Sclerotherapy (Vein Removal)

Everyone wants perfect, smooth and blemish-free legs. However, sometimes there are these pesky veins ruining perfection. What are these things? How did I get them? And more importantly, how do I get rid of them?

What Are Spider Veins?

Spider veins, (called telangiectasia veins by medical professionals) can be caused by weak or damaged valves in the veins. Veins have valves that act as one-way flaps to prevent blood from flowing backwards as it moves up your legs. If the valves become weak, blood can leak back into the veins and collect there. Backed-up blood makes the veins larger, causing spider veins.

How Did I Get Spider Veins?

There are a number of causes for spider veins. Studies show that there is a strong correlation between family occurrences on the maternal side, suggesting a sex-linked inherited pattern. Pregnancy is the second leading cause for predisposing a woman to developing spider veins. These veins may occur early in the first trimester of pregnancy.

The final major cause for developing spider veins is jobs that require you to be standing for about 6 hours per day. Other causes can include oral contraceptive usage, obesity, wearing tight clothing, prolonged sitting in chairs, sitting with one leg crossed over the other, trauma to the area, excessive sun exposure, and chronic increased intraabdominal pressure, that is the fancy way of saying constipation.

How Do I Get Rid Of Spider Veins?

The most common way of eliminating spider veins is by injecting a solution, called a sclerosing agent, into the veins. The purpose of injecting the veins is to cause the formation of fibrous tissue in the vein, causing an inflammatory reaction. As the inflammatory reaction dissipates, the veins collapse and dissolve. The treated vein will gradually fade over a period of several weeks to several months.

Will Sclerotherapy Treatment Work For Me?

Most people treated will have a good result; however there are always those people who don’t conform. Approximately 10% of patients who undergo sclerotherapy have poor to fair results. A definition of a poor result is if the veins have not totally disappeared after 6 treatments. In very rare instances, some people’s veins become worse after treatment.

How Many Times Do I Need To Be Treated?

The number of treatments differs from patient to patient, depending on the extent of spider veins present. One to six or more treatments may be needed; the average is three to six. Individual veins usually require one to three treatments.

What Are The Most Common Side Effects?

Bruising: This can last for one to several weeks. Use of support hose may be recommended and the avoidance of alcohol and anticoagulant medications (aspirin, Motrin, Aleve, high dose Vitamin E) for 72 hours prior to each treatment session may help minimize bruising.

Transient Hyperpigmentation: Approximately 30% of patients who undergo sclerotherapy notice a discoloration of light brown streaks after treatment. In almost every patient, the veins become darker immediately after the procedure (but then go away). In rare instances, this darkening of the vein may persist for four to twenty months.

Pain: A few patients may experience mild pain at the site of the injection. The veins may be tender to the touch after treatment. This pain is usually temporary, in most cases lasting from 1-7 days at most.

Blood accumulation in treated vessel: This may present as a tender bump at a treatment site, especially when treating larger veins. The use of compression hosiery will minimize this possibility.

Other side effects include a burning sensation during injection of some solutions and the development, usually temporary, of new tiny blood vessels; transient swelling of the vein might cause the ankles to swell, temporary superficial blebs or wheals (similar to hives); and, very rarely, ulcers, wound infection, poor healing and scarring.

Can Anyone Be Treated With Sclerotherapy?

There are a few medical conditions that make Sclerotherapy not a treatment option. They are as follows:

1. Pregnancy or Nursing (May start sclerotherapy 6 months after childbirth)
2. Advanced Collagen Vascular Disease/Autoimmune Disorders
3. Rheumatoid Arthritis/Crippling Osteoarthritis
4. Acute Deep Venous Thrombophlebitis (DVT)
5. Acute febrile illness
6. Anticoagulant therapy
7. Severe Bronchial Asthma (how bad, last episode, last hospitalization?)
8. Insulin-Dependant Diabetes Mellitus (IDDM)
9. Corticosteroid use
10. Hyper-keloid Formation
11. Severe Circulatory problems (ex. Cellulitis)
12. Diseases which severely interfere with mobility

I Am Ready For Sclerotherapy. What Do I Need To Do Before The Treatment?

There are a few things you can do to make your treatment easier and ensure that you have the best results you can.

It is very important that you do not take Aspirin or other blood thinning drugs (e.g. Vitamin E, Fish Oil, and Gingko Biloba), ibuprofen, or other non-steroidal inflammatory drugs (e.g. arthritis medicine) for 2 days after your treatment because these medications can increase bruising.

If you take birth control pills or estrogen, inform the sclerotherapist about it. These medications can increase your risk for forming blood clots, and you may be asked to stop taking them before the treatment. (Please remember to use an alternative method of birth control during this time.)

We recommend not to drink alcoholic beverages and not to smoke for 2 days before and 2 days after your treatment because drinking alcohol and smoking may impair healing.

Do not apply cream, lotion, oil, or self-tanners to your legs the night before or the day of your treatment.

Eat a light meal or snack 1 ½ hours before your appointment.

Bring loose fitting shorts or a leotard to wear during the treatment and a long skirt or long loose fitting slacks to wear after treatment. It is also a good idea to bring support hose if there will be a number of veins to be treated.

It is advised when having treatment of larger veins to postpone flying for 48 hours.

If you develop fever or flu or other illness before your appointment you must reschedule.

Is There Anything Special I Need To Do After Sclerotherapy?

The majority of the instructions for after sclerotherapy are to prevent blood from being forced back through the treated veins. The longer the sclerosing solution remains in the vein, the better the result!

Immediately after the procedure, you may be required to put on support hose and walk for 10-30 minutes. Be sure to have loose-fitting slacks/skirt and comfortable walking shoes with you.

Taped compression pads/cotton balls are gently removed twenty-four to forty eight hours after sclerotherapy procedure. If you notice a developing allergy (rash/redness) to the tape, remove tape and put on support stocking.

If you remove the tape prior to the twenty-four hours, try and wear support hose (you may use a Spanx-style if sclerotherapy was not performed at ankles).

Maintain normal activities. You are encouraged to walk as much as possible and avoid standing in a single position for prolonged periods of time.

Avoid strenuous physical activities such as high-impact aerobics, running, weight-lifting, for the first 48-72 hours following your treatment.

Avoid hot baths for 2 weeks. Cool your legs with cold water after each shower.

Avoid Sunbathing and Ultraviolet Exposure (nasty tanning beds!!) for at least 1 week.

Avoid blood-thinning medications, such as Aspirin and other non-steroidal anti-inflammatory drugs, (e.g. Ibuprofen, Motrin, Advil, etc.) for 24-48 hours following your treatment.

Should you experience any redness or a small lump use warm compresses several times a day. If you experience any open area(s) you may use Bactrian Ointment (NOT Neosporin) to the affected area along with the warm compresses.