Dr. Gail Nield does all the injectable procedures in our office, including Botox® and soft tissue fillers. Many patients take advantage of their time alone with Dr. Nield to discuss other dermatologic and cosmetic concerns.
Developed over 75 years ago, sclerotherapy is one the safest and widely-used treatments for spider and varicose veins. Using a tiny needle, Dr. Nield injects a solution into your vein that replaces the blood and causes the walls of the vein to corrode. Your body’s natural healing process then causes the vein to break down, shrink and eventually disappear.
During your initial consultation, we will review your medical history to see if sclerotherapy is a good option for you.
Most sclerotherapy patients see a significant improvement or are completely cleared of their leg veins. There is, however, no guarantee that sclerotherapy will work in every case; about 10% of patients who undergo the treatment have some remaining veins after the recommended number of treatments. In very rare cases, your condition could get worse after treatment.
Dr. Nield will do a thorough exam of your legs in a standing position, and if she feels that you may have large varicose veins that will not respond to local in-office injections, she will recommend further evaluation such as a non-invasive Duplex scan of your veins. Once the results are available, she will review the findings with you to determine available options.
We start by examining the veins in question, and working up a treatment strategy that will best eradicate them. You may be asked to stand while problem veins are marked and photographed. Then, using a tiny needle, Dr. Nield injects the sclerosing agent into the targeted veins. Treatment lasts anywhere from 15 to 30 minutes, depending on the number of veins being treated in a particular session.
No anesthesia is needed for this treatment – any discomfort you feel will be minimal.
You will see results gradually. Most patients see 60% to 80% of their unwanted veins disappear over a series of treatments.
Multiple treatments may be necessary to get satisfactory results. The number you’ll need depends on the how many varicose and spider veins you have. The average for most of our patients is 4-6 treatments, though up to 8 treatments may be required.
Spider veins will immediately turn darker after a treatment and will look like small scratches – they will disappear in 3 to 4 weeks. Larger veins may bruise. Facial veins usually require up to 3 sessions to resolve. They can return over time but can be retreated.
For the first 3 days after each treatment, you’ll be asked to wear tensors (you can take them off at night). You may need to wear support hose or a supportive wrap for a short while after your treatment to improve your response to the therapy and prevent recurrence.
For 3-5 days after each treatment, you should avoid hot baths or any strenuous exercise such as high impact aerobics, running or weightlifting. Walking, however, is highly recommended.
For the first month after treatment, you’ll need to avoid flying (unless you’re wearing support stockings). Tanning should also be avoided while you’re undergoing treatment.
The most common side effects of sclerotherapy treatment are:
Spider veins pose no health risk; getting rid of them is purely a cosmetic decision. However, large varicose veins (ones greater than 4 or 5 mm in diameter) can cause problems if left untreated. Spontaneous phlebitis or thrombosis can occur, with the associated risk of possible pulmonary embolism (a blood clot to the lungs). If you have long-standing varicose veins with venous insufficiency (when the valves in your leg veins are unable to pump blood to your heart and blood pools in your legs) you can develop ulcerations in the ankle region. Rarely, these ulcers may hemorrhage or become cancerous.
In Dr. Nield’s experience, leg vein injections are the simplest, safest and most cost-effective treatment for leg veins, so she usually offers this procedure first. However, other options can be discussed during your initial consultation.
Facial, chest and neck spider veins usually respond quite nicely to Laser or Intense Pulsed Light sources. A series of treatments are usually required. Some patients have small 1 to 2 mm blue veins lateral to their eyes known as periorbital reticular veins. These can be treated with our Yag Laser.
Vein ligation and stripping may be an option, but unlike sclerotherapy, it is surgery. In it, the vein is surgically removed (stripped) through several incisions in the skin.
Endovenous laser treatment (EVLT) collapses veins using laser energy delivered from a thin laser fibre placed within the vein.
Laser treatment for smaller veins is also an option, especially for cases of neovascularization (the development of tiny new blood vessels). Laser vein removal is offered in our clinic. Some patients may be candidates for Yag laser vein treatments while others may need Intense Pulsed Light treatments for their leg veins.