Leg Veins - Varicose Vein & Spider Vein Treatment
Hiding your spider veins under clothing is a daily and often upsetting inconvenience. If you are tired of not being able to enjoy life your way, especially in summer, talk to our friendly doctors, and make a start on saying goodbye to spider veins!
Spider veins on the legs have a red (telangiectasia)or bluish (venules) colour; they are a common problem which particularly affect women. Unfortunately these veins are often unsightly and attempting to conceal them with clothing or cosmetics are not always successful, in many cases people change their lifestyle to avoid exposing their legs. Larger leg veins may be raised above the skin surface and may be associated with some aching.
What causes blood vessels to become visible?
The cause is not known, except that in many cases they run in families. More women than men seem to develop this condition perhaps as a result of pregnancy or because of hormones. Trauma to the leg in the form of blows or falls may contribute and long periods of standing or sitting may also be causative factors.
How can spider veins & varicose veins be prevented?
There is no proven method of prevention. The use of support stockings, weight control, and regular exercise may be beneficial.
What treatments are available?
Laser can effectively treat the smaller (red to purple) spider veins, whilst sclerotherapy is useful for the larger (purple to blue) varicose veins. Often a combination of the two is used. Sometimes assessment of the venous circulation in the legs is important for planning effective treatments. Doppler Ultrasound assessment can assess the presence of incompetent valves in the circulation where backflow occurs and varicose veins develop. In cases of significant varicose veins, our doctors will often recommend assessment by a vascular surgeon, or radiologist (endovenous laser is an alternative to stripping operations).
How does laser treatment work?
The Cynergy Pulsed Dye and YAG Laser works by targeting these vessels and causing them to shrink over a period of 4 - 6 weeks after treatment. The use of a special cooling tip on the handpiece minimises any discomfort and also helps to protect the skin. It is most effective when vessels are 1 to 1.5 mm in diameter. Multiple treatments will generally be required before end results are achieved. Treatment is quick and a large number of veins can be treated in a session of between 15 and 60 minutes. Immediately afterwards the area becomes red with some minor swelling.
Sclerotherapy involves injecting a fibrosing agent - aethoxysklerol or polydocanol, directly into the blood vessel. The solution displaces the blood within the vein and irritates the internal layer of the vessel. This irritation causes inflammation which results in the vessel gradually shrinking in size over a period of weeks to months.
Most leg veins require multiple treatments but it is important to understand that complete disappearance of all vessels is rare. A small percentage of patients fail to show any improvement at all despite repeated attempts.
If there is a family history of DVT (deep vein thrombosis), blood tests may be ordered to exclude a familial blood clotting disorder prior to treatment (over 5% of the population have some inherited or acquired blood clotting disorder). Sometimes there is significant backflow from the deep to the superficial leg veins. This occurs from incompetent or leaking valves in the veins. In some cases our doctors will order a doppler ultrasound examination of your legs to clarify if this is present, as other therapy such as vein stripping or endovenous laser treatment may be needed to achieve good results. Some conditions are a contra-indication to sclerotherapy. A previous DVT is an important contra-indication, as are a medical history of auto-immune disease or significant other illness.
What are the risks of laser?
These are as follows:
- Skin discolouration. This is where the skin may become lighter or darker in colour along the line of the treated veins. This is generally temporary.
- No improvement. A small number of patients find no improvement occurs.
- Scarring. This is not common.
- New vein formation. This is where tiny new veins form to replace the treated vessel and is uncommon.
Find out more about the Risks and Effects of Laser Treatment
Note - IPL should not be used on spider vessels - IPL is ineffective on spider vessels, and should not be used due to significant risks of burns or hyperpigmentation on the legs.
What are the risks of sclerotherapy?
These are as follows:
- No improvement. A small number of patients find no improvement occurs
- Skin discolouration – brown discoloration which usually disappears over time, but in 5% can persist for years. Laser may improve this.
- Blisters due to small amounts of solution seeping into the tissues - heal quickly
- Lumps within the vessels - small clots, not dangerous. Will disappear spontaneously
- Swelling - especially in patients whose jobs require standing or sitting for long periods of time. More likely to occur when ankle or lower legs are injected. Helped with elevation and compression stockings
- Inflammation (phlebitis) may occur with larger vessels.
- Matting - the development of new fine vessels near sites of injection, especially on the thigh. Most will resolve, but in a few these may become permanent.
- Ulcers at injection sites
- Allergic reactions - very rare
- Thrombosis (DVT) in vulnerable individuals. Sclerotherapy should not be done in individuals who have a clotting disorder or who have had a DVT in the past, or in pregnancy.