FAQ: SCLEROTHERAPY
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What causes these blood vessels to become visible?
The cause of spider veins is not known. In many cases they seem to run in families. Identical twins may be affected in the same area of body and to the same extent. The condition can also occur as part of a large number of diseases.
Spider veins are found in both men and women, but appear more frequently in women. The hormones estrogen and progesterone may play a role in their development. Puberty, birth control pills, pregnancy, or hormone replacement therapy often seem to bring them on. They may also appear after injury or as a result of wearing tight girdles or hosiery held up with tight rubber bands. Spider veins may also occur along with large varicose veins.
Spider veins that tend to occur on the nose or checks of fair skinned persons may be related to sun exposure.
Can spider veins be prevented?
Spider veins can't always be prevented. Wearing support hose may prevent some unwanted blood vessels from developing in some people. Keeping one's weight at a normal level and exercising regularly may also be helpful. Eating a high-fiber diet and wearing low-heeled shoes can also help. Sun protection is important to limit the number of unwanted vessels on the face.
How are unwanted blood vessels on the legs treated?
In the majority of cases, a procedure called sclerotherapy is used to treat unwanted blood vessels. A solution, called a sclerosing solution, is injected with a very fine needle directly into the blood vessel. This procedure has been used for spider veins since the 1932 and, before that, for larger veins. The solution irritates the lining of the vessel, causing it to swell and stick together and the blood to clot.
Over a period of weeks, the vessel turns into scar tissue that fades, eventually becoming barely noticeable or invisible.
A single blood vessel may have to be injected more than once, some weeks apart, depending on its size. In any one treatment session, a number of vessels can be injected.
The solutions are slightly different depending on the size of the vessel to be injected. Your dermatologist will decide the solution that is best for your particular case.
Occasionally larger varicose veins are underneath the spider veins. In such cases, some physicians believe these vessels should be treated before the spider veins. This can be done by sclerotherapy, followed by compression or by a procedure performed by a vascular surgeon. Other physicians believe that spider veins may be treated by sclerotherapy without worrying about the varicose veins unless they become troublesome.
How successful is sclerotherapy?
After several treatments, most patients can expect a 50 to 90 percent improvement. However, the fading process is gradual. Total disappearance of spider veins is usually achieved.
Can sclerotherapy be used on all skin types?
Yes. All skin types and skin colors respond equally well.
Will insurance cover the treatment of unwanted blood vessels?
Insurance coverage varies. If the treatment is solely for cosmetic reasons, it may not be covered. Sometimes a second opinion, laboratory studies, or photographs are required by insurance companies before treatment is started.
Are there side effects to sclerotherapy?
Even with a highly experienced physician performing the treatment, there are some possible side effects. These include stinging or pain at the sites of injection, swelling of the ankles or feet, or muscle cramps. Muscle cramps almost always occur when the injection takes place in the ankle area. All of these usually go away within 10 to 15 minutes after an injection.
Any red, raised areas at the sites of injection should disappear within a day or so.
If brown lines or spots on the skin occur at the sites of treated blood vessels, they are probably made up of a form of iron stored in the blood. These darkened areas may result when blood escapes from treated veins, and occur more often in patients who have larger veins treated. In most cases, they disappear within a year, but in a small percent of patients they may last for years.
About a third of the patients develop groups of fine red blood vessels near the sites of injection of larger vessels, especially on the thighs. Most disappear by themselves, some go away with injection treatment or laser therapy, and a few may last.
Sometimes small, painful ulcers occur at treatment sites either immediately or within a few days of injection. This results when some of the solution escapes into the surrounding skin. These can be successfully treated, but it is necessary to inform the physician of them immediately.
Bruises at the site where the needle went into the skin are also possible, but will disappear within a few weeks, and are probably related to the thinness of the blood vessels' walls.
Allergic reactions to certain sclerosing solutions may occur. On rare occasions, such reactions may be serious, and can be treated by immediate injections of epinephrine. Less serious reactions are treated with antihistamines.
Inflammation of the treated blood vessels is very unusual, but, when it occurs, is treated with medications such as aspirin, compression, antibiotics or heat.
Will treated veins recur?
Larger veins are likely to recur unless support hose are worn; spider veins may also recur. It is possible for a previously injected to vessel to appear as though it has recurred, when, in fact, a new spider vein has appeared in the same area.
Is a history of blood clots in the lungs or legs a reason to avoid therapy?
Not necessarily, but the procedure must be done with caution to lessen the risk of blood clots.
What do I do after treatments?
Physicians may differ in their after-treatment instructions to patients. Depending on certain factors, such as the size of the blood vessels injected, patients may be instructed to put their legs up for an hour or two and then walk. Others are asked to walk immediately. All patients are instructed to walk a good deal in the days following the procedure so that the blood will be pushed through other vessels.
Some physicians bandage the injected areas and instruct patients to 'compress' the treated vessels, keeping the blood from collecting under the skin, and reducing the development of dark spots. It may also reduce the number of treatments necessary, and the possibility of recurrence. Others put tape dressings on the areas and do not use compression unless the veins are large or have certain other characteristics.
Between treatments, many physicians recommend the use of compression or support hose. This may be particularly recommended for people who spend a lot of time on their feet.
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For more information, give us a call at (281) 597-1010 or send us email.
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