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May 24, 2006
Sclerotherapy: Spider Vein Treatment
by SirGan
 Spider veins are also known as broken capillaries. These are nothing more then tiny blood vessels no more than 2 mm in diameter that may appear on different places on the body such as face, legs and ankles. They are very easy to recognize because they look like some bluish, purple or red and often form web-like netting just below the skin’s surface. Spider veins are generally just an unattractive nuisance, although when they become large they can cause heaviness in the legs, night cramps and itching.Varicose veins represent a similar condition, although they represent the veins near the surface of the skin on the legs which have become permanently distended and filled with blood. The heart pumps blood to supply oxygen and nutrients to all parts of the body. Arteries carry blood from the heart towards the body parts, while veins carry blood from the body parts back to the heart. So, the fact is that veins have valves that are designed to prevent blood from flowing backwards due to gravity. When a valve malfunctions or vein walls weaken, blood collects in the vein, forcing it to bulge.
Causes of spider veinsA number of factors contribute to the development of spider veins, including:
Spider veins appear in both men and women, but more frequently in women. The fact is also that female hormones may play a role in their development. That’s why puberty, birth control pills, pregnancy, or hormone replacement therapy may contribute to them. They may also appear after an injury or as a result of wearing tight girdles held up with elastic bands. Varicose veins occur mainly from genetic susceptibility.
SymptomsSpider veins usually take on one of three basic patterns.
They may appear in a true spider shape with a group of veins radiating outward from a dark central point.
They may be arborizing and will resemble tiny branch-like shapes.
They may be simple linear and appear as thin separate lines. Linear spider veins are commonly seen on the inner knee, whereas the arborizing pattern often appears on the outer thigh in a sunburst or cartwheel distribution.
Although many people think that these two things are the same, varicose veins differ from spider veins in a number of ways. Varicose veins are larger, usually more than a 6-7milimetres in diameter, darker in color and tend to bulge. Varicose veins are also more likely to cause pain and be related to more serious vein disorders, while the spider veins are painless.
Treatment of spider and varicose veins – SCLEROTHERAPYSpider vein removal, or sclerotherapy, is a procedure designed to permanently remove those spider veins, leaving legs looking younger and healthier. This involves either delivering intense pulsed light to the veins, or through injections of a sclerosing solution that collapses these veins and causes them to fade away. Sclerotherapy as an injection therapy is one special, non-surgical, procedure in which a solution is injected into the varicose veins or spider veins in order to cause its disappearance. A variety of solutions are used to do sclerotherapy and the dosage is usually adjusted based on the size of the veins. What's so good about this- no surgical incisions are made and anesthesia is not necessary. When a problem vein is closed off via sclerotherapy, the blood will re-route through the normal veins and flow much more efficiently.
Benefits of sclerotherapyThere are many reasons why a person would want to have spider vein removal. The most common reasons:
Indications for the therapyThe statistical fact is that most women who undergo treatment are usually between the ages of 30 to 60. The fact is also that men can receive this treatment, but it is not much of a cosmetic problem because hair growth usually conceals the spider veins. If we would like to talk about possibly ideal candidate for spider vein removal, it would be a patient who would like to improve the appearance of legs. A person considering this procedure should have realistic goals and expectations.
There is one important thing that every pregnant woman should know- pregnant or breastfeeding women should consider holding off on treatments for spider veins through injection sclerotherapy. That’s because spider veins caused by pregnancy will naturally disappear on their own a few months after the baby is born.
The procedure
If there are several affected veins then the larger veins are usually treated first. During this procedure, a dosage of intense laser light energy is delivered to each vein in a series of long or short pulses. It is reasonable to assume that the blood vessels then absorb the light energy, which causes the blood within the vein to coagulate and close down the vein.
Patient should know that each treatment session lasts about 15 to 45 minutes depending on the condition of the veins. While stretching the skin to keep it tight, the doctor is injecting the sclerosing agent into the spider veins. This is usually done with a use of some magnification tool. The spider vein removal involves many injections, one for each inch of spider vein. Anywhere from five to 40 injections may occur during treatment.
Ultrasound guided sclerotherapyUltrasound guided sclerotherapy is one special method that uses ultrasound to locate the underlying leaking veins and then therapy is performed! The leakage could come from small 'perforating veins' that are usually below the knees, or main valves behind the knees or in the groin.
Indications for this type of sclerotherapy are:
Laser therapyAlthough not so many people know this, lasers have been used for more than twenty years. But even now, patients are often suspicious about all this. Wavelengths of light are absorbed by the hemoglobin in the blood vessels to destroy them. Many types of lasers are being used such as pulsed dye, long-pulsed, variable-pulsed Nd-YAG, and Alexandrite, as well as the non-laser intense pulsed light technique.
Expectations
Complete correction is not expected on the first treatment. Only about 50 to 70% of the treated vessels will be permanently gone. 3 to 4 treatments are generally required for optimal results.
Possible procedure complicationsPossible side effects of sclerotherapy include:
Prevention of spider and varicose veinsThere are several easy things you can do to help prevent varicose and spider veins and to relieve discomfort from the ones you have:
Alternative therapiesSome dermatologist are recommending a classical surgical approach to this problem, although it has been used very little these last couple of years! Some physicians bandage the injected areas and instruct patients to compress the treated vessels by wearing support hose. This may help seal the treated vessels, keep the blood from collecting under the skin, and reduce the development of dark spots. Others put tape dressings on the areas and do not use compression unless the veins are large or in special locations.
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