The sight of spider veins, which represent a network of tiny abnormal blood vessel on the skin surface, is never pleasant. These can be caused by various reasons ranging from heredity, pregnancy, trauma, obesity, or hormonal changes.Fortunately, today there are treatment options for spider veins, sclerotherapy being most widely available and used.
Sclerotherapy is undoubtedly the simplest and most effective medical procedure that has been used for the treatment of varicose and spider veins since the 1930s. It involves the injection of a solution directly into the vein, which irritates the blood vessel’s lining leading to its collapse and eventual resorption. Over a period, the vessel turns into a scar and begins to fade after a couple of weeks. However, it may take up to a couple of months for you to see full results.
Sclerotherapy involves injection of a sclerosant into the vein through a very fine needle, leading to minimal discomfort and almost immediate collapse of the vein. The procedure takes approximately 15-30 minutes, depending on the area requiring treatment. While the patient’s general medical condition certainly plays a role in deciding the number of veins that are injected in one session, it also depends on the veins’ location and size. Fortunately the newest sclerotherapy agents are extremely safe, FDA approved and have been used for decades.
The injection of the solution or sclerosant into the vein causes permanent damage to the internal lining of the vein wall. Subsequently, this triggers an inflammatory cascade, which results in the patient’s body realizing that the veins are no longer viable and the body slowly works to resorb the vein over the following weeks.
Sclerotherapy should be considered by anyone suffering mentally or physically by unsightly spider or varicose veins. Spider veins may at times be an early indicator of a larger underlying problem. If you have spider and varicose veins and also suffer from symptoms of leg pain, aching, cramping, restlessness, throbbing or swelling, you likely have underlying venous insufficiency. Venous insufficiency is an underlying valve problem in the veins which requires a diagnostic ultrasound for diagnosis. Anyone with symptoms in their legs along with visual changes of spider and varicose veins should seek medical attention by a vein specialist. Vein expert Dr. Vinay Madan at the Center for Varicose Veins will review your medical history and physical with you and discuss your treatment options. Patients with venous insufficiency may require additional forms of treatment including radiofrequency ablation, endovenous laser ablation or Venaseal. These form of treatment will resolve the larger underlying venous problems and relief of leg symptoms.
Various studies carried out to determine the efficacy of sclerotherapy have revealed that each session of this procedure results in the elimination of 50%-80% of injected veins. The percentage of people who do not respond to the therapy at all is less than 10%. Sclerotherapy represents a safe and effective form of treatment of spider and varicose veins.
Spider veins generally respond to treatment within a few weeks. Larger veins take about three to four months to respond. While veins that respond to treatment don’t reappear, the appearance of new veins over time may require additional treatments in the future. Usually, a follow-up visit with the doctor is scheduled a month after the procedure to get a measure of its success. Depending on the outcome, further sessions are conducted as needed.
Now we know sclerotherapy is effective in treating spider veins but are there any risks to the procedure? There are only minimal risks related to sclerotherapy. All the risks are very uncommon, including allergies to the medication and extremely rare risk of deep venous thrombosis. You should discuss any history of allergies and prior clotting disorders with your vein expert prior to having sclerotherapy. There is usually mild bruising with the procedure which resolves over the following week or two. There is also an uncommon risk of cutaneous necrosis, which represents a small area of dead skin from the injection. This complication is also very rare and usually can be avoided with good injection technique. Cutaneous necrosis usually resolves with no sequelae, with more severe cases possibly leaving a small area of scarring.
If you would like to know if sclerotherapy is right for you, visit the Center for Varicose Veins in Wilton, CT and make an appointment with Dr. Vinay Madan. Dr. Madan is a board certified Interventional Radiologist and Phlebologist with over 25 years of experience treating vein disease. Dr. Madan will review you medical history and perform a thorough exam to determine if you are a good candidate for sclerotherapy.
