Sclerotherapy

Sclerotherapy involves injecting a fluid, frequently concentrated saline, into unwanted leg veins, causing injury to the wall of the vessels with the end effect being scarring down and closing of the vessels.

Benefits

Sclerotherapy enables us to reduce or eliminate unsightly small or mediun sized veins without producing scarring or long term adverse changes.

Alternatives

Leg veins can also be removed using the Sciton YAG laser, and larger varicose veins can be destroyed with energy delivered through cannulas that are inserted into the veins.

How It Works

One of several kinds of solutions, called sclerosing solutions, 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. Dr. Bock will decide the solution that is best for your particular case.

Occasionally larger varicose veins are underneath the spider veins. In such cases, many physicians believe these vessels should be treated along with the spider veins. This can be done by sclerotherapy followed by compression.

Problematic leg veins can be divided into spider veins, larger blue reticular veins, and still larger varicose veins. Spider veins are dilated small blood vessels that have a red or bluish color. They can be short, unconnected lines each about the size of a large hair. They may also look like a spider web or a tree with branches. Sometimes, they occur in a small area and aren't very noticeable, or they can cover a large area of skin and be quite unattractive. Reticular veins are larger and deeper than spider veins and tend to have a blue color. Larger dilated blood vessels called varicose veins may be raised above the skin surface. They may occur along with spider or reticular veins.

Some people with unwanted blood vessels can have pain, ranging from a dull throbbing pain to a burning sensation. The larger vessels are more likely to cause discomfort. Although all these unwanted blood vessels carry blood, they are part of the superficial circulatory system and do not play an important role in circulation. If they are unsightly or uncomfortable, they can be treated by sclerotherapy: injection of a solution that will cause them to disappear or become much smaller. There is about a 50-90 percent chance for a greatly improved appearance. Sometimes, for technical or other reasons, some vessels can not be injected and these can often be well-treated with the Sciton Laser.

What causes these blood vessels to become visible?

Spider, reticular and varicose veins appear in both men and women, but more frequently in women. Heredity, hormones and pregnancy often seem to play a role in their development. They may also appear after an injury or as a result of wearing tight girdles or hosiery held up with tight rubber bands.

Can spider veins be prevented?

Spider veins can't always be prevented. Wearing support hose may prevent some unwanted blood vessels from developing. Keeping one's weight at a normal level and exercising regularly may also be helpful.

Safety & Side Effects

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.
• Red, raised areas at the sites of injection. These should disappear within a day or so.
• Brown lines or spots almost always appear 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. 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 a third of patients develop these. Most disappear by themselves; some go away with injection treatment or laser therapy and a few may last.
• Small ulcers in the injected areas. These usually heal nicely, but rarely visible scarring occurs
• 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 are a very rare occurrence.
• Inflammation of treated blood vessels. This is relatively common when varicose veins are treated and usually no treatment is necessary.
• Lumps in injected vessels, particularly larger ones, may develop. This is coagulated blood, but is not dangerous. Occasionally, Dr. Bock may drain the blood out of these areas a few weeks after injection.

Recovery Time

The brown discoloration following injection of sclerosing solution can persist for a number of months, and occasionally up to a year.

Questions and Answers

Who is a candidate?

All skin types and skin colors respond equally well.

What can i expect after treatment?

After several treatments, most patients can expect a 50 percent to 90 percent improvement. However, fading is gradual. Disappearance of most spider veins is usually achieved, and the Cutera Laser can often remove many of the residual vessels. However, over a period of years it is likely that new vessels may develop. Even if these are not treated, one would always have fewer vessels than if no vessels had been removed previously. However, for optimal results it is realistic to anticipate that eventually additional treatments will need to be performed.

Not all the treated vessels will disappear, but those vessels that are destroyed will not recur. However, new vessels may eventually develop in the area of treatment, giving the appearance of recurrence. However, it is likely that most of these would have developed in any case and resulted in a greater number of vessels in the area.

Does It Hurt?

A fine needle is used so the multiple small needlesticks are not very uncomfortable. A local anesthetic is added to the saline solution so it does not burn.

Before-treatment instructions:

Avoid aspirin or aspirin containing products. Do not tan or use self tanning products.

After-treatment instructions:

Patients are asked to walk after the procedure. For larger vessels we will 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. It also may reduce possibility of recurrence. For smaller vessels we may use no compression or support hose alone.

Between treatments, we may recommend the use of compression or support hose. This may be particularly recommended for people who spend a lot of time on their feet.

Who Performs the Treatments?

Dr. Bock performs the treatments.

Will insurance cover the removal of unwanted leg veins?

Usually insurance does not cover the removal of leg veins, with the possible exception of varicose veins.

If you are interested in leg vein treatment, what is the next step?

The next step is to call California Skin & Laser Center at 800-500-5842 and to schedule an evaluation. At that time Dr. Bock will advise you whether you are a candidate for this procedure, and what other possibilities exist for improving your appearance.

Why should you choose the California Skin & Laser Center for your leg vein treatments?

At California Skin & Laser Center, we want you to have an excellent outcome and to feel that your needs and concerns have been promptly addressed in a caring and sensitive fashion. We strive diligently to ensure your satisfaction, your comfort, your privacy, and your safety. All treatments are supervised or performed by a board-certified dermatologist with many years of successful experience in a large variety of cosmetic procedures. Many treatment modalities are available, and we can recommend the one or two that are most likely to meet your needs; we're here to meet your needs and help you realize your aspirations. At our clinic in Stockton, CA, we serve communities throughout San Joaquin County and the Central Valley, including Lodi, Sacramento, Tracy, Manteca, Modesto, Galt, and Valley Springs; many of our patients also come from the San Francisco Bay Area.