LEG VEIN TREATMENTS (SCLEROTHERAPY)
Do you wear long pants and skirts to hide your varicose veins? Are you concerned about unsightly veins in your face?
Good news – we offer vein removal treatments that will let you show your face and legs again. Sclerotherapy is a simple, effective cosmetic procedure that involves injecting a solution into your veins to make them shrink and disappear. The difference is remarkable; your legs will be smoother, feel healthier and look more attractive.
Most men cannot fathom the distress that women feel when they have leg veins.
Women will wear pants in the heat of summer if they have obvious networks of veins on their legs. Some will even try to tan their legs to try to cover up their veins. Overall, this is not a very effective solution.
Contrary to popular belief, spider leg veins do not usually respond very well to laser treatments. Sclerotherapy is a much better, effective option. Dr. Nield injects a sclerosant such as saline which dissolves the unsightly veins over time. Many clinics only offer laser leg vein treatments since technicians are unable to perform Sclerotherapy. Hence, many patients come to our clinic, having paid for ineffective laser treatments of their leg veins at spas that do not have qualified physicians who can offer more effective treatments.
Dr. Nield performs the treatments herself. A series of 4-6 sessions may be needed to dissolve the veins. Dr. Nield also recommends prescription support hose to further enhance the results. Maintenance treatments will be needed in the future. All patients are encourage to wear 20-30 mm Hg support hose to improve results.
Large varicose veins will need further ultrasound evaluation and referral to a vascular surgeon to discuss options such as EVLT or surgery.
Facial veins do respond to laser or Intense Pulsed light treatments that are available here in our clinic.
To find out if sclerotherapy is right for you, please contact us to book a consultation with Dr. Nield.
Dr. Gail Nield does all the injectable procedures in our office, including Botox®/Xeomin® and dermal 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 become inflamed. 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 few weeks after each treatment, after each treatment, you will be asked to wear prescription support hose, 20-30 mmHg. 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:
- Itching. You may experience some itching along the vein route for 1-2 days.
- Pain. Veins may be tender to the touch after treatment, with an uncomfortable sensation along the vein route. Some patients may experience moderate to severe pain and some bruising, usually at the site of the injection. The pain is usually temporary, in most cases lasting 7 days at most.
- Discolouration. 30% of patients notice light brown streaks. For almost all patients, veins become darker immediately after the procedure. This discolouration is temporary, though in rare instances, it can take 4-12 months to disappear. In 1% of patients, that pigmentation becomes permanent.
- Sloughing. In 3% of patients, a small blister may form at the injection site and become ulcerated. The scar that follows should return to a normal colour.
- Allergic reaction. Some patients may have an allergic reaction to the sclerosing agent, or to the tape used.
- Thrombus. A ropey, painful area may form along the treated vein. This is uncommon but can be treated with drainage.
- Granulomas. A painful, firm area can form around the treated vein. This is rare and can be treated with Kenalog injections.
- Neovascularization. Tiny new blood vessels may develop.
- Transient phlebetic-type reactions. The swelling of the vein might cause the ankles to swell.
- Temporary wheals. You may notice bumps that are similar to hives.
- Wound infection, poor healing or scarring. This occurs very rarely.
- Phlebitis. This is a very rare complication (seen in 1 out of every 1000 patients treated for large varicose veins. The dangers of phlebitis include the possibility of a pulmonary embolism (a blood clot to the lungs) and post-phlebitis syndrome, in which the blood clot remains in the leg, resulting in permanent swelling of the leg.
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.
We’re happy to answer any questions or provide you with additional detail. Please download our consent form here: