Click on a question below to view the answer:
The gold standard of eliminating spider and varicose veins in the legs.
Spider Vein Treatments: two types of treatments exist, and we perform both. Sclerotherapy, the gold standard of treatments, involves injecting veins with a safe solution that causes the body to absorb the vein without harming the rest of your body. The success of the treatments is dependent on many factors, including the solution used, the technique of the physician, the general health of the patient, and the anatomy of the particular vein. Tiny needles are used, and complications are extremely unusual. The treatment involves no significant limitations or downtime, and the patient may go immediately back to work following their appointment.
Spider veins are small dilated veins in the skin. When these veins become larger and protrude, they are called varicose veins. They are common in both women and men, and are principally genetically determined. The gold standard of eliminating spider and varicose veins in the legs continues to be sclerotherapy, or injection therapy. As this is a medical procedure, it is important that an experienced practitioner, known as a phlebologist, perform that sclerotherapy, to assure ideal results. Basically, the injected solution locally injures the dilated veins, causing the body to absorb the vein over a period of weeks to months. By directly injuring the underlying leaking feeder veins, sclerotherapy effectively reduces the later appearance of new spider and varicose veins. Through meticulous attention to detail, we are able to deliver the art and science of sclerotherapy to eliminate even the largest varicose veins that previously were treated only by surgery.
Laser Therapy is effective in select cases – the proper laser must be used, and the feeder veins supplying the treated veins need to have properly treated prior to laser therapy in order for the laser to be effective. Our laser is particularly effective on facial spider veins (telangiectasiae), and no general anesthesia is required nor is bruising produced.
Laser therapy, while variably effective in eliminating leg veins, should only be used selectively by an experienced practitioner well trained in vein therapies. Laser therapy only treats the target vein, and does not treat the underlying feeder veins causing the problem.
Spider veins on the face are much more responsive to light based treatments, including laser and intense pulsed light therapies. Elos technology very effectively treats and eliminates dilated capillaries on the face by combining light energy with radio-frequency energy, thereby eliminating dilated vessels as well as brown discoloration (“age spots”).
While much has been written about lasers for the treatment of varicose and spider veins, sclerotherapy (vein injections) continues to remain the gold standard for eliminating spider veins (telangiectasiae) and smaller varicose leg veins.
Proper sclerotherapy must be performed by an experienced health care provider for excellent results to be reliably obtained. Gently and accurately injecting the unwanted veins with a sclerosing solution causes the target vein to immediately shrink, and then dissolve over a period of weeks as the body naturally absorbs the treated vein. Because the sclerosant is injected directly into the vein, there is no damage to the surrounding skin as can be experienced during laser therapy. Unlike a laser, the sclerosing solution additionally closes the “feeder veins” under the skin that are causing the spider veins to form, thereby preventing a recurrence of the spider veins at the treated sight.
Many patients suffering with spider veins and varicose veins of the legs report associated uncomfortable symptoms such as fatigue, burning, heaviness, restlessness, cramping, and pain. Commonly, these symptoms improve dramatically from one set of injections, frequently within 24-48 hours. While the aesthetic improvements take a few weeks to progress, the painful symptoms resolve much faster. Generally, a series of treatments are required to eliminate leg veins – a typical treatment regimen would include 3-5 30-minute sessions, each 2 weeks apart. A consultation with our physician will be required to provide an accurate assessment of your individual condition. At that time, you will be given an estimate of the number of sessions you will require.
Always check the credentials of the doctor you plan to visit.
Select a facility that specializes in phlebology (vein disorders). There are many facilities that claim to treat veins, but they do not have specialized training in phlebology. Avoid medical spas that offer vein treatments or other specialists that do occasional vein work to supplement their practice, make sure your doctor is a member of the American College of Phlebology.
The American Board of Phlebology
The American College of Phlebology is an organization dedicated to the diagnosis and treatment of vein disorders, including cosmetic and the more serious disorders; such as phlebitis and ulceration.
The top credential a doctor can receive is becoming board certified. A doctor who achieves board certification has demonstrated extensive training and experience in the field. The facility must provide a color flow duplex ultrasound that is mandatory for accurate diagnosis of vein disease. Many times, a simple appearing superficial vein can be caused by an uderlying deeper vein. An ultrasound is needed for accurate diagnosis and appropriate treatment.
At California Vein Specialist, we use an ultrasound to diagnosis, treat, and later confirm the proper closure of vein that has occurred.
If I have had large vessels such as the saphenous closed, is there chance of circulatory problems later on?
Endovenous laser ablation is minimally invasive and very safe. The worst complication would be a blood clot in the leg. This is very rare complication compared to any surgical procedure. In answer to your second question, if the larger saphenous vein is refluxing, or non functioning, the blood has already by- passed that vein. So when you close it off, it will actually make your leg health improve and help preserve the normal veins. The long term venous health will improve if the vein is ablated, but if untreated, will only become worse.
Mapping of a vein is done prior to any EVLT procedure. Ultrasound is done prior to even minor procedures such as sclerotherapy. This eliminates the possibility of missing an important refluxing vein. The EVLT procedure is done entirely under ultrasound guidance.
What is EVLT?
EVLT stands for endovenous laser treatment. It is an effective method for getting rid of varicose veins, a condition caused when vein valves do not close correctly, thereby allowing blood to pool in the affected area. Veins begin to bulge as blood pushes against the vein walls. The result is painful, causing legs to ache and swell. In worse case scenarios, varicose veins can lead to unnecessary bleeding and eczemaor ulceration.
Foam sclerotherapy is a good alternative to EVLT, but I find that the laser ablation is more complete. Over ninety nine percent closure rate. I also find it to be less painful then foam procedures, especially when using the newer laser frequencies such as the 1470. Nerve injury would be a very rare complication from the EVLT. The only nerve injury we have ever encountered is a temporary superficial numbness. This usually resolves in a few weeks and again is very rare. I find the laser the best way to close the large saphenous vein, and the foam procedures are best to close the connecting trunk veins. So a combination of the two procedures is ideal. This avoids all surgery.