Spider veins or telangiectasia of the leg is an issue that particularly affects women. Small blue, red or purple veins can form anywhere in the leg. Sclerotherapy is a procedure which involves the use of a very fine needle to inject a sclerosant solution directly into the veins. The solution causes the blood in the vein to cause damage to the vascular endothelium, and possibly the entire vascular wall.
• Safe and effective
• Non-invasive
• Minimal downtime
• Virtually painless
Laser sclerotherapy
• Standing for long periods of time
• Lack of exercise
• Obesity
• Wearing high-heeled shoes
• Wearing tight undergarments or pants
• Oral contraceptive pill
• Localized trauma
• Pregnancy
Sclerotherapy is recommended for all veins smaller than 4mm in diameter, but for those less than 1mm in diameter that persist following sclerotherapy, Nd:Yag laser (Gemini, Cynergy) needs to be considered.
A solution of sclerosant is injected into the vessels with a very fine needle needle. The solution acts on the wall of the blood vessels to induce the blood vessels to close up (sclerose). The significance of this technique is that many of the blood vessels communicate with each other, and thus one injection may eradicate an entire interconnecting complex of vessels. A number of injections are usually placed in each complex of vessels to increase the success of treatment. After a few weeks the vessels disappear. Several treatments may be necessary to eliminate the vessels completely.
There is minimal discomfort during this procedure.
Pain – the solution may sting a little on injection, however most people tolerate the sensation quite well.
Hyperpigmentation – some increase in colour around the blood vessels occurs in 20% of cases. This usually settles within six weeks. Rarely, pigmentation may be long-lasting.
Crusting – at the injection site occurs in 10% of cases. This heals uneventfully.
Swelling – of the ankles after treatment of this area may occur. This resolves without treatment.
Bruising – around the injected area occurs occasionally.
Tenderness – and some noticeable clotting around the vessel may occur with larger veins. This may feel like a rope and be warm to touch, but resolves uneventfully.
Telangiectatic formation – a network of tiny pink vessels occurs in 5% of patients. These vessels will often resolve by themselves within six months, or may be re-injected for a speedier resolution.
Ulcer – an ulcer at the injection site develops in 1% of patients. This will heal with a flat scar, usually.
Deep vein thrombosis – is a very rare complication. It is only a significant risk where injection of large vessels near their junction with deep vessels is being performed.
Please instruct Dr McKerrow if you have any inherent blood disorders (such as Von Willebrand’s disease), or if you are taking any blood thinning pills such as Aspirin, Cartia, Warfarin, Clopidogrel (Plavix). Compression bandages are required and are fitted immediately after sclerotherapy. We recommend stockings with a pressure of 20 – 30mm Hg pressure. Stockings are supplied by Active Physio (Brigit Holford) – phone 524-0624, 264 Manukau Road, Epsom. Such stockings are to be worn for at least 3 - 7 days, 24 hours a day and after that time on a 12 hour basis for a further three weeks. I suggest you walk for 30 minutes immediately following the procedure, and encourage you to walk for 30 minutes each day in the weeks after treatment. Compression has several benefits:-
• It results in direct apposition of the treated veins to produce more effective sclerosus of your vein.
• It decreases the extent of thrombus formation.
• It decreases the incidence of pigmentation following this procedure.
• Lastly, it improves the function of your calf muscles.
The number of treatments and results expected will be discussed in detail and may require predominantly sclerosants only, and for small veins laser ablation.
Who Performs the Treatment?
Dr McKerrow