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Do those purple or red "spider veins" keep you from wearing
shorts or a nice dress? Would you like a relatively simple,
time-honored method for treatment of these leg veins?
- Sclerotherapy is treatment of leg veins with an injectable
medication (hypertonic saline) that can cause many of the
veins to disappear. Most experts in the country utilize this
method for treatment of leg veins (telangiectasias).
- Vascular Laser target veins with a laser beam. However,
this often involved multiple treatments. Additionally,
one must hit the vein with the beam every 1 to 2 millimeters.
On the other hand, with sclerotherapy, if one can inject
the "trunk" of the tree, often all of the "branches" will
disappear.
- Radio Frequency is used in some parts of the country for
larger leg veins. Cost can range up to $2,000 per
session.
- Laser Probe/Heated Wires are used to occasionally for larger
varicose veins. Cost can range up to $2,000 per session.
- Ligation and Stripping is an older method for surgical
removal of varicose veins. This method may result
in multiple scars in the legs.
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SPIDER VEINS - LEGS AND
FACE
Did you feel like you did not want
to wear shorts last summer? Do your cheek or nose veins cause
your face to look dark red or purple in cold weather or with
exercise? If so, treatment is just around the corner. |
Dr. Swinehart has treated these superfluous,
unnecessary leg veins for 20 years with sclerotherapy. The
hypertonic saline used for this purpose has the advantage
of not causing allergies. You have saline at a concentration
of 0.9% in your blood stream; we use a concentration of 23.4%
for sclerotherapy. Your veins are simply tubes of living
cells. The saline eradicates these cells, causing the unwanted
veins to disappear.
Although more than one treatment may be necessary, sclerotherapy has an
advantage over laser therapy in both cost and efficiency. Using a laser,
the doctor has to deliver a pulse every few millimeters along each and
every vein. With sclerotherapy, however, one injection into the trunk of
the "tree" may cause all of the "branches" to disappear!
Smaller numbers of facial veins may be treated in the office with the electric
needle (cautery); the pulsed dye laser is used for larger areas of numbers
of "spider veins" on the nose, cheeks, and face. |
| View our photos at www.coloderm.com |
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Before |
After |
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LEG VEINS |
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| TREATMENT OF SPIDER
VEINS ON THE LEGS |
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| QUESTIONS & ANSWERS |
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| DENVER DERMATOLOGY
CENTER, P.C. |
| JAMES M. SWINEHART,
M.D. |
| 950E. HARVARD
AVE. #630 |
| DENVER, CO.
80210 |
| (303)744-1202 |
TREATMENT OF SPIDER VEINS
Are you dismayed by the presence of increasing numbers of unsightly, small,
bluish-red or purple veins on your legs? Does this unwelcome development
now prevent you from participating in activities or wearing clothes that
expose these areas of your skin? Fortunately, newer, more successful techniques
and methods have now made treatment of this embarassing condition possible.
Often, dermatologists have noted that people who have had this done are
among their mose appreciative patients. Not only can these individuals
get back into athletics, swimsuit activities, and wear new fashions, but
some even note that their legs don't become as tired as they did before
treatment.
WHAT ARE "SPIDER VEINS?"
These are the small, dialated (enlarged) veins seen frequently
on the thighs, around the knees, on the calves, and around
the ankles. Medically known
as "telangiectasias", they are also called "star-burst varicosities", "sunburst
vessels", or "broken capillaries" (actually if the vessels were really
broken, they would bleed). They do not serve a purpose, but rather represent
an enlargement of surface vessels secondary to increased pressure in the
deeper veins.
WHAT CAUSES THESE TO APPEAR?
Doctors are not completely sure, but certain families seem predisposed,
particularly the female relatives. Other factors suspected include: hormones,
or pregnancy, prolonged sitting or standing, chemical exposure or infection,
decreased local oxygen supply, or falls, blows, or other forms of physical
injury.
TREATMENT OF SPIDER VEINS
Some Authorities feel that the use of support hose may be helpful, as well
as avoidance of the factors listed below. Weight reduction and exercise
may also be of benefit.
HOW ARE THEY TREATED?
Treatment is performed by the technique of sclerotherapy, in which a chemical
substance is injected into the unwanted veins with a tiny needle. This
substance irritates and damages the lining of these small vessels, causing
them to sclerose (close off) so that blood no longer flows through them.
They then gradually disappear as they are absorbed by the body. A number
of different injection materials is currently available, and these can
be discussed more fully with your physician.
HOW WELL DOES IT WORK"
A great majority of patients are very gratified, since 70% to 90%
of the "spider
veins" can be eventually removed if enough treatments are performed. Some
vessels clear completely, and others may only lighten. Of course, perfection
is not possible, and this technique will also not prevent the development
of new blood vessels in the future.
HOW SOON DO THE BLOOD VESSELS DISAPPEAR?
Each vessel often requires 2 to 3 injections. Usually the blood vessels
disappear over a period of 2 weeks to 3 months.
DOES IT NEED TO BE REPEATED?
Depending on the number, size, and extent of the "spider veins",
anywhere from 2 to 10 or more treatment sessions may be required.
These are usually
done at intervals of 2 to 3 weeks, although different sizes of the legs
can be injected each week. Maintenance sessions will probably be necessary
in the future as new veins appear.
CAN ALL PATIENTS BE TREATED?
Most patients are good candidates for treatment. However, pregnant
or nursing mothers must wait to have this done. Very large or deep
varicose veins
are best treated with other methods, although the small "spider veins" can
still be treated by injection. Other medical conditions which make treatment
difficult or impossible include: uncontrolled diabetes, some liver or kidney
disease, a previous history of blood clots or thrombophlebitis (inflammation
of the deep leg veins), or a past history of bad scarring, bleeding disorders,
or allergy to the injection materials.
I UNDERSTAND THAT INJECTIONS DON'T ALWAYS WORK. ARE THERE
OTHER METHODS?
Treatments by cautery with an electric needle has been done in the past.
This is painful and can often leave many small, white, dot-like scars.
Argon or carbon dioxide lasers have been used by some physicians, but they
may also cause small, pitted, depressed or pigmented scars to remain. Very
large veins can be removed with surgical techniques.
DOES INSURANCE COVER THE TREATMENT?
That varies with your coverage. We do not accept assignment for
the sessions, and appreciate payment at the time each service is
rendered.
DO SOME VESSELS RECUR OMRE COMMONLY?
Yes - the very thin, red, mat-like radiating vessels, with a "slapped
cheek" appearance,
can recur. However, these represent less than 1% of the vessels treated.
ARE THERE RISKS?
With any cosmetic procedure
there are always risks. Immediately after the injection,
some
swelling, itching, stinging,
redness and tenderness may
be present. There is usually some bruising, which can last
from one to several weeks - in other words, they often "look worse before they get
better". In some instances a brownish stain (pigmentation)
may be present at the site of the shots or along the vein,
especially
with larger
vessels. This usually fades within 6 months.
Other uncommon side effects include:
allergic reactions to the medicine, infection, numbness,
or fibrosis (scarring). It is possible to develo
a sore or blister where the medication goes into the skin. If a small
crust
of skin sloughs off, a small white mark may occasionally result. In
larger veins, a linear surface clot may develop until it
is absorbed by the
body. Of course, other or new blood vessels may appear, and further
treatments may be needed in the future.
HOW CAN I PREPARE FOR THE PROCEDURE?
Moisturizers or dry skin creams should not be used on the legs for 24 hours
prior to the visit, since they get in the way and will have to be removed.
It is advisable to wear shorts or a bathing suit under a full skirt of
culottes, or loose slacks. If possible - avoid tight-fitting clothes. Since
alcohol will be used on the skin, it is best not to shave the legs for
48 hours before the procedure.
ARE THESE SPECIAL INSTRUCTIONS AFTER THE PROCEDURE?
It is best to avoid excessive heat, prolonged sitting or standing, and
strenious exercise such as aerobics, for the first 48 hours after treatment.
During this period, leg evaluation while sitting is recommended. The best
results are often obtained by wearing special compression hosiery almost
continuously for the first 48 hours, and as much as possible for the three
weeks following treatment. This hosiery lessens the number of treatments
necessary, reduces discomfort, swelling, and bruising after treatment,
and has long-term benefits such as prevention of the development of new
vessels and reappearance of old ones, and prevntion of inflammation of
leg veins (thrombophlebitis).
AN EXTRA BONUS
Don't be surprised if:
- You consider telling your friends how you got rid of veins
like theirs.
- You become extremely compulsive about getting rid of all your
veins - even the ones that you wouldn't have noticed as much
before your sessions. This may be the first time in years that
you have felt good about your legs after looking at them.
- Your wardrobe expands to include fashions you wouldn't have
dreamed of wearing before treatment.
- You expand your activities to include exercise, swimming, or
other sports where others can see your legs.
- You develop a greater sense of well-being, and fell better
about both yourself and about other situations and people in
your life.
A FINAL WORD
Sclerotherapy, the best single treatment for unwanted
small "spider veins" on
the legs, has been used successfully for decades. Now, when these bluish-purple
blood vessels appear, it is reassuring to know that this condition doesn't
have to be permanent. This is not an easy or overnight cure, but thousands
of patients have been pleased to see the unsightly leg veins vanish.
The Denver Dermatology Center's staff wishes to assist in any way possible
with health care needs, and we look forward to a long and continued association!
James M. Swinehart, M.D.
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