SCLEROTHERAPY

What causes unwanted vericose veins?

Unwanted let veins affect over 1 out of 4 Americans. Women are 2x more likely to develop vericose veins than men and over 80% of these unwanted veins are not medical related but are cosmetic. The causes for these unwanted veins are multi-fold and vary between individuals. There are small, red or blue surface veins called reticular veins. There are also perforating veins that protrude outside the skin that are also vericose veins but have underlying anatomy that requires other modes of treatment for clearance and correction.

Spider veins and reticular veins are easily treated through a variety of modalities. These conditions typically are the results of heredity especially if both your mother and father suffered from the same condition and can start to appear at a young age. Other causes for the appearance of these veins are hormonal imbalances (from pregnancy) occupational situations (prolonged standing/sitting) injury, or other deeper vein insufficience or reflux (valve malfunction). Since these veins are very superficial to the skin and do not protrude from the skin they typically do not carry a large blood supply and are not high pressure that can be easily treated with a high degree of clearance and patient satisfaction.

Though the treatments will eliminated these unwanted veins, there is a very good possibility that you will need "touch-up" subsequent treatments from time to time thereafter. The veins treated initially will be eliminated however the underlying condition for having these types of veins will still persist. The time between the initial and subsequent treatment needed var upon the individual but it is not uncommon to have 12 months of clearance.

Perforating veins (veins that protrude above the skin) are not treated through traditional sclerotherapy or by venous lasers. These veins have an underlying health risk or can only be treated by vein removal(vein stripping) or by laser. These procedure require additional workup, vein mapping, and possible other ultrasound guided deep vein destruction prior to eliminating these types. In come cases these veins can't be eliminated since they may be associated with a venous disorder that may exclude these types of procedure.

It should be noted that spider veins and reticular veins do not present a health risk and these veins can be eliminated without worry. Spider veins and reticulare veins form because of excess blood flow and act as a "sponge" and not an integral part of blood circulations.

How successful is sclerotherapy in treating varicose and spider veins?

Sclerotherapy works well for most patients. It is estimated that as many as 50 percent to 80 percent of injected veins may be eliminated with each injection session. A few (less than 10 percent) of the people who have sclerotherapy do not respond to the injections at all. In these instances, different solutions or a different method, such as laser therapy, may be tried.

In general, spider veins respond to treatment in 3 to 6 weeks, and larger veins respond in 3 to 4 months. If the veins respond to the treatment, usually they will not reappear. However, new veins may appear over time. If needed, you may return for injections.

How will I know if I am a candidate for sclerotherapy?

Before the procedure, you will have an initial consultation with a vascular specialist who will evaluate your eligibility for sclerotherapy. You are not eligible for sclerotherapy if you are pregnant, breastfeeding, or are bedridden. You must wait at least three months after delivery before you can be considered for this procedure. You can have sclerotherapy if you take birth control pills. If you have had a blood clot in the past, your eligibility will be determined on an individual basis, and will depend on the extremity and the cause of the clot.

Veins that are potentially usable for future surgical bypass procedures (such as the saphenous vein for coronary artery bypass graft surgery) will generally not be considered for injection, unless they are already deemed unusable.

Will Insurance cover Sclerotherapy?

Insurance companies do not provide coverage for sclerotherapy when it's performed for cosmetic reasons. Your insurance company may request a letter from your physician concerning the nature of your treatment.

What to do before the procedure?

Medications:

Prior to sclerotherapy, certain medications should be avoided. Please follow these gudelines:

Tetracycline/Minocin

Tetracycline/Minocin, both antibiotics may posiibly cause a staining of the skin if taken 7-10 days before or after sclerotherapy.

Do not take aspirin, ibuprofen

Do not take aspirin, ibuprofen (advil, nuprin) or other anti-inflammatory medications for 48 hrs before aand after sclerotherapy as they may interfere with the sclerosing agent or increase bleeding. Tylenol is permitted.

Prednisone decreases the effectiveness of sclerosing agent.

Prednisone decreases the effectiveness of sclerosing agent. Ask the doctor who prescribed your prednisone if it can be safely discontinued for 48 hrs before the procedure.

How Will I feel?

Mild discomfort may occur when the veins are injected and a cramping senstation may be felt for 1-2 minutes when larger weins are injected.

How long will the treatment last?

The sclerotherapy procedure takes about 30-45 min.

What are the side effects of sclerotherapy?

Side effects of sclerotherapy may include:

  • Larger injected veins may become lumpy or hard for several months before resolving.
  • Raised, red areas may appear at the injection sites and should disappear within a few days.
  • Brown lines or spots on the skin may be noted at the site of injection, possibly caused by a form of iron that escapes from the blood in the injected veins.  They disappear within 3-6 months, but can be permanent about 5% of the time.
  • Bruising may occur around the injection site and can last several days or weeks.
  • Temporary tiny blood vessels may develop at the treated area.
  • Allergic reactions to the sclerosing agent may occur at the time of injecting and are rarely serious.  Symptoms include itching and swelling.

What happens after the treatment?

After the treatment you will be able to drive yourself home. You may resume your regular activities and are encouraged to walk. You will be instructed to wear support hosiery or compression wraps to compress the treated vessels for one week.

For 48 hours after the procedure, please follow these guidelines:

  • Avoid anti inflammatory
  • Do not take hot baths or sit in the whirlpoos or sauna.  You may take showers, cut the water should be cooler than usual.
  • Wash the injection sites with mild soap and lukewarm water.
  • Do not apply hot compresses or any form of heat to the injected areas.
  • Avoid direct exposure to sunlight (including sun tanning and tanning beds).

Why Sclerotherapy?

80 million Americans have some kind of venous disorder and out of these 80% are cosmetic. Although most Americans do not have a major circulatory discorder, visible veins give the impression of aging and of poor health. Movost people wnat treatment but are not aware of the safety, effectivenes, and lack of discomfort of new modern vein treament options. The major reason for unwanted weins is herediety, most of these are inherited.

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