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Vein Treatment

What are varicose veins and spider veins?

Varicose veins are veins that can enlarged and be red, blue, or other colors. They appear as twisted and/or bulging. Frequently they are swollen above skin surface. They are most likely to be found on the inside leg, calves and thighs. Spider veins are smaller then varicose veins. They also do not bulge and swell as much as a varicose vein. They look like spiderwebs with their jagged lines. They are found mostly on the face and legs.

Causes for spider and varicose veins

Varicose veins are frequently associated with damaged valves. The heart pumps blood filled with oxygen and nutrients to the whole body through the arteries. Veins then carry the blood from the body back to the heart. As your leg muscles squeeze, they push blood back to the heart from your lower body against the flow of gravity. Veins have valves that act as one-way flaps to prevent blood from flowing backwards as it moves up your legs. If the valves become weak, blood can leak back into the veins and collect there. (This problem is called venous insufficiency.) When backed-up blood makes the veins bigger, they can become varicose. Spider veins can be caused by the backup of blood. They can also be caused by hormone changes, exposure to the sun, and injuries.

How are varicose and spider veins treated?

Sclerotherapy

Sclerotherapy is the most common treatment for both spider veins and varicose veins. The doctor uses a needle to inject a liquid chemical into the vein. The chemical causes the vein walls to swell, stick together, and seal shut. This stops the flow of blood, and the vein turns into scar tissue. In a few weeks, the vein should fade. This treatment does not require anesthesia and can be done in your doctor’s office. You can return to normal activity right after treatment.

The same vein may need to be treated more than once. Treatments are usually done every 4 to 6 weeks. You may be asked to wear gradient compression stockings after sclerotherapy to help with healing and decrease swelling. This treatment is very effective when done correctly.

Possible side effects include:

  • Stinging, red and raised patches of skin, or bruises where the injection was made. These usually go away shortly after treatment.
  • Spots, brown lines, or groups of fine red blood vessels around the treated vein. These also usually go away shortly after treatment.
  • Lumps of blood that get trapped in vein and cause inflammation. This is not dangerous. You can relieve swelling by applying heat and taking aspirin. Your doctor can drain the trapped blood with a small pinprick at a follow-up visit.

There is a type of sclerotherapy called ultrasound-guided sclerotherapy (or echo-sclerotherapy). This type of sclerotherapy uses ultrasound imaging to guide the needle. It can be useful in treating veins that cannot be seen on the skin’s surface. It may be used after surgery or endovenous techniques if the varicose veins return. This procedure can be done in a doctor’s office. Possible side effects include skin sores, swelling, injection into an artery by mistake, or deep vein thrombosis (a potentially dangerous blood clot).

Surface Laser Treatments

In some cases, laser vein treatments can effectively treat spider veins and smaller varicose veins. This technique sends very strong bursts of light through the skin onto the vein. This makes the vein slowly fade and disappear. Not all skin types and colors can be safely treated with lasers.

No needles or incisions are used, but the heat from the laser can be quite painful. Cooling helps reduce the pain. Laser vein treatments last for 15 to 20 minutes. Generally, 2 to 5 laser vein treatments are needed toremove spider veins in the legs. Laser therapy usually isn’t effective for varicose veins larger than 3 mm (about a tenth of an inch). You can return to normal activity right after treatment.

Possible side effects of lasers include:

  • Redness or swelling of the skin right after the treatment that disappears within a few days
  • Discolored skin that will disappear within 1 to 2 months
  • Burns and scars from poorly performed laser surgery, though this is rare

Endovenous Techniques (Radiofrequency and Laser)

These methods for treating the deeper veins of the legs, called the saphenous (SAF-uh-nuhs) veins, have replaced surgery for most patients with severe varicose veins. These techniques can be done in a doctor’s office.

The doctor puts a very small tube, called a catheter, into the vein. A small probe is placed through the tube. A device at the tip of the probe heats up the inside of the vein and closes it off. The device can use radiofrequency or laser energy to seal the vein. The procedure can be done using just local anesthesia. You might have slight bruising after treatment.

Healthy veins around the closed vein take over the normal flow of blood. The symptoms from the varicose vein improve. Usually, veins on the surface of the skin that are connected to the treated varicose vein will also shrink after treatment. If they don’t, these connected veins can be treated with sclerotherapy or other techniques.

Surgery

Surgery is used mostly to treat very large varicose veins.

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