Millions of
men and women are bothered by spider veins—those small, unsightly clusters of
red, blue, or purple veins that usually appear on the thighs, calves and ankles
and occasionally on the face. An estimated fifty percent of the adult female
population and fifteen to twenty percent of men share this cosmetic problem.
Spider veins are small,
thin capillaries that lie close to the surface of the skin. They are connected
to a larger venous system, though they are not an essential part of it since
they do not actually carry blood to the heart.
Many factors can
contribute to the development of spider veins, including:
pregnancy
weight gain
chronic sun exposure
activities that demand
prolonged standing or sitting
heredity
Spider veins form when
excess blood backs up in the blood stream. The excess blood creates pressure.
The body releases the pressure by creating new veins on the skin’s surface.
The primary problem with
spider veins is their unsightly appearance, but they can also cause aching,
swelling, burning and night cramps in legs.
Spider veins and varicose
veins are often lumped together, but they are actually very different
conditions. Varicose veins are caused by faulty valves in the venous system,
creating twisted and swollen veins. Varicose veins are larger, darker and tend
to bulge with a rope-like texture on the skin’s surface. Varicose veins are also
more likely to cause pain and be related to more serious vein disorders. In
contrast, spider veins are smaller and closer to the skin’s surface in a
branch-like or linear formation. Treatment of large varicose veins is outside
the realm of this practice and patients are referred to a vascular surgeon.
The techniques most used
to treat spider veins are Laser and/or Sclerotherapy. Spider veins on the face
can be treated with Laser. Small to medium sized leg veins are treated with
Laser and/or Sclerotherapy. Both are relatively simple procedures with high
success rates.
Laser therapy can
completely remove the spider veins. Studies have shown that 80 to 90 percent of
patients treated for spider veins are happy with the results. Laser and
Sclerotherapy cannot, however, prevent new spider veins from forming. To help
prevent future Spider and Varicose veins from reoccurring, we strongly recommend
the use of compression stockings.
Procedure The techniques most used to treat spider veins are Laser and/or
Sclerotherapy. Both are relatively simple procedures that have great success in
removing small to medium sized veins.
Laser is fast becoming the preferred treatment for spider veins on the face
or spider veins on the legs too small to warrant sclerotherapy. Laser treatments
are constantly evolving with faster and safer results. It sends a pulse of high
energy Laser Light — destroying the vein — without damaging the surrounding
skin. Dr. Pearsall uses the Smartepil II Laser by Cynosure.
During the treatment, you will feel a slight pinching or burning sensation as
the light energy touches your skin. The blood vessels in the spider vein absorb
the light energy, which causes the vein to coagulate, collapse, and in time
disappear.
Laser procedures are performed in the office by Dr. Pearsall. A pre-operative
topical anesthetic will be prescribe by Dr. Pearsall during your initial
consultation.
The amount of time required to perform Laser Therapy depends upon the number
and length of the spider veins. The standard Laser procedure can take fifteen
minutes to an hour. The severity of spider veins also determines how many laser
treatments you will need. Laser therapy can also be used in conjunction with
sclerotherapy to treat the larger veins which feed the smaller spider veins.
Sclerotherapy is the procedure most often used for removing spider veins.
This treatment is done on an outpatient basis in our office.
The process is fairly simple: The skin around the spider veins is cleaned
with an antiseptic solution. Then Dr. Pearsall pulls the skin tight around the
spider vein area while injecting a saltwater solution called a sclerosing agent
into the vein. The injected solution causes inflammation, which stops the blood
flow within the veins. When blood stops flowing, the veins collapse. The
collapsed vein wall seals itself and the vein is absorbed back into the
surrounding tissue.
Sclerotherapy requires no anesthetic; pain is minimal due to the thin needle
used and the mild sclerosing solution. The procedure takes fifteen minutes to an
hour or more, depending on the number and size of the spider veins being
treated. Anywhere from five to twenty injections are given per treatment
session, and it may take two to four sessions to rid the area of spider
veins—especially for patients with more extensive spider vein conditions.
Following the injections, the treated area is bandaged and covered with a
compression stocking, and the patient is sent home. The bandage can be removed
after five days. There may be slight itching for a day or two after the
treatment owing to a mild release of histamine from the treated blood vessels.
Candidate?
If you are in reasonably good health, you are an appropriate candidate for
sclerotherapy or Laser treatment to remove spider veins. Dr. Pearsall will
review the severity and scope of your condition and recommend a course of
action. Dr. Pearsall will also examine you to make sure that you do not have any
other conditions of the venous system that might be causing the spider veins.
For the treatment to be effective, you must address any underlying causes as
well as the spider veins themselves.
Typical patients are women between the ages of 30 and 60 though increasing
numbers of men are seeking treatment for spider veins.
Spider Vein Treatment: Preparing for treatment
Prior to treatment, your Dr. Pearsall will conduct a complete physical exam
to make sure that sclerotherapy or FPL treatment is an appropriate response to
your condition. Dr. Pearsall will be on the lookout for more serious ‘deep vein’
problems, which can often be detected by swelling, sores, or skin changes at the
ankle. You may also undergo an ultrasound test to detect any back flow of blood
within the venous system. If problems are found with larger veins, they must be
treated first by a vascular surgeon, or the spider vein treatment will be
probably be unsuccessful.
If you are scheduled for spider vein treatment:
Avoid alcohol a few days prior to treatment, as alcohol consumption decreases
your platelets count, which can lead to excessive bruising.
Shower or bathe the night before the procedure.
Wear loose-fitting garments if the treatment is being done on your legs.
With sclerotherapy, you may experience some pinching or burning sensations
during your treatments. You may feel the sclerotherapy needle, and the
sclerosing agent may cause the burning sensation. A typical sclerotherapy
session may involve anywhere from five to twenty injections, depending on the
severity of the problem and the size of the area being treated.
Laser treatments tend to be less painful, with only a brief pinching or
burning sensation when the laser touches the skin.
Following either of these procedures, you may experience:
itching
redness
swelling
bruising
These symptoms usually go away within a week or so. Your doctor may recommend
that you use an icepack to treat swelling.
Most patients are back to their normal activities the day after treatment
with very little pain.
Treated veins usually look worse before they look better. Bruising is common,
but it normally goes away within two weeks to a month. You may also experience
some discoloring of the treated area. This, too, should disappear in a few
weeks. You can minimize bruising by avoiding aspirin and alcohol for two weeks
after your last treatment session.
Recovery time is different for each patient. Some people heal faster than
others. Usually within one month, most patients are recovered enough to see the
results of the treatment, including faded veins or even the disappearance of
most of the spider veins.
During your recovery period, walking can help prevent any blood clots from
forming in the deep veins in your legs. Weight lifting, and other heavy pressure
exercises, like jogging or running, however, should be avoided during the
treatment and recovery periods.
Prolonged sitting or standing should be also avoided. With sclerotherapy, you
will be asked to wear a support stocking during recovery to compress the veins
and minimize bruising. Avoid exposing the treated area to direct sunlight until
it is fully healed and you get your doctor’s okay.
Your doctor will want to see you in a few weeks to examine the treated
area—and decide if more treatments are needed. You will have to wait one month
between treatments. Eventually, the spider veins will disappear completely,
although new spider veins can emerge at any time. You may find the need for
“touch-ups” in the future.
There are very few risks associated with the treatment of spider veins with
sclerotherapy and Laser therapy, but complications can occur.
Possible complications of sclerotherapy include scarring, blood clots, severe
inflammation, adverse reactions to the sclerosing solution and brownish-red
spots on the treated area.
Laser treatments can cause a change of skin color around the treated area,
which may take weeks to fade.
