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Half of all women suffer from blue varicose veins
and red spider veins on the legs. Unsightly veins cause many people
to avoid wearing shorts, skirts, or dresses. In fact, a recent survey
found that American women are more concerned about leg veins than
any other cosmetic problem. Fortunately, Drs. Laurie Massa and Kelly
Webb offer effective and safe therapy that can significantly diminish
the presence of undesired leg veins.
What causes spider veins
or varicose veins?
Unfortunately, genetic factors play the largest role. This is why
varicose veins tend to run in families. Pregnancy is associated
with the onset of varicose veins in half of all patients. A baby
places pressure on the deep veins that return blood from the legs
to the heart. This increases pressure in the surface veins of the
legs, causing varicose veins. Other factors include prolonged standing
or sitting, trauma, hormones, sun exposure, and, yes, crossing your
legs.
Although considered a cosmetic condition, some varicose
veins may pose a health risk. Many patients with varicose and spider
veins suffer from aching or burning in their legs. Some patients
with severe varicose veins suffer from chronic swelling in the legs,
which can eventually cause ulcers of the skin.
What types of treatment
are available for undesired leg veins?
The mainstays of treatment are sclerotherapy and laser therapy,
both of which are performed regularly in our office. The goal of
these treatments is to remove or destroy a defective vein so that
its function can be taken over by healthy veins. Some very large
varicose veins may require advanced procedures not currently available
at our office. “Ambulatory phlebectomy” and “radiofrequency
closure (e.g. VNUS)” are good choices for patients with disease
not amenable to sclerotherapy or laser treatment. Patients with
significant vein problems are often best served by a vascular surgeon.
What is sclerotherapy?
Invented in the 1930’s, sclerotherapy involves the injection
of a small amount of a “sclerosing” solution into unwanted
veins. This irritates the lining of the vein, which then gradually
narrows (“scleroses”) and becomes invisible. Patients
are usually surprised by the lack of significant pain, and pleased
with the rapid recovery time.
Sclerotherapy generally requires several treatment
sessions. One to three injection sessions are required to effectively
treat any vein, and 10-40 veins may be treated in one session. The
same area should not be retreated for 6-8 weeks to allow for complete
healing, although other areas may undergo treatment during this
time. Occasionally, diagnostic tests such as ultrasound may be recommended
to enhance the results of treatment.
Aren’t lasers
better than sclerotherapy?
Although lasers have revolutionized the removal of red facial spider
veins and other unwanted blemishes, they are not effective for the
treatment of blue and purple varicose veins. The diminished effectiveness
of lasers on blue leg veins is due to the higher degree of blood
flow through these veins, coupled with their deeper location. Lasers
can be effectively used following sclerotherapy to treat residual
tiny red blood vessels that are either too small for sclerotherapy
or that have failed to respond to previous injections. In other
words, laser therapy nicely compliments sclerotherapy but does not
replace it.
Does treatment hurt?
Both sclerotherapy and laser therapy cause little discomfort for
most patients. Patients rarely complain about the tiny needle itself,
but a few patients report a mild burning or cramping sensation associated
with the injection of the medication. This subsides after a few
minutes.
What can I do to help
maximize my results?
Regular exercise, such as walking, causes the calf muscles to function
as pumps - returning blood to the heart. This decreases swelling
and pressure in the legs, and thus reduces formation of new spider
veins. It also makes sclerotherapy more effective. After your treatment,
we will encourage you to walk.
We also strongly encourage patients to wear medical
compression stockings for several days following treatment. Compression
is necessary to give your body time to eliminate treated veins.
Support hose also prevent the formation of new spider veins. Elevating
your legs, weight control, and sun avoidance help as well.
What are the possible
complications of therapy?
Leg vein therapy is very safe, with little risk of serious complications.
However, minor side effects may occur in a few patients. Occasionally,
small clots can develop at the injection site. These are not a cause
for concern and may be removed to allow healing to progress. About
25% of patients experience a few areas of temporary brown/tan pigmentation
overlying treated veins. This discoloration may last several weeks
or even months before disappearing.
Rarely, the number of spider veins actually increases
following therapy. In these cases, the body’s healing process
is “too good” and replaces damaged leg veins with new
spider veins. Fortunately, this complication can usually be effectively
treated with laser therapy.
In very rare instances, ulceration and scar formation
may result. Allergic reactions to the sclerotherapy solution have
been reported in less than 1 in 1000 treated patients. These can
be effectively treated in a manner similar to bee stings by our
trained, certified staff.
Will my veins ever come back?
Individual treated veins rarely return, but you may develop new
spider veins in the future. Fortunately, these can be effectively
treated with touch-up procedures. Practicing preventative techniques
will also help you maintain your hard-earned gains.
No reputable physician can guarantee the elimination
of every unwanted vein, but most patients achieve a 70 - 90% improvement
and are very satisfied with their treatments. Leg vein treatment
is considered cosmetic and is not covered by insurance companies.
Payment is due at the time of scheduling.
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