red colored leakage. However, normal activity (with some limitations) may be resumed.
You should keep yourself moving and avoid remaining immobile. This is needed to promote blood circulation and you will be advised to engage in activities such as housework and walking, as long as strenuous activity is avoided. The compression stocking will be worn for a week (even when bathing – you can use a plastic covering).
When the compression stocking is removed, it is possible you’ll see veins that look like hard, small ropes. This is normal and a sign of recovery. During a follow-up visit, the doctor may remove some blood from those particular veins. Some bruising and skin discoloration may be initially apparent and should eventually clear up. The original visible veins should continue to disappear, however.
For laser sclerotherapy patients, the patients will usually be asked to elevate their legs as continuously as possible within the first 24 hour period following treatment. As opposed to injection sclerotherapy, compression stockings are not usually considered necessary due to the smaller size of the veins treated with this procedure.
The treatment is usually performed in stages, spaced approximately 3 months apart, in order to achieve the maximum effect. With laser treatments, the effects can take up to several months to be fully evident.
Risks Associated with Spider Vein Removal:
While sclerotherapy is generally a simple and safe way to remove spider veins, all cosmetic medical procedures carry certain risks associated with that procedure. Some are general medical-related risks and some risks are specific to that procedure.
Risk factors increase for those patients who have certain health issues in their medical history. Other issues that might prohibit patients from undergoing the procedure can be related to blood issues, such as hepatitis, diabetes, heart problems and poor blood circulation.
Procedure specific complications are rare, but may include; allergic reactions (through fluid injections), inflammation, blood clots, increased vein visibility, minor scarring and uneven pigmentation. These complications can be effectively addressed by your doctor.
Procedure Costs:
Procedure costs for spider vein removal will vary, depending on several factors. However, the national average is approximately $500 - $1,000 for treating both legs. Things that will influence total costs are; the experience of the doctor performing the procedure, the type of procedure to be performed and the region (city/state) where the procedure will be performed.
It should be noted that the cost, mentioned here, will only cover the doctor’s fee. There are other miscellaneous charges (facility fee, after care products, medications, etc.) that you will need to discuss with your doctor during your consultation. Multiple treatments, of course, will incur additional expenses.
In some cases, medical insurance will cover procedure costs if there is pain associated with the condition. But this is rare (as opposed to varicose vein problems). Procedures that are performed for purely cosmetic reasons will not fall under this category.
Things to Discuss with Your Doctor During Your Consultation:
In order to make an informed decision regarding whether or not a procedure is right for you, you first need to have a consultation with your doctor. The various topics that you can discuss would include specifics about the procedure which would include;
- What type of procedure would be best suited for your needs (laser light or injection sclerotherapy)?
- Are the expected results realistic?
- What are the details of the procedure and how long does it take?
- What anesthesia is used and where will the procedure be performed?
- Is the facility accredited?
- What is the experience level of the doctor performing that particular technique (how many procedures has he or she performed in the past year)?
- What can be expected during the recovery period?
- What are the risks involved and what percentage of patients have experienced complications?
- How many treatments will be needed?
- What is the policy for corrections should the results not meet agreed upon goals?
- What are the total costs associated with the procedure(s) and (if needed) what are the financing options available?