Treatment of Veins (Sclerotherapy)
WHAT ARE SPIDER AND VARICOSE VEINS?Spider veins are formed by the dilation of a small group of blood vessels located close to the surface of the skin. Spider veins are most commonly found on the face and legs and look like a red or purple sunburst pattern. Spider veins pose no health hazard but may produce a dull aching in the legs after prolonged standing.
Varicose veins are enlarged blood vessels caused by the weakening of the veins wall or valves. The valves help push the blood back up to the heart. In certain cases, when these valves weaken, there is pooling of the blood in these bigger vessels. Varicose veins are located deeper than spider veins and often look blue.
The exact cause of spider and varicose veins is unknown. Hereditary disposition, pregnancy, and hormonal changes are believed to be contributing factors. As people age, these unsightly veins become more common and are often more pronounced. Forty-one percent of women forty to fifty years of age have varicose veins. This increases to seventy-two percent in women sixty to seventy years of age.
WHAT IS SCLEROTHERAPY?
Sclerotherapy is a technique used to treat varicose veins and spider veins by injecting the vein with an agent called a sclerosant. The sclerosant affects the vein lining, causing its destruction. The sclerosant is injected with a very small needle into the spider or varicose vein. The vein hardens and is absorbed by the body. The work of carrying the blood is shifted to other healthy blood vessels nearby.
Sclerotherapy generally requires multiple treatment sessions. One to three injection sessions are usually required to effectively treat any vein. The same area should not be retreated for approximately six weeks to allow for complete healing. Other areas may undergo treatment during this time. A patient's tolerance to pain varies. Some find the procedure painless while others report a stinging sensation upon injection of the sclerosant.
Post-therapy treatment includes wearing compression support hose for three days for small veins and one to three weeks for larger veins. Walking may help speed the recovery. The treated blood vessel generally disappears over a period of six months. Sclerotherapy works for existing spider veins, it does not prevent new ones from developing.
WHAT OTHER TREATMENT OPTIONS ARE AVAILABLE FOR SPIDER AND VARICOSE VEINS?
Larger varicose veins may not respond to sclerotherapy alone. The physician determines whether the valves are working effectively in the groin area. If the valves are not working properly in the groin area then referral to a vascular surgeon for a procedure called surgical ligation may be necessary.
Vbeam laser surgery and Nd Yag laser are two relatively new approaches to leg veins. These approaches may be effective for extremely small blood vessels that may not be treated with a needle because of their small size. The laser beam selectively destroys the abnormal veins.
WHO HAS QUALIFICATIONS FOR TREATMENT OF SPIDER AND VARICOSE VEINS?
Dermatologic surgeons have extensive training and experience in the diagnosis and treatment of venous disorders. Dr. Cox received training in sclerotherapy both in her residency program in dermatology and then sought additional expertise studying with a surgeon in Michigan. Additionally, she has received training in the use of a Doppler ultrasound for evaluating venous disorders.
WHAT DOES SCLEROTHERAPY COST AND WILL INSURANCE PAY FOR IT?
The cost of sclerotherapy is related to the amount of time that a physician spends treating veins. Insurance may cover sclerotherapy when it is done for medical reasons, for example, when the vein condition is causing pain. Prior to initiating treatment, check with your insurance company to see whether sclerotherapy will be covered in your case.
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