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Is hospitalization required for laser
treatment?
No. The procedure is performed at the Aesthetic
and Laser Dermatology Center. Before arrival, you may be advised to
take analgesics and or topical medications. Prior to treatment,
local ice and a topical anesthetic cream may also be applied. During
the treatment, you will experience a feeling similar to a rubber
band snapping on your skin. After the procedure, there is no
significant pain.
How soon will the veins disappear
with the laser treatment?
Your veins will lighten within
8-12 weeks. Some vessels treated with laser light will disappear.
Others will require repeat treatments and or sclerotherapy.
How many laser treatments will I need?
The
number of treatments varies from person to person. Most patients
will need 2-3 treatments.
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
can be affected in the same area of the body and to the same extent.
The condition can very occasionally occur as part of an internal
disease.
Spider veins appear in both men and women, but 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 out. They
may also appear after an injury or as a result of wearing tight
girdles or hosiery held up with tight rubber bands. Spider veins may
also occur with larger varicose veins.
Spider veins on the
nose or the cheeks of fair skinned persons may be related to sun
exposure.
Can Spider Veins be Prevented?
Spider
veins can't always be prevented. 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. One of several kinds of
solutions called sclerosing solution, is injected with a very fine
needle directly in the blood vessel. This procedure has been used
for spider veins since the 1930s 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 available are slightly
different and the choice of which solution to use depends on several
factors including 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 surgical
procedure. 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 percent to 90 percent improvement. However, fading is
gradual. Disappearance of spider veins is usually achieved, but
similar veins may appear in the same general area.
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. They
include:
- Stinging or pain at the sites of injection,
swelling of the ankles or feet or muscle cramps. Muscle cramps
almost always occur with the injection takes place in the ankle
area. These usually go away within 10 to 15 minutes after
injection.
- Red, raised areas at the sites of injection.
These should disappear within a day or so.
- Brown lines or
spots on the skin at the sites of treated blood vessels. Probably
made up of a form of iron in the blood, these darkened areas may
result when blood escapes from treated veins. These dark areas 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 longer.
- Development of groups of fine red
blood vessels near the sites of injection of larger vessels,
especially on the thighs. About 5% of patients develop these; most
disappear by themselves, some go away with injection treatment or
laser therapy, a few may last.
- Rarely small, painful ulcers
at treatment sites either immediately or within a few days of
injection. These occur 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. These will
disappear in a few weeks and are probably related to the thinness of
blood vessel walls.
- Allergic reactions to certain
sclerosing solutions. Although such reactions can be serious, and
require immediate injections of epinephrine. Less serous reactions
are treated with antihistamines.
- Inflammation of treated
blood vessels. This is very unusual but when it occurs it is treated
with medications such as aspirin, compression, antibiotics or
heat.
- Lumps in injected vessels, particularly larger ones,
may develop. This is coagulated blood but is not dangerous. The
dermatologist may drain the blood out of these areas a few weeks
after injection.
Will Treated Veins
Recur?
Spider veins may recur. It may seen that a previously
injected vessel 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.
Are There Other Treatment
Methods?
New lasers may hold promise for treating blood
vessels, but currently vessels in the legs do not respond uniformly
to laser treatment.
Surgically typing veins off (ligation) or
pulling them out (stripping) are other procedures for treating
unwanted blood vessels. They are usually reserved for large varicose
veins.
How are Spider Veins on the Face
Treated?
There are several ways to treat spider veins on the
face. Lasers have been used successfully, alone or in combination
with electric needle therapy.
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 blood will be pushed
through other vessels.
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