Spider veins are formed by the dilation of a small group of blood vessels located close to the surface of the skin. Although they can appear anywhere on the body, spider veins are most commonly found on the face and legs. They usually pose no health hazard but may produce a dull aching in the legs after prolonged standing. Varicose veins are abnormally swollen or enlarged blood vessels caused by a weakening in the vein’s wall. They can be harmful to a patient’s health because they may be associated with the development of one or more of the following conditions: Phlebitis or inflamed tender vein; Thrombosis or a clot in the vein; and Venous Stasis Ulcers or open sores from inadequate tissue oxygen and fluid retention. The exact cause of spider and varicose veins is unknown, although heredity, pregnancy, and hormonal influences are believed to be primary factors contributing to both conditions. More than 20 percent of women have some form of varicose conditions, and more women than men have varicose veins.
Sclerotherapy is considered the gold standard treatment for removing spider and some varicose leg veins. It is a very cost-effective procedure that seldom leaves a scar or produces adverse effects. It is typically performed on an outpatient basis by a dermatologic surgeon. A concentrated saline or specially developed chemical solution is injected with a very small needle into the spider or varicose vein. The solution causes the vein to close up or collapse and become scar tissue that is eventually absorbed by the body. The work of carrying the blood is shifted to other healthy blood vessels nearby.
Sclerotherapy generally requires multiple treatment sessions. One to three injections are usually required to effectively treat any vein. The same area should not be retreated for four to six weeks to allow for complete healing, although other areas may undergo treatment during this time.
Post-treatment therapy includes wearing bandages and support hose for two days to three weeks following treatment. Walking and moderate exercise may also help recovery.
Although Sclerotherapy works for existing spider veins, it does not prevent new ones from developing. Most patients report few, if any, minor side effects, which usually disappear in time. Temporary reactions can include a slight swelling of the leg or foot, minor bruising, itching, redness, and moderate soreness.
Improvement in the appearance of varicose veins in the knee and leg.
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JUDY K. CHIANG, MD
MEDICAL AND COSMETIC DERMATOLOGY
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