Sclerotherapy – Spider Vein Injections
Varicose and Spider veins are leg veins which have become abnormally enlarged. They can protrude or appear flat on the surface of the skin. The reason they occur is because valves in the vein stop functioning properly and allow a backward flow of blood to enlarge and fully weaken the veins. The enlarged veins can be classified into 1 of 3 general sizes:
1. LARGE TRUNCULAR VEINS – These large veins include the large and short Saphenous Veins. These divide into the Reticular Veins.
2. MEDIUM SIZED or RETICULAR VEINS – These usually comprise a network of blue- green which feed into the spider veins.
3. SMALL SIZED or SPIDER VEINS – These can be blue, red, or purple. The reticular veins must be treated before the spider veins. Spider veins on the face can be treated as well, usually with laser techniques.
Causes of Varicose Veins
The main cause is hereditary (runs in the family). Women are more prone to varicose veins because of female hormones, and are especially worse after pregnancy. Age also plays a role – with increasing age more veins develop. Other less common causes include: prolonged standing, obesity, whirlpools, wearing high heels or tight girdles and the use of birth control pills.
Symptoms of Varicose Veins
Varicose veins may not be painful at all. Larger veins are not necessarily more painful than smaller ones. Often it is the smaller spider veins that cause more discomfort and burning. Vein symptoms are often worse at the end of the day, or with menstruation, or pregnancy. The discomfort may be described as a sharp pain, dull pain, burning, aching tiredness, or restlessness. Night cramps may also occur.
Treatment Options for Varicose Veins
SURGERY ~ This is the preferred treatment for the large varicose long and short Saphenous Veins. A stripping operation removes the large veins leaving only a few small scars. After surgery, Sclerotherapy is used to treat the side branches even if they are large truncular veins. There are many large veins the can be treated by Sclerotherapy thereby avoiding surgery and anaesthesia.
SCLEROTHERAPY ~ This technique is used to eliminate veins of all sizes. It involves a tiny injection into the vein causes an irritation of the walls of the vein. The vein then hardens, and gradually breaks up disappearing without a trace. A typical appointment lasts approximately 10-15 minutes.
LASER ~ Laser can be used to treat some veins- usually on the face. Sclerotherapy is still a superior treatment to laser for leg veins.
What is Sclerotherapy?
Sclerotherapy is a series of needles given at The Toronto Vein Clinic, cotton balls are taped to each injection site. The tapes are important to give gentle pressure to the treated veins. The cotton balls may be removed 2-3 hours later. Some bruising may last for several days.
The injections are not very painful, in fact, less painful then a blood test.
Normal activity can resume right after treatment, but we ask that you avoid strenuous work/exercise on the day of treatment. Please avoid prolonged periods of immobility on the day of treatment such as long naps or long car drives. Do not schedule any air flights for 2 weeks after your treatment. Do not schedule any overseas flights for 3 weeks after treatment. Please check with Dr. Weksberg prior to your appointment regarding any long flights over 3 hours duration.
Treatments are usually performed every two weeks, and occasionally weekly. The total number of treatments will vary between patients, but can be as short as 1-2 visits, or require over 15 visits. The larger veins are treated first, then the smaller veins afterwards.
Sclerotherapy will not eliminate hereditary tendency to develop varicose or spider veins. Patients may therefore notice some new but different veins in the future. These should be treated to keep the veins under control. Yearly follow up and treatment at The Toronto Vein Clinic is therefore recommended as necessary.
What are the possible Side Effects of Sclerotherapy?
Rare side effects may include:
- Small brown patches may occur on spots treated in about 5% of cases. These will usually fade in several weeks to months. They are almost never permanent.
- A slightly tender red bump may develop in injected areas. This is an irritation of the vein from the injected medicine. There is no need to rest in bed. It will generally resolve in less than a few weeks.
- Spider veins (telangiectasia) may develop after the larger veins are treated in about 5% of cases. They usually disappear by themselves within 4 – 8 weeks. If a few veins persist these can be treated at a future visit to the clinic.
Complications are very rare but may include:
- Skin ulcer healing with a scar (very rare).
- Allergic reactions are very rare. The reaction may be mild (eg. itchiness) or severe (eg. anaphylaxis or very low pressure).
- Deep vein thrombosis (blood clot in leg) and pulmonary embolism (blood clot in the lung) are very rare.
What do I need to do BEFORE my Sclerotherapy Treatment?
- Do not use creams or oils on your legs the night before and the day of treatment. Using creams or oils interfere with adherence of the tapes to the skin, and can result in more bruising.
- Avoid hot baths and whirlpools. These cause further enlargement of veins.
- Do not shave legs the day before and the day of treatment.
- Try to avoid self tanning creams. The tapes may cause temporary discoloration of the artificial tan.
What do I need to do AFTER my Sclerotherapy Treatment?
- Remove the cotton balls 3-4 hours after treatment. You may notice sticky tape marks on your legs. These can be easily removed with adhesive remover.
- You may notice small bumps, or darkening of the veins. This is temporary and should gradually resolve.
- Continue your normal routine. Moderate exercise such as walking is encouraged.
- For optimal outcome Dr. Weksberg recommends you wear compression stockings following your treatment and suggests Jobst Medical Compression stockings with a compression level of 15mmHg or higher.
- If standing for long periods, remember to tense and relax your calf muscles periodically to aid circulation.
- Try not to wear tight girdles. They block blood flow through veins. High heeled shoes also slow the circulation.