Sclerotherapy is a minimally invasive medical procedure used to treat varicose and spider veins, most commonly found on the legs, by collapsing them through the use of a solvent. Sclerotherapy has been used on patients since the 1930s with great success, producing increasingly effective medical, as well as cosmetic, results. Call (805) 540-3333 today to learn more or to schedule a Sclerotherapy consultation with Dr. Ken Stevens!
What causes spider veins to form?
Dr. Stevens often has patients ask why they suddenly have these unsightly purple and blue veins on their legs. Here’s why.
Veins are the highways that return deoxygenated blood to the heart. In the legs, veins have to push uphill fighting gravity the entire way. Our muscles and tissues act to help push the blood through the veins, but as we age these tissues lose some of their strength, plus the vein walls and valves become weaker. This combination allows the blood to backup and pool. This pushes the vein wall outward, making the vein visible through the outer skin. This is how spider veins form.
Other factors that can affect the formation of these veins are heredity, hormonal changes such as those during pregnancy, weight fluctuations, and occupations that require long periods of standing or sitting.
Who is more at risk for developing spider veins?
Some people are more at risk for developing spider (and varicose) veins. Here are some risk factors:
- Pregnancy — Extra weight from the fetus and increased blood flow can lead to spider veins.
- Genetics — Around 90 percent of people with spider veins have a family history.
- Female — Women develop spider veins more often.
- Aging — Backflow valves weaken with age, as do our vein walls. Leg muscles don’t provide the same compression to help blood flow as they did in younger days.
- Obesity — The extra body weight can cause stress in blood flow. Increased blood pressure also can lead to pooling in leg veins.
- Sitting and standing — Sitting and standing for long periods of time forces veins to work hard to pump blood to the legs and back to the heart.
- Hormones — Estrogen changes in birth control and menopause can weaken valves in the leg veins.
Reasons for Sclerotherapy
Some of the reasons a patient may desire, or Dr Stevens may recommend, sclerotherapy may include one or more of the following symptoms:
- Pain, aching or burning sensations in the legs or feet
- Swelling or redness at the site
- Cramping of the legs, especially at night
- Scaly, dry or discolored skin at the site
- Discomfort after sitting or standing for long periods
Individuals troubled by varicose veins may choose, in consultation with Dr Stevens, to undergo sclerotherapy either because they find them unattractive or because the diseased veins are causing unpleasant and/or dangerous symptoms. Dr. Stevens and his staff have extensive experience with sclerotherapy, performing over 700 procedures to date with excellent results.
Sclerotherapy Before and After
Who is a good candidate for sclerotherapy?
There really aren’t any restrictions on who can have sclerotherapy to remove their spider veins. The procedure is simple and reactions to the sclerosants used are exceedingly rare.
Typical liquid sclerotherapy doesn’t work on varicose veins that push the skin upward. Varicose veins which are too large would require too much liquid sclerosant and thus ultrasound guided foam sclerotherapy is used instead.
The Sclerotherapy Procedure
During sclerotherapy, a sclerosant is injected into the damaged veins. Only FDA approved agents such as polidocanol and sodium tetradecyl sulfate are utilized in the practice. The sclerosant will cause irritation in the affected veins and produce their eventual collapse. During this procedure, Dr Stevens is guided through the use of ultrasound to ensure precision; sometime Veinlite guidance is utilized as well. When the weakened veins collapse, they will be reabsorbed into the body and other healthier veins will take their place in the circulatory system.
Sclerotherapy has proven to be a safe procedure and is performed outpatient in the office. Typically, sclerotherapy is performed in less than an hour, although a varying number of injections may be required, depending on the number of veins involved. Patients do not require an anesthetic and usually report little or no discomfort during the procedure, only a mild burning sensation. In some instances, several sclerotherapy treatments may be necessary. Sclerotherapy techniques include both liquid sclerotherapy and ultrasound guided foam sclerotherapy.
Recovery from Sclerotherapy
Patients are able to return home shortly after sclerotherapy. Most can return to work and resume normal activities the next day, although exercise and strenuous activities are to be avoided a week or two. Compression bandages usually need to be worn for a few days after the procedure per Dr. Stevens instructions. While it may take up to a month for the patient to see full results, some improvement is sometimes visible immediately.
In order to promote vascular health and to preserve the positive effects of the sclerotherapy, it is recommended that patients maintain a healthy weight and make exercise part of their daily routine, and use their support stockings as instructed.
What can I expect from my sclerotherapy results?
Immediately after injection, that portion of the vein visibly diminishes. The color will change from a dark blue or purple to light red, and the vein will resemble a slight cat scratch. Over the next 4-6 weeks, the body will absorb the closed-off vein and it will disappear. Sometimes a larger vein may need a second session, but most spider veins respond well to a single session with Dr. Stevens.
Are my results from sclerotherapy permanent?
Once the targeted clusters of spider veins are targeted and injected with the sclerosant, they close off and the body then gets down to the business of absorbing them. These veins are permanently closed off. They will not have blood routed through them again.
Of course, if you’ve developed spider veins, there’s nothing preventing the future development of new spider veins.
Is sclerotherapy painful?
Dr. Stevens uses a very tiny needle for these injections, and they do not need to be made to much depth because the targeted veins are near the surface of the skin. Because of that, topical numbing cream is not necessary. Patients describe the sensation of the injections to that of a pinprick.
WHAT ARE THE RISKS ASSOCIATED WITH SCLEROTHERAPY?
Although sclerotherapy is a safe procedure that has been successfully performed for many years, there are certain risks associated with any medical procedure. Certain minimal, temporary side effects are to be expected, including bruising and discoloration. More serious complications are rare, but may include:
Swelling, warmth and discomfort around the injection site may indicate the presence of an infection for which the doctor may prescribe antibiotics, or more often irritation or inflammation of the vein from the scleroscent; a quick ultrasound is often used to make the correct diagnosis
A lump of clotted blood may form in a treated vein and require drainage. Rarely, a deeper blood clot may develop, known as a deep vein thrombosis. Since there is danger that such a clot will break off and travel to the chest, resulting in a pulmonary embolism, such a clot requires urgent medical attention. Sudden shortness of breath, chest pain, dizziness or the coughing up of foamy blood are signs of pulmonary embolism and must be addressed immediately. Again, a quick ultrasound is used to establish the diagnosis
Allergy and Other Adverse Reactions
While rare, it's possible for a patient to have a severe allergic reaction to the sclerosant used in the treatment. Tiny air bubbles may rise in the bloodstream. These may not result in any symptoms, but if the patient experiences visual disturbances, headache, coughing or nausea, Dr Stevens should be contacted.
Numbness or odd sensations in the affected limb following sclerotherapy should always be investigated.
What can I do to help prevent new spider veins from forming?
It’s probably impossible to fully prevent spider veins from forming. It’s just a part of normal aging. But it does help to understand why they are forming and to try and make some lifestyle changes, if possible, to preclude future spider vein development.
Faulty, aging vein valves and weakening vein walls are why blood pools and forms spider and varicose veins on the legs. Anything you can do to keep the blood flowing through your legs will help.
Here are a few tips to do that:
- Exercise regularly
- Elevate your legs when sitting
- If you do need to sit (say at your desk) for long periods, get up and walk around a bit every 30 minutes
- If you have to stand for long periods, sit down every 30 minutes or so for a couple minutes
- Avoid soaking in hot baths for long periods of time
If you do have a job where you need to be on your feet, consider wearing compression hosiery. These socks or full pantyhose apply steady pressure to help move the blood back up to your heart. The steady pressure also lessens swelling in your lower legs and reduces the risk of developing a blood clot.