Sclerotherapy
What are spider and varicose veins?
Veins are the vessels that return blood to the heart once it has circulated through the body (as opposed to arteries, which carry oxygen-rich blood from the heart to the body). They have one-way valves that help keep blood flowing in the proper direction. If these valves stop functioning the way they are supposed to, blood can flow backwards and pool in the vein, causing it to stretch. These enlarged blood vessels are classified into two groups: spider veins and varicose veins.
Spider veins are visible red or blue blood vessels that may spread like a web across the skin anywhere on the body, most commonly on the face and legs. Varicose veins are blood vessels with weak walls that swell or balloon outward, raising the skin surface.
Are spider and varicose veins common?
Yes. More than 80 million people in the United States have problems with their veins, including about 50 percent of women.
What causes spider and varicose veins?
It is not entirely known what causes spider and varicose veins, although many likely factors have been identified. The most significant contributing factor is heredity. Others include:
- Puberty
- Pregnancy
- Menopause
- Birth control pills
- Estrogen and progesterone
- Aging
- Occupations that involve standing
- Obesity
- Leg Injury
Can they be harmful?
Yes. Abnormal veins in the legs can cause pain (including fatigue, heaviness, aching, burning, throbbing, itching, cramping and restlessness) and prevent proper skin nutrition, leading to eczema, inflammation and ulceration.
I don't see any red or purple vessels and I don't have any bumps. Could I still have a venous disorder?
Yes. Physical examination, often with the aid of specialized equipment such as non-invasive ultrasound, by a professional can detect problems with blood vessels that aren't visible otherwise.
What is sclerotherapy?
Treatments involve one or more injections during one or more sessions, depending on the type, number and severity of the veins being treated. By the end of the treatment program, the veins are no longer visible on the skin surface. Sclerotherapy usually also relieves symptoms associated with enlarged veins and prevents further complications from occurring.
How is ultrasound-guided sclerotherapy different?
Ultrasound-guided sclerotherapy allows doctors to treat problematic veins that aren't visible on the skin surface by monitoring veins on an ultrasound screen during the procedure.
Are there alternative treatments?
Yes. These include microphlebectomy and TriVex.
Microphlebectomy removes varicose veins with a special hook that is used through multiple tiny incisions that do not usually require stitches and leave minimal scarring. Recent advances have made it possible to perform the procedure using only local anesthesia and light sedation in a doctor's office as an outpatient. After the microphlebectomy you will be asked to wear compression garments temporarily. The incisions typically heal within two weeks.
TriVex employs a powerful light that targets only the damaged vein, which is then precisely removed with a powered resector under local anesthesia. The treated area is then flushed clean through a process called tumescent infiltration. Advantages of TriVex over other vein removal methods are faster procedure and recovery time, and less scarring.
Can I do anything to prevent the development of spider and varicose veins, or to reduce their side effects?
Yes. Spider and varicose vein formation and complications may be prevented by wearing sunscreen on the face, exercising regularly, controlling your weight, elevating legs when resting, not crossing the legs when sitting, avoiding long periods of standing, wearing elastic support stockings, and eating high-fiber foods.
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Asclera®
Asclera® is a prescription medication administered in injection form to treat spider and varicose veins during sclerotherapy. This substance, known as a sclerosing agent, damages the inside lining of the blood vessels and causes platelets to attach to the vessel walls over time, creating a blood clot and causing blood to divert to a healthier vein. The clotted vein will eventually dissolve and be replaced with tissue.
Sclerotherapy treatment with Asclera takes 15-45 minutes to perform, depending on the size and severity of the affected blood vessel. For most patients, one injection is administered for each inch of the affected vessel, with multiple injections performed during each treatment session. After this procedure, patients will need to wear compression stockings or support hose to facilitate proper healing.
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