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Spider veins are due to heredity, hormones, and are associated with pregnancy and menstruation. Spider veins can be very symptomatic as well as the accompanying reticular veins,(also referred to as feeder veins) found deeper in the skin. Patients experience symptoms such as itching, burning and pain. Many women have a combination of both varicose and spider veins. While they may seek treatment for cosmetic improvement, many female patients are in fact looking for relief from pain.
Does vein disease affect women and men equally?
Women account for approximately 85-90% of varicose vein cases, mainly because of the unique additional risk factors for females, including estrogen levels and pregnancy. While pregnancy contributes to the high incidence of large varicose vein disease women are particularly afflicted with spider veins. These light blue veins usually appear in a lattice framework. They are the most harmless looking veins, but they are usually the most symptomatic of all. Spider veins are infrequent with men but men do have large varicose vein issues.
What should I look for in a vein therapy physician?
Experience matters. Varicose vein disease can be very complex and each patient is unique. Therefore, it’s important to find a physician experienced in treating the entire spectrum of vein disease from spider veins, to large ropey varicose veins to leg ulcers.
At Vein Centers of America, we have been successfully treating vein disorders without surgery for over 15 years. We are dedicated to making patients feel at ease throughout the process. We will thoroughly evaluate your condition, discuss the details of your situation so you feel comfortable and present you with a course of action that works best for you.
What is sclerotherapy?
Sclerotherapy is a microinjection procedure that requires no pain medication or surgery. Abnormal veins are destroyed by injecting a solution called a sclerosant, which irritates and destroys the vein wall. It is not simply injecting the sclerosant, but paying attention to the volume, concentration and “exposure time” that makes the difference between success and failure
How does the sclerosant work exactly?
The sclerosant we use is an FDA-approved medication, sodium tetradecylsulphate. It is a detergent like chemical which intentionally causes injury to the inner vein wall by precipitating the protein in the vein wall thus causing it to collapse and heal shut. This injury occurs in a controlled manner, depending on the volume and concentration of the medication used in each site. The medication is inactivated quickly by dilutional effect and interaction with structural components of the vein wall, making the effect localized. It has no systemic effect. The initial injury to the vein wall results in a healing process which causes the vein to literally heal shut over time. This results in shrinkage of the vein, and eventually, complete obliteration of the target vein as the body absorbs the injured vein.
How long does vein treatment take?
Sclerotherapy treatments takes approximate 6-8 weeks for the healing to occur. Each vein treatment session takes about 30 minutes.
How many vein treatments am I going to need?
This will be determined at your consultation with the Doctor. It will depend on the severity of the disease. The large veins are usually successfully treated at the first treatment visit. Small vein disease will require multiple visits.
How frequent will my vein treatments be?
Dr. Karlin or the PA usually sees small vein disorder patients on a weekly basis.
Does sclerotherapy cause any damage or side effects?
As with all medical procedures, side effects and complications are possible. This is why it is important to seek treatment from an experienced physician. Allergic reactions are extremely rare and mild such as a rash when they do occur. They are somewhat more likely to occur when treating larger varicose veins because the medicine is more concentrated and used in greater volumes.
A mild, temporary increase in pigmentation (staining of the skin) may occur if you have any of the following: darker skin, overly sensitive skin, very dense spider veins, or if your skin is already damaged because your veins have deteriorated too much.
Sometimes when the vein is collapsed pockets of blood may be trapped in the injured vein (trapped blood). Trapped blood can cause a little discomfort and is treated by gently removing it with a syringe.
Rarely some of the sclerosant may escape from the vein wall and cause a slight burn injury to the skin which can heal with a chicken pox like scar.
How will my blood circulate if I eliminate my varicose veins?
Varicose veins are a burden on your circulation. Because the blood inside them
is refluxing (going backwards) and pooling, correcting the flow can only improve
your circulation. In treating varicose veins, we eliminate only the bad veins
and safeguard the healthy veins for normal circulation. Ultrasound helps to
ensure that treatment is highly selective.
Just how serious a problem is recurrence?
Sclerotherapy is not a curative process because vein disease is progressive. Patients will require maintenance vein therapy treatment in the future in order to keep their results. The severity of the initial disease is a good indication of how frequently maintenance may be required.
Is it okay to postpone vein therapy treatment?
As you probably know, postponing any type of treatment can have its drawbacks. Varicose vein disease is a progressive disease that, if left untreated, will only get worse. Vein therapy treatment is meant to prevent the potential complication of large vein disease such as bleeding, phlebitis and skin ulcers. When making a decision about your varicose veins, keep in mind that the sooner you get your veins treated, the easier they are to treat and control.
What about treating other parts of the body affected by veins?
At Vein Centers of America we treat not only the veins in our patient’s legs but anywhere on the body. The veins around the eye are especially bothersome to many patients as are unsightly enlarged veins on hands which make patients look older than they are. Breast veins often get enlarged after breast augmentation surgery and are easily treated.
Will I need to be hospitalized or take time off from work after my vein treatments?
Vein therapy treatment is on an outpatient basis during convenient office visits. You can resume most activities shortly after each session. In fact brisk daily walking of 45 minutes in duration is a required part of the treatment.
What happens during the initial physician consultation?
When you come to Vein Centers of America, you will complete a patient medical history form. Your legs will be examined and the blood flow will be evaluated with a non-invasive Doppler, and an individualized vein therapy treatment plan will be developed for you. If a condition other than a vein disorder is identified, you will be referred to the appropriate physician.
Will I have to undergo any testing before vein treatment?
Dr. Karlin may recommend diagnostic tests, including Arterial Doppler, Continuous Wave Doppler and Duplex Ultrasound. This state-of-the-art technology provides painless and non-invasive testing, and is performed in the physician's office.
How does Duplex Ultrasound help the treatment of my spider or varicose veins?
Duplex Ultrasound is a non-invasive, non-painful test which works by sound waves (like a Doppler) and allows Dr. Karlin to visualize the vein system and identify any abnormalities and (leaks) in the system. It allows the vein system to be mapped out. The Ultrasound is used during treatment to show Dr. Karlin where to inject the sclerosant or EVLT laser and as follow up to ascertain the success of the treatment.
What will happen on my first visit to Vein Centers of America?
Doctor Karlin will review your medical history and examine your legs to determine the types of veins you have. Your first vein therapy injections, if you wish to have a treatment, will then be given by the physician at Vein Centers of America.
Which veins can be injected using vein therapy?
The small "spider veins" and most non-bulging and bulging "blue" veins can be treated with injections.
What is the solution injected this vein treatment?
The solution injected during this vein treatment is called Sotradecol. Sotradecol was developed in Europe and has been in use for many years. However, the solution has been diluted so as not to produce any unwanted side effects on the surrounding skin. In our extensive experience we have seen no systemic effects. We do not use saline solution because it is painful and less effective.
How does the solution work using this vein treatment?
The solution is injected directly into the veins with one of the smallest needles available. As solution enters the veins it temporarily displaces the blood and causes a gentle irritation to the inner lining of the vein. The blood returns into the injected area and becomes trapped in the injected veins. The body then gradually absorbs the trapped blood and veins themselves.
Is the solution used safe for pregnant women?
For our Vein Centers of America patients who are pregnant we can use a different solution during this vein treatment which is safe for both the mother and baby.
Will the veins disappear immediately after this vein treatment?
No. This is the most important fact in understanding your vein treatment. The healing process begins as soon as the solution is injected. However, in the beginning the healing process is microscopic and is not visible to the naked eye.
When will I be able to see any changes?
Approximately 2-3 weeks after your first injection you will begin to see a change in color from a deep blue or purple to pink. The pink color will gradually fade until the veins become invisible. The length of time varies greatly between patients and the size of veins and may take up to 8-12 weeks. Some veins may need an extra "touch-up" several weeks after the first injections.
Will the veins return after vein treatment?
No. The veins that have been injected during vein treatment will not return. However, since the tendency to have varicose veins is inherited it is very likely that you will develop other veins in the future. Usually one or two visits every year or so will keep the veins under control.
Is the injected procedure painful?
Since the solution is so diluted there may be only a slight stinging or burning sensation as it is injected. You will also feel the small pinch of the needle. It is so minimal that often nothing is felt.
Do I have to stay in bed after the injection?
Absolutely not! We want you to continue your normal activities. The only restriction after this vein treatment is to avoid heavy aerobic exercise and swimming on the day of the injection. All the activities may be resumed on the following day. We also request that our patients shower rather than bathe the evening of the injections and refrain from the use of bath oils for 24 hours.
How will my legs look after injection?
You may notice some slight redness and a few little welts similar to mosquito bites after vein therapy injections. This is normal and will disappear in 48 hours. Very rarely, there will be a temporary discoloration.
Are there any complications to this procedure?
It is extremely rare that one may develop a small blister at the injection site after vein therapy. This will usually heal without scarring. If this occurs at all it is most likely in older patients with very fragile skin.
Do I have bandages or elastic wrap after injection?
Usually there are no bandages necessary. However, on some larger veins a temporary "pressure" bandage will be applied at Doctor Karlin's discretion.
Will I have any pain after the injections?
No. However, you may notice some "itching" or "tingling" for a few hours after injection. We recommend wet compresses. Do not scratch areas or apply any ointments.
What about laser therapy for vein treatment?
We use laser on facial veins. Laser on leg veins has not been proven to be effective.
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Absolutely not! We want you to continue your normal activities. The only restriction after this vein treatment is to avoid heavy aerobic exercise and swimming on the day of the injection. All the activities may be resumed on the following day. We also request that our patients shower rather than bathe the evening of the injections and refrain from the use of bath oils for 24 hours.