Sclerotherapy is considered the gold standard treatment for reticular (blue 1-3mm veins) and spider vein removal. The skin of your legs will appear younger, clearer and more healthy-looking. Once again, you can wear skirts and shorts without feeling uncomfortable about the look of those unsightly veins and broken capillaries.
At Pacific Dermatology & Cosmetic Center in Seattle, we have performed hundreds of leg vein treatments. Dr. Reichel underwent specialty training in leg vein treatments while she was an attending physician at the University of Washington. She worked with renowned vascular surgeons and dermatologic surgeons around the country during her training. As experienced practitioners in this field, we feel comfortable treating your small leg veins with sclerotherapy. Dr. Reichel also performs Ambulatory Phlebectomy for slightly larger veins. If you have large varicose veins, we work closely with local vascular surgeons and can refer you for endovenous laser treatment (EVLT) as needed.
» Click here to view before/after photos of this procedure in the Photo Gallery.
How Does Sclerotherapy Work?
Sclerotherapy is a relatively simple spider vein treatment and reticular vein removal procedure using tiny needles to inject a sclerosing solution into the problem veins, causing them to collapse and fade. Not only will your leg's appearance improve dramatically, but the bothersome symptoms associated with spider veins will also significantly improve, including burning, aching, swelling and night cramps. Sclerosing agents that are used for reticular and spider vein removal are mild enough to allow predictable and relatively painless treatment.
At Pacific Dermatology & Cosmetic Center, Andrea English PA-C, Dr. Jacobson, and Dr. Reichel currently treat spider and reticular veins with a combination of minimally invasive techniques; including Hypertonic saline and the FDA-approved prescription medicine Asclera. Asclera® is a sclerosing agent that is injected into the vein. It works by damaging the endothelium, the cells lining the inside of blood vessels. This causes blood platelets to attach to the lining of the vessels; eventually, cellular debris and platelets cause the blood vessel to clot. Over time, the clotted vein will be replaced with tissue and new, healthy vessels that aren’t visible on the skin’s surface.
What to Expect During a Sclerotherapy Session
The typical spider vein treatment session is relatively quick, lasting only about 30 to 60 minutes. While lying on an examination table, the treatment area of your legs will be cleansed with an antiseptic solution. The needles that are used for reticular and spider vein removal are very small and well tolerated. In addition, discomfort is minimized by mixing local anesthetic in the injected solution, and the occasional application of numbing medicine to sensitive areas, like the ankles.
Approximately one injection is administered for every inch of spider vein removal. Some people may experience some cramping or a mild burning sensation, which quickly dissipates. Typically, for any given area, two to three spider vein treatment sessions are required to achieve optimal results. The procedure treats only those leg veins that are currently present, whether visible or not to the naked eye, and does nothing to prevent the emergence of entirely new spider veins in the future.
What Is Recovery From Sclerotherapy Like?
Although sclerotherapy generally does not require any recovery time, it is advisable to avoid activities that may lead to dilation of veins and blood stagnation, such as heavy lifting, strenuous exercise or hot baths. You are encouraged to walk to speed up the circulation in the legs and enhance the safety of the procedure. Wearing compression stockings for about two weeks after treatment is also recommended to improve the spider vein removal outcome and minimize discomfort and complications.
Is There Any Pain After Sclerotherapy?
Most patient experience no pain, or only mild tenderness for a few hours after a sclerotherapy session. However, there can be some degree of inflammatory response after a sclerotherapy session, with mild to moderate sensitivity and tenderness in the area, depending on the density and thickness of the veins treated as well as the type and strength of the solution used. Anti-inflammatory medications are commonly used to minimize these symptoms.
We like patients to wear their compression stockings for 24 hours after the procedure, and then for 2 weeks during the day (as much as possible). It is not a requirement to wear them, however, we do recommend it.
What Are the Side Effects of Sclerotherapy?
Serious medical complications from reticular and spider vein treatment with sclerotherapy are extremely rare when the procedure is performed by a qualified physician. Common side effects of spider vein treatment with sclerotherapy are usually temporary and well tolerated. The most common effects of sclerotherapy include:
- Swelling, redness, tenderness and itching (these tend to gradually disappear within hours to days).
- Some bruising and retained dark blood clots in the treated veins (minor bruising usually occurs, but fades over a few weeks in most cases).
- Brown pigmentation and matting (the appearance of a blush-like microscopic network of fine red vessels).
- A Small skin ulceration that would heal leaving a permanent scar. This sis a rare event in experienced hands and is minimized by a meticulous technique and use of the mildest solution that can achieve the desired result.
- Allergic reactions to the commonly used sclerotherapy solutions (tends to be very rare).
When is the Best Time of the Year to Have Sclerotherapy?
Sclerotherapy could be performed any time of the year; however, many patients feel more comfortable wearing compresssion stockings during the cooler months of the year in Seattle. Moreover, complete healing, including the disappearance of the treated spider veins, bruising and pigmentation, may sometimes take several weeks. Consequently, if you want to make sure that your legs are ready for summer, make sure to start the treatments in the fall. Since you will need more than one treatment, this timeline will get you on track for beautiful legs in the spring.
Who Are the Best Candidates for Sclerotherapy?
Woman and men of any age who are suffering from unsightly spider veins and reticular veins (small to medium-sized blue or red veins) are good candidates for sclerotherapy. If you are pregnant or breastfeeding, it is advisable to postpone sclerotherapy, as fetal safety is not established. In addition, many pregnant women experience dramatic spontaneous improvement in the months following delivery, making treatment simpler, and sometimes unnecessary. The physicians and trained specialists at Pacific Dermatology & Cosmetic Center will examine your legs, review your medical history and the severity of your condition to determine the best spider vein treatment procedure or a combination of treatments.
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