Primary options for small and superficial veins on the legs include both laser and sclerotherapy.
Sclerotherapy is a minimally invasive injection treatment for smaller veins called reticular veins and spider veins. (Large varicose veins are generally treated with endovenous laser, a surgical procedure that is performed by vein specialists.)
A special medicine is injected into the vein that causes it to shrink. The inner lining of the vein is injured by the medication’s action. This messages the body to trigger a natural resorption of the vein. This process can take weeks or months depending on the number and size of the veins present.
The side effect of most concern with sclerotherapy is hyperpigmentation. We recommend treatment when patients will have minimal sun exposure. The hyperpigmentation may last for several months, but in most cases fades over time. Rare cases do occur where the discoloration may last longer than year. In extremely rare cases a small sore or ulceration may occur at the site of injection. This may heal with a small white depressed scar.
Sclerotherapy: The procedure
Your physician will place you in a comfortable position on the examination table, which allows best access and visibility to the treated area. Photos of the area may be taken to document your improvements. Your doctor will cleanse the area with alcohol. A concentrated salt solution (hypertonic saline) will be injected into the appropriate sites through a very fine needle. There is a minute amount of discomfort as the needle penetrates the skin. Occasionally there is a flushing or “hot” feeling when solution is being injected. Some people may experience a mild cramping sensation that passes after a few minutes. You may notice during the treatment that as the solution is injected that a whole network of veins may disappear and reappear moments later, this is normal. The vessels may appear swollen or irritated after the treatment and this will resolve in two to five days. The injections sites will all be covered with gauze and tape. Finally an ace wrap or compression stocking (we regularly recommend that patients purchase 20 to 30 mmHg) will be placed over the treated regions.
Sclerotherapy: Post procedure
The area may ache slightly after the treatment. Tylenol should be taken for discomfort. We recommend the night following the procedure to keep your legs elevated and not to do extensive walking or exercise. Walking is encouraged the next day, but heavy exercise should be avoided for one week. The gauze and tape may be removed the next day, but the Ace wrap or compression hose should be worn consecutively for seven days with the exception of bathing. You may develop noticeable swelling in your legs especially in the ankle area during the week following your treatment. Foods high in salt content should be avoided three days after the treatment. Sun avoidance in mandatory in areas where there is bruising or discoloration to facilitate healing and resolution of discoloration.
How many treatments will I need?
Patients will most likely require several treatment sessions to get the best clearance. Veins can recur which will necessitate future treatments. It is recommend to start with a small area of involvement, wait six weeks and determine if this therapy has the expected results you desire. On the average, most individuals will have between 40-70% clearing per treatment session.
For the Needle Phobic patient, GlamDerm also offers leg vein removal via laser with the Elite Plus.
Light energy causes the blood within the vein to coagulate. The now non functional vein is seen by the body as unnecessary and it is absorbed by the body. Blood flow is redirected to deeper veins. Successful varicose vein treatment may require both Laser and sclerotherapy to provide the most complete resolution. The process is gradual and often requires 2 to 3 sessions for maximum clearance.
Laser Removal of Leg Veins: The procedure
Prior to treatment, your skin is cleansed and you will be given protective goggles to wear. When the laser fires, you will feel a warming or tingling. Many people describe the sensation as the sharp snap of a rubber band. The procedure takes anywhere from 5 to 30 minutes, depending on the number of areas treated. A cold compress applied afterward helps calm the skin.
After the treatment your skin will feel warm for several hours. There may be some redness and minimal swelling that can last up to 48 hours. In some cases you may experience a bruise, but this is often a result of taking common blood thinning supplements such as aspirin, Vitamin E, Omega 3 or anti inflammatory medications like Ibuprofen, Advil.
Laser Removal of Leg Veins: Post procedure
It is normal to see redness and some swelling. In some cases, when more aggressive settings are used, you may notice “welts” or “stripes” which develop within the first 24 to 48 hours. This possible side effect can be minimized by frequently applying cold compresses the day of treatment.
If a bruise occurs, this usually disappears in under a week. Vascular laser treatments create few complications when performed by properly trained medical providers.
Veins can recur and most often multiple sessions are required to get the best clearance. Post treatment pigmentation can sometimes occur despite the most careful treatment. Should this happen, the area will resolve with time. In some instances, a bleaching cream may be prescribed.