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Sclerotherapy for spider vein removal

Sclerotherapy injections for spider vein removal.

The Veinlite ring used during Transilluminated Sclerotherapy

The Veinlite ring used during Transilluminated Sclerotherapy. The light generated by the Veinlite device makes the skin translucent and allows the vein doctor to locate even the tiniest veins as well as hard-to-find deeper veins.


Sclerotherapy Injections for Spider Vein Treatment

Sclerotherapy: The Best Treatment in Los Angeles for Small Blue Veins and Leg Spider Veins

Sclerotherapy, best performed by a vein specialist doctor, is considered the gold standard treatment for leg reticular (blue 1-3mm veins) and spider veins. It also gives excellent results when used for the removal of prominent hand and arm veins. When applied to leg veins, the skin of your legs will appear younger, clearer and more healthy-looking. Once again, you can wear skirts and shorts without feeling uncomfortable about the look of those unsightly veins and broken capillaries. Laser vein treatment; on the other hand, works best on facial spider veins and very fine veins on other parts of the body.

Click spider vein removal FAQ for answers to frequently asked questions regarding the choice of treatment technique as related to the type and location of reticular and spider veins. These answers were provided by Dr. Raffi Dishakjian, M.D., the vein specialist at the Center.

Click reticular and spider veins to learn about the nature of these veins.

How Does Sclerotherapy Work?

Sclerotherapy is a relatively simple spider and reticular vein removal procedure using tiny needles to inject a sclerosing solution into the problem veins, causing them to collapse and fade. Not only will your leg's appearance improve dramatically, but the bothersome symptoms associated with spider veins will also significantly improve, including burning, aching, swelling and night cramps. Sclerosing agents that are used for reticular and spider vein removal are mild enough to allow predictable and relatively painless treatment.

It should be pointed out that currently Sclerotherapy is usually not used for the treatment of varicose veins due to the fact that the treatment of these larger veins requires large quantities of sclerosing agents, which could exceed safety limits. Bulging varicose veins are treated best with either foam Sclerotherapy or endovenous closure techniques.


Sclerotherapy Spider Vein

BEFORE & AFTER GALLERY. click here...

Who Are the Best Candidates for Sclerotherapy?

Woman and men of any age who are suffering from unsightly spider veins and reticular veins (small to medium-sized blue veins) are good candidates for sclerotherapy. If you are pregnant or breastfeeding, it is advisable to postpone sclerotherapy, as fetal safety is not established. In addition, many pregnant women experience dramatic spontaneous improvement in the months following delivery, making treatment simpler, and sometimes unnecessary. Dr. Dishakjian, the vein specialist doctor, will examine your legs, review your medical history and the severity of your condition to determine the best spider vein treatment procedure or combination of treatments.

What to Expect During a Sclerotherapy Session?

The typical spider vein treatment session is relatively quick, lasting only about 30 to 60 minutes. While lying on an examination table, the treatment area of your legs will be cleansed with an antiseptic solution. The needles that are used for reticular and spider vein removal are very small and well tolerated. In addition, discomfort is minimized by mixing local anesthetic in the injected solution, and occasional application of numbing medicine to sensitive areas, like the ankles. For better visualization, Dr. Dishakjian uses a hand-held ring, called the Veinlite. This small, but advanced device virtually illuminates the skin from beneath, allowing the doctor to locate even the tiniest veins as well as hard-to-find deeper reticular veins that serve as feeder veins for superficial thread veins. The technique is known as transilluminated Sclerotherapy because the Veinlite device transilluminates the skin making it translucent. Transillumination by the Veinlite device is achieved by the light generated by a halogen bulb which travels through a high quality fiber into the Veinlite ring, which is placed in direct contact with the skin to provide uniform illumination and visualization of spider and the deeper-lying feeder veins. The treatment of feeder veins is important for longer-lasting Sclerotherapy outcome.

Approximately one injection is administered for every inch of spider vein removal. Some people may experience some cramping or a mild burning sensation which quickly dissipates. Typically, for any given area, two to three spider vein treatment sessions are required to achieve optimal results. The procedure treats only those leg veins that are currently present, whether visible or not to the naked eye, and does nothing to prevent the emergence of entirely new spider veins in the future.


Sclerotherapy for reticular vein removal

Is There Any Pain After Schlerotherapy?

There is often some degree of inflammatory response after a sclerotherapy session, with mild to moderate sensitivity and tenderness in the area, depending on the density and thickness of the veins treated as well as the type and strength of the solution used. Anti-inflammatory medications as well as herbal homeopathic preparations that are commonly used are helpful and minimize these symptoms.

What is Cryo-sclerotherapy?

Cryo-sclerotherapy is a new modified sclerotherapy technique using cold air before and during the injections of sclerosing liquid into unsightly veins. The use of cold air for cooling is not new in cosmetic surgery; for example, cold air is used for many laser procedures such as in laser resurfacing. Main advantages of cryosclerotherapy instead of traditional sclerotherapy relies in the physical effect of cold at treated veins, whereby the skin is cooled and numbed at the injection site, alleviating the discomfort during the procedure, such as sensation of multiple pinpricks or mosquito bites. Cryo-sclerotherapy is indicated for the treatment of small varicose veins, reticular veins, and spider veins of the leg and hands.

When is the Best Time of the Year to Have Sclerotherapy?

Sclerotherapy could be performed anytime of the year; however, many patients feel more comfortable wearing compression stockings during the colder months of the year. Moreover, complete healing, including the disappearance of the treated spider veins, bruising and pigmentation, may sometimes take several weeks. Consequently, if you want to make sure that your legs are ready for summer, make sure to start the treatment accordingly.


Sclerotherapy for reticular and spider vein treatment

Is Sclerotherapy Safe?

In expert hands, sclerotherapy is remarkably safe. Serious complications like deep vein clotting or major allergic reactions are rare. Some side effects (like bruising, tenderness, itching, pigmentation, matting, etc) may occur, but are manageable and not very serious in nature.

What Are the Side Effects of Sclerotherapy?

Serious medical complications from reticular and spider vein treatment with sclerotherapy are extremely rare when the procedure is performed by a qualified physician. Common side effects of spider vein treatment with sclerotherapy are usually temporary and well tolerated. The most common effects of sclerotherapy include:

  • Swelling, redness, tenderness and itching (these tend to gradually disappear within hours to days).
  • Some bruising and retained dark blood clots in the treated veins (some bruising almost always occurs, but gradually fades over a few weeks in most cases).
  • Brown pigmentation and matting (the appearance of blush like microscopic network of fine red vessels).
  • A Small skin ulceration that would heal leaving a permanent scar. This should be rare event in experienced hands and is minimized by a meticulous technique and use of the mildest solution that can achieve the desired result.
  • Allergic reactions to the commonly used sclerotherapy solutions (tends to be very rare).

Why Does Pigmentation Occur?

The chance for developing brown staining (pigmentation) after sclerotherapy is anywhere from less than 5% to about 30%. It is dependent on several factors, like the skill and technique of the doctor, the nature and strength of the solution used, the density and size of the vessels in the area as well as your skin complexion.


Sclerotherapy Spider Veins removal

Could the Pigmentation Resulting from Sclerotherapy be Treated?

Most pigmentation resolves spontaneously over time, although it may sometimes take several months or longer to disappear. Light based treatments like IPL sometimes help expedite the process.

What Can One Do to Get Rid of the Matting that Sometimes Follows Sclerotherapy?

Matting, not a common side effect, may disappear even if untreated. In resistant cases it may be treated with a combination of sclerotherapy and or light based treatments like lasers and IPL (Intense Pulsed Light).

How to Prepare Oneself for Sclerotherapy?

Avoid tanning during the weeks leading to sclerotherapy treatment, and do not take any NSAID medications (such as ibuprofen, Advil, Motrin), vitamin E, or herbal supplements that increase your chances of bruising. Don't shave on the day of the treatment as the solution used for cleansing purposes may cause some stinging. It is also recommended that you bring a short that you can wear during leg vein sclerotherapy.

What Is Recovery From Sclerotherapy Like?

Although sclerotherapy generally does not require any recovery time, it is advisable to avoid activities that may lead to dilation of veins and blood stagnation, such as heavy lifting, strenuous exercise or hot baths. You are encouraged to walk to speed up the circulation in the legs and enhance the safety of the procedure. Wearing compression stockings for about a week after sclerotherapy is also recommended to improve the spider vein removal outcome and minimize discomfort and complications. Go to compression therapy and watch the video on how to wear compression stockings.

What Are the Sclerosant Solutions Used for Spider Vein Treatment?

Hypertonic saline (18%-30% salt solution) was the primary sclerosing agent for many years. Hypertonic saline is FDA (U.S. Food and Drug Administration) approved, but not as an sclerosant for spider vein removal. Until recently, Sotradecol (Sodium Tetradecyl Sulfate or STS, an anionic surfactant) was the only FDA approved sclerosant intended for spider vein removal. On March 30, 2010, the FDA approved Asclera (polidocanol, a non-ionic detergent) injection for the treatment of spider veins (tiny varicose veins less than 1 millimeter in diameter) and reticular veins (those that are 1 to 3 millimeters in diameter). Chromated glycerin (Sclermo), regularly used for spider vein removal by many vein specialists in the United States is not yet FDA-approved, despite being a very popular sclerosant throughout the world with a long track record of safety and effectiveness. Other sclerosant solutions that are rarely used in the United States for spider vein treatment of the legs include sodium morrhuate (fatty acids in cod liver oil), ethanolamine oleate, hypertonic saline/dextrose (10% saline, 5% dextrose) and polyiodide iodine (chemical irritant). Among these, Dr. Dishakjian uses Polidocanol, Sotradecol, both FDA approved, or chromated glycerin, especially when brown pigmentation has been a problem with previous sclerotherapy treatments with either Polidocanol, or Sotradecol.

Can All Spider Veins be Treated in a Single Sclerotherapy Session?

There is a maximum safe dose for each sclerotherpy solution that can be safely used in a single session, limiting the number of veins that can be treated in a single session.

How Does a Treated Area Look Like After Sclerotherapy?

Immediately after the injections, the treated areas often look somewhat inflamed, like a bug bite, a little raised and pinkish. This often disappears within a few hours, replaced by dark blue bruising, which over time gradually fades to red or brown, before disappearing.

What to Expect After the First Treatment Session?

As the initial bruising subsides, some veins may disappear completely, others may show little islets of isolated beads of clots along the track of the vein. Other veins may survive but become much thinner and weaker and more susceptible to closure with the following session. Sometimes one can see the emergence of new and thinner veins around a successfully treated larger vein. These veins can be easily treated during a follow up treatment session. Generally speaking, most patients should expect improvement of at least 50-60%, over a few weeks after a single treatment.

How Many Sclerotherapy Sessions Are Usually Needed?

Although individual outcomes vary, in experienced hands, most patients need 2-3 treatment sessions for any given area, with each treatment session resulting in at least 50-60% improvement compared to before. At the end of the process most patients can expect about 80-90% clearance, the remaining veins often being hardly visible except at a close range.

How Long Should One Wait Between Sclerotherapy Sessions?

In most cases it is recommended to wait about 3 weeks before re-treating a particular area.

How Long Does it Take for the Spider Veins to Disappear?

It depends on many factors, including the technique of injection, the type and strength of solution used in sclerotherapy, the density and thickness of the vessels in a given area, as well as the skin complexion of the patient. In our experience most veins disappear between 2 weeks and two months, although in select cases the process may take somewhat longer.

Are There Any Particular Instructions for After Sclerotherapy?

It is recommended to engage in moderate physical activity, wear the prescribed compression stocking, and avoid sun exposure of the area while healing.

What Sort of Activities One Should or Should Not be Doing After Sclerotherapy?

Moderate physical activities that involve the use of the legs like walking, cycling, hiking, use of the treadmill or elliptical exercise machines are most encouraged. These activites enhance the blood flow to the legs and speed up the circulation. Activities that lead to venous pooling in the legs, on the other hand, should be avoided. These include lifting of heavy weights, belly crunches and any exercise that increase the core pressure of the body, as well as extreme heat environments like hot tubs, sauna, or intense exercise. These tend to dilate the veins and result in venous pooling.

Why to Wear Compression Stockings After Sclerotherapy?

For most vessels other than the tiniest spider veins, the compression stockings are believed to increase the effectiveness and safety of the procedure. Compression stockings keeps the treated and injured vessels compressed and helps them heal shut, preventing the trapping of blood in them. Trapped blood in these veins may cause unnecessary pain, inflammation and pigmentation, as well as decreased effectiveness of sclerotherapy. In addition, compression pushes the venous blood out of the leg faster, accelerates the blood circulation in the legs and potentially minimizes chances of an unintended secondary clot formation in any of the non-targeted vessels. This, of course, increases the safety and comfort of the procedure. To learn more, click compression therapy and compression stockings.

For How Long to Wear Compression Stockings After Sclerotherapy and How to Wear Them?

Except for the tiniest spider veins, most patients would probably benefit from a week of compression therapy, although opinion varies among doctors in this regard. And no, you don't have to sleep with them. You put them on first thing in the morning and take them out last thing at night, before sleep. You can also remove them for a quick lukewarm shower, but avoid hot baths or sauna, as these further dilate your veins.

Is There a Downtime After Sclerotherapy?

No time off work is typically needed. Patients should be able to drive home after a sclerotherapy treatment and resume work the following day.

When Should One Not Have Sclerotherapy?

Sclerotherapy should be avoided if someone is bedridden, cannot be physically active for whatever reason, or if planning to tan in the weeks following a treatment. A history of allergic reaction to one of the sclerotherapy solutions or history of blood clots in the legs may also make a patient unsuitable for this kind of treatment. Pregnant patients should also wait for 3-6 months before considering sclerotherapy treatments.

Can You Have Sclerotherapy Before a Vacation Trip?

Vacation trips often involve long periods of immobility in a car or an airplane and therefore are best avoided for at least two weeks after a sclerotherapy treatment session.

How Soon Can You Tan After Sclerotherpy?

Since sun exposure of an inflamed area increases the risk of pigmentation, one should avoid tanning until all bruising has disappeared.

Is the Use of Spray Tanners Allowed After Sclerotherapy?

Spray tanning does not present problems and can be used safely after and in between sclerotherapy sessions, particularly with the use of a deep penetrating light source during the procedures. The same is not true for laser treatments, since the laser energy may target any pigment on the skin resulting in burns.

Do the Treated Spider Veins Come Back?

Once treated effectively, the treated reticular and spider veins should not come back. However your body will make new ones over time, at about the same rate as before. Remember, sclerotherapy is not a cure for this condition but an effective treatment that does not take away your body's predisposition to make new spider and blue veins in the future.

Why to Treat Spider Veins if New Veins Are Expected in the Future?

If untreated, spider and blue veins always get worse over the years, multiplying, branching out, getting thicker and more unsightly. These veins would then take longer to treat, require more retreatment sessions, would take longer to heal and with higher chances of side effects like pigmentation.

How Often Should Leg Spider Veins be Treated in the Future?

Most patients need to have periodic follow up spider vein treatment sessions to maintain optimal results. The frequency varies from a year to several years.

Questions About Cost of Spider Vein Treatment or Sclerotherapy?

Call 818-832-4500 for any enquiries regarding cost of spider vein treatment or sclerotherapy, additional information, or scheduling a consultation session with Dr. Dishakjian, a cosmetic surgeon and phlebologist. Consultations with the doctor are free with the purchase of any service. We charge a nominal refundable consultation fee for the first office visit only. This fee is fully credited towards a subsequently purchased service.

Click spider and varicose vein treatment Los Angeles to read about other vein treatment options available at the Center.

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Nu Vela Esthetica
Cosmetic Laser Surgery and Vein Treatment Center

Postal Address:
11200 Corbin Ave
Porter Ranch
United States

Phone: 818-832-4500

Office Hours: Tuesdays 10:00 AM - 3:00 PM; Wednesdays to Fridays 9:00 AM - 6:00 PM