Leg Vein Treatments

Treatments for leg veins, spider veins

Many women are bothered by clusters of red, blue or purple veins that appear on the thighs, calves and ankles. There are many factors that cause these veins, known as telengiectasias to develop including heredity, pregnancy, obesity, prolonged standing and sitting and hormonal influences. They usually develop after age 30 and increase from there.
Spider veins or telengiectasias of the legs take on one of three shapes; spider shape with a group of veins radiating out from the center, barbarizing (sunburst appearing) like a tree, or linear. Varicose veins are larger, darker in color and usually bulging.
Treatment options for spider veins include sclerotherapy which involves the injection of specialized solutions to collapse the veins and laser therapy. Very often a treatment regimen consists of both procedures.
About 50 to 55% of American women and 40 to 45% of American men suffer from some form of vein problem. Varicose veins affect 1 out of 2 people age 50 and older.

Laser surgery for leg veins

New technology in laser treatments can effectively treat spider veins in the legs of patients with all skin types. Laser surgery delivers intense pulses of light energy into the veins and this causes them to fade and disappear. Laser surgery appeals to some patients because it does not use needles.
Laser treatments take about 20 minutes. The GentleYag Nd: YAG and Vbeam Pulsed dye lasers is the most advanced laser for the treatment of leg veins. Depending on the severity of the veins, three to four treatments may be needed to achieve a treatment goal. There is some discomfort during the procedure but this is gone by the time patients leave the office. Patients can return to normal activity right after treatment. For larger veins, over 3mm, other forms of therapy are indicated. For tiny veins that can’t be treated with sclerotherapy, the laser is the treatment of choice.
It is not uncommon for sclerotherapy to be performed initially and then the laser is used to clean up the veins that have been resistant.

Sclerotherapy

Sclerotherapy involves injections of a specialized sclerosing agent which collapses the veins and lets them fade away. It normally takes a series of treatments spaced about 4-6 weeks apart to achieve the goal. It is common to see additional veins develop over time and thus the need for maintenance.
One of the concerns with sclerotherapy is the development of brown discoloration on the skin after sclerotherapy which may take a very long time to fade. Another is a condition called matting where a group of tiny red blood vessels develop around the treatment area.
In patients with varicose veins or a severe case of spider veins, one has to be suspicious of a problem with the valves in the larger veins of the legs. This is evaluated with Doppler, similar to the way you look at a developing fetus during obstetrics care.
A typical sclerotherapy session takes about 30 minutes during which time a series of 20-40 injections are made into the unwanted veins. After treatment tight fitting support hose is recommended to be worn for a period of time. Walking is encouraged in the post operative period. It is common for the treatment area to look worse before it improves, with bruises, brown discoloration and angry looking veins temporarily.
You should be aware that your treated veins will look worse before they begin to look better. When the compression dressings are removed, you will notice bruising and reddish areas at the injection sites. The bruises will diminish within one month. In many cases, there may be some residual brownish pigmentation which may take up to a year to completely fade.
During laser treatment, a laser is applied to the skin over your spider veins. Laser energy causes your spider veins to coagulate and shrink. Laser therapy is most effective for small and medium size spider veins. Large spider veins respond poorly and are best treated with sclerotherapy. You are likely to experience mild discomfort similar to having a small rubber band snapping against skin. Treatments usually do not require sedatives, pain medications, or injections of local anesthetic.
Immediately following treatment, spider veins will be darker and more visible. Over two to six weeks, your spider veins usually fade. After each treatment, you will see a 70% to 80% improvement in the appearance of face spider veins and 30-40% improvement in leg spider veins. An average of three treatments will be required at three-month intervals to produce desired results. Combination therapy can be considered and beneficial if you have small, medium and large spider veins. You may wish to start with sclerotherapy, because sometimes all veins will be improved after injecting the larger ones. This may reduce the number of veins that need to be treated by laser and minimize your overall cost.

Endovenous Techniques (radiofrequency and laser)

These methods for treating the deeper varicose veins of the legs (the saphenous veins) have been a huge breakthrough. They have replaced surgery for the vast majority of patients with severe varicose veins. This technique is not very invasive and can be done in a doctor’s office.
The doctor puts a very small tube called a catheter into the vein. Once inside, the catheter sends out radiofrequency or laser energy that shrinks and seals the vein wall. Healthy veins around the closed vein restore the normal f low of blood. As this happens, symptoms from the varicose vein improve. Veins on the surface of the skin that are connected to the treated varicose vein will also usually shrink after treatment. When needed, these connected varicose veins can be treated with sclerotherapy or other techniques.
Surgical Ligation and Stripping - With this treatment, problematic veins are tied shut and completely removed from the leg. Removing the veins does not affect the circulation of blood in the leg. Veins deeper in the leg take care of the larger volumes of blood. Most varicose veins removed by surgery are surface veins and collect blood only from the skin. This surgery requires either local or general anesthesia and must be done in an operating room on an outpatient basis.

Further information on legs veins:

What factors make it more likely for a person to develop spider or varicose veins in the legs?

• Increasing Age
• Having family members with vein problems.
• Hormonal changes during puberty, pregnancy, and menopause or from the birth control pill.
• Pregnancy. This is due to the increased amount of blood and pressure of the expanding uterus.
• Obesity, leg injury, prolonged standing and other things that weaken vein valves

Why do varicose veins and spider veins usually appear in the legs?

The force of gravity, the pressure of body weight, and the tough task of carrying blood from the legs to the heart are all responsible.

What are the signs of varicose veins?

• Aching pain
• Easily tired legs
• Leg heaviness
• Swelling in the legs
• Darkening of the skin (in severe cases)
• Numbness in the legs
• Itching or irritated rash in the legs

How can I prevent varicose veins and spider veins?

• Exercise regularly to improve your leg strength and circulation.
• Maintain a healthy weight.
• Do not cross your legs when sitting.
• Elevate your legs when resting as much as possible.
• Do not stand or sit for long periods of time.
• Wear elastic support stockings and avoid tight clothing around the waist or legs
• Eat a low-salt diet rich in high-fiber foods.

What is the difference between spider veins and varicose veins?

Spider veins, also called telangiectasias, are tiny visible vessels just underneath the skin. They develop most commonly on the face and legs. Varicose veins are distended veins beneath the skin. They may appear as bluish bumps and often cause discomfort. Those with unsightly varicose veins and aching pain often choose to have surgery to remove their varicose veins. If you have both varicose and spider veins, your varicose veins must be treated first. Treating spider veins first is not recommended because, in the presence of varicose veins, they are bound to return soon.