Introduction
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 sclerotherapy and/or Fluorescent Pulsed Light Therapy (FPL). Spider veins on the face can be treated with FPL. Leg spider veins are treated with sclerotherapy and/or FPL. Both are relatively simple procedures with high success rates.

Both sclerotherapy and FPL therapy can completely remove the spider veins, although FPL therapy is effective on smaller areas or less extensive cases of spidering. Studies have shown that 80 to 90 percent of patients treated for spider veins are happy with the results. Sclerotherapy and FPL therapy cannot, however, prevent new spider veins from forming. If new spider veins appear, you may need to repeat the procedure.

TO FIND A VARICOSE VEIN OR SPIDER VEIN CENTER NEAR YOU, VISIT VEINSonline.com.

Procedure
The techniques most used to treat spider veins are sclerotherapy and/or FPL therapy. Both are relatively simple procedures that have great success in removing spider veins.

Sclerotherapy
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.

Fluorescent Pulsed Light (FPL) Therapy
FPL is fast becoming the preferred treatment for spider veins on the face or spider veins on the legs too small to warrant sclerotherapy. FPL  treatments are constantly evolving with faster and safer results. FPL is afiltered flash lamp systems. It sends a rapidly pulsating light beam to the spider vein with great accuracy—-destroying the vein--without damaging the surrounding skin. Dr. Pearsall will use the Prolite FPL System, the newest and most advanced pulsed light system.

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.

FPL procedures are performed in the office. No anesthesia or bandages are needed.  Only the compression stocking will be applied.

The standard FPL procedure can take fifteen minutes to an hour, depending on the extent of spider veins being treated. The severity of spider veins also determines how many laser treatments you will need. Laser therapy can also be used in conjuction with sclerotherapy to treat larger spider veins.

Candidate?
If you are in reasonably good health, you are an appropriate candidate for sclerotherapy or FPL 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 both sclerotherapy and FPL treatments, 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 FPL 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. 

FPL treatments can cause a change of skin color around the treated area, which may take weeks to fade. It is also possible that your veins will not respond to the FPL treatment at all.

TO FIND A VARICOSE VEIN OR SPIDER VEIN CENTER NEAR YOU, VISIT VEINSonline.com.