Spider Vein Removal - Treatment Options

Safe Procedures for Spider Vein Removal and Cosmetically Appealing Outcome

Why do Spider Veins Appear As We Age?

While it is true that there are some conditions like pregnancy, obesity, sedentary lifestyle, localized trauma or general aging that may hasten the appearance of spider veins, the vast majority of patients have a genetic predisposition to develop them. Facial spider veins, on the other hand, usually appear due to sun damage and wearing sunscreen is the best preventative measure you can take. Click Varicose and Spider Veins to learn about the nature of spider and other veins.

It should be pointed out that the genetic tendency is not always expressed in every individual in the family. It may sometimes skip a generation, or fathers may transmit the tendency to a daughter.

Is There Anything You Can Do to Prevent Spider Veins from Appearing in the First Place?

As pregnancy is the most common precipitating event for the appearance of spider and blue veins in the child-bearing age female population, wearing of high compression stocking in the third trimester may have some preventative benefits in these patients. Other preventative measures may include being physically active, avoiding prolonged periods of standing, and keeping your weight in check. Wearing of high compression stockings consistently may have theoretical preventative benefit, but is unacceptable to most patients. Interestingly, most of the patients that seek spider vein removal are otherwise healthy, fit, physically active, and relatively young, in the 30-55 age range.

Is There a Medical Reason to Have Spider Vein Treatment?

Most spider and blue veins do not cause symptoms and if untreated do not cause any significant health problems. Accordingly, spider vein removal is considered cosmetic in nature. Occasionally however, Leg spider vein clusters and blue veins may cause significant symptoms like aching, burning sensation and itching, especially at the end of the day, in hot weather, or during the menstrual cycle. Treating these veins often brings alleviation of pain and other symptoms and improves the quality of life. In fact, in many patients, vein symptoms do not necessarily correlate with vein size. Sometimes huge bulging veins remain completely without symptoms, whereas a cluster of spider veins may cause significant discomfort.

What Happens if Spider Veins Are Not Treated?

Left untreated, spider and blue veins never get better on their own, except, perhaps after pregnancy, where significant spontaneous improvement is expected to occur in 3-6 months after delivery. In general, untreated spider and blue veins grow, dilate, multiply and recruit more veins over time, but at variable rates. Sometimes these veins do not change for many years, then rapidly multiply, and expand over a year or two.

Does the Presence of Spider Veins Mean You Will Have Bulging Veins in the Future?

Spider and blue veins are much more common than bulging veins, and most people who have them will not develop bulging varicose veins. However, most (but not all) patients with bulging varicose veins will also develop spider and blue veins.

What Are the Treatment Options for Spider Vein Removal?

Spider vein removal involves the destruction of spider veins either by means of a chemical or heat energy. The two main treatment options for spider vein removal are Sclerotherapy (chemical destruction) and Laser Vein removal (heat energy). These treatments are also very effective for the removal of superficial small blue veins, the reticular veins. Radiofrequency electrocauterization, commercially known as VeinGogh or VeinWave is another heat-based technique for spider vein removal, but works only on the very fine surface spider veins; not the subsurface larger blue veins.

What Is Sclerotherapy?

Sclerotherapy refers to the injection of a special solution directly into the veins using the tiniest needles, to chemically damage or "sclerose" the veins sealing them shut. The body's clearing mechanisms will eventually remove the veins in the following weeks.

What Does Laser Spider Vein treatment Involve?

These treatments involve delivering a laser beam by means of a device hand-held close to the skin surface. The laser beam selectively heats the blood in the vein, damaging the vein wall and causing its ultimate destruction.

How Would Blood Circulate After Spider Vein Removal?

Except in rare cases, spider veins are considered dysfunctional veins which allow backwards flow and pooling of blood. Eliminating these veins will generally improve the circulation by channeling the venous blood through more efficient routes back into the deep vein system and the heart.

What Does a Sclerotherapy Session Involve?

After signing of a detailed informed consent form and discussing any questions with your doctor, a set of baseline photographs are taken of the spider veins to be treated. These standardized, high-resolution pictures would serve as a baseline for future reference. You will be seated in a comfortable position and then the skin is cleansed with a disinfectant, and the targeted spider veins are sequentially injected with multiple injections of a very small amount of the sclerotherapy medication, using the finest possible needles In a few minutes, the injected areas appear a little swollen, raised, sometimes red or blue, like a bruise.

SCLEROTHERAPY TREATMENT OF LEG VEINS

In the hands of experienced vein doctors, the discomfort of a spider vein treatment by means of sclerotherapy should be minimal or at least easily tolerable for the vast majority of patients. An occasional spot may be more sensitive than others, but generally the procedure should be well tolerated for most patients; even the needle phobic ones. In fact, most patients are pleasantly surprised at how little discomfort occurs during leg spider vein removal with sclerotherapy.

What Is a Laser Spider Vein Removal Session Like?

After signing a detailed informed consent form and discussing any unanswered issues that you may have, a potent numbing cream is applied in the area for about 45 minutes before the laser spider vein removal procedure. Just before treatment, the numbing cream is removed and standardized baseline pictures are taken. You will be wearing protective goggles on the eyes. Cooling gel and contact cooling is applied just before and after the application of laser energy. Expect to feel mild to moderate stinging sensation that most patients find tolerable.

What Types of Medications Are Injected for Reticular and Spider Vein Removal?

There are several time-tested and widely used sclerotherapy solutions that have been used safely over several decades over hundreds of thousands of patients. There are numerous published, peer reviewed studies defining the benefits and side effects of these solutions. The most commonly used ones for sclerotherapy in this country include STS (sodium Tetradecyl Sulfate), polidocanol, chromated glycerine and Hypertonic saline. Each of these solutions has its advantages and shortcomings, and it is up to your doctor to choose the best solution and best strength of solution for your veins.

Can Sclerotherapy be Used for Facial Spider Vein Removal?

Sclerotherapy is not commonly used for facial spider vein removal due to the small but very serious complication of travel of the injected solution over short distances to the eye and the brain, causing permanent blindness. For leg veins this is not a problem due of the progressive dilution and mixing of the medication with blood in the larger veins of the legs. Lasers are much safer here because damage to vessels from a laser pulse is restricted only to the targeted part of the vein and does not travel much.

Is it Possible to Treat Spider and Blue Veins on Parts of the Body Like Arms, Hands, Chest, and Feet?

Spider and blue vein removal in the foot and ankle areas are considered more challenging and higher risk to treat. These veins should be treated more cautiously and conservatively; preferably by experienced vein doctors. Blue veins on the chest can be treated with sclerotherapy with relative ease and great results.

Prominent veins on the hands should perhaps not be treated at all because they serve as convenient routes for intravenous access for any future operative procedures or hospital admission, should the need arise. The prominence of these veins often is due to loss of fatty tissue, and as such is best addressed by dermal injectable fillers like Radiesse or fat grafting.

What Makes Lasers Poorly Effective in Treating Leg Spider Veins?

Besides the fact that laser spider vein removal ends up being a lot more painful than a comparable sclerotherapy treatment (lasers damage the vessels by heating the blood in the veins), lasers are less effective for leg spider vein removal than sclerotherapy. Following are the characteristics of Leg spider veins that make them unsuitable for laser treatment:

• Leg spider veins tend to have higher blood pressure in them due to gravity and direct communication with small feeding arteries.
• Leg spider veins are often present under the skin as interconnected network of veins of different colors, depths and sizes and these characteristics imply the use of different laser settings.
• Topical lasers may not be able to penetrate deep enough to treat the "feeder veins" that supply the surface spider veins with blood. (Failure to treat these feeder veins is one of the more common reasons of treatment failures in spider vein removal).
• The large amount of heat generated during the treatment of veins that are somewhat deep may result in skin burns.

Note that there is a special kind of treatment for varicose veins called EVLT (referring to Endovenous Laser Treatment) whereby a special laser fiber is introduced into the main superficial veins feeding the varicose veins. This treatment is very effective and should not be confused with surface lasers used for spider vein removal.

Can Lasers Treat Under Eye Blue Veins?

These "reticular" or blue veins can effectively be treated with surface lasers, but should be handled with caution and only by experienced laser doctors comfortable with working in this area. Safety should be of paramount importance here, due to the proximity of the eye and arteries in the temple area. Dr. Dishakjian, the vein specialist at the practice has successfully treated hundreds of patients using the Cutera's Nd:Yag that is available at the Center.

Are Compression Stockings of Any Help in Either Preventing or Treating Spider/Blue veins?

If symptoms are present, compression stockings may provide temporary relief. In fact, many people whose jobs require prolonged standing benefit from everyday use of low pressure compression stockings (10-15mmHg). These stocking, however, would not eliminate any spider/blue veins already present, but could potentially prevent new ones from appearing in the future, although scientific evidence on this particular issue is rather soft. On the other hand, wearing of high pressure compression stockings (20-30 mm Hg) may be more effective, but unacceptable by most patients for lifetime use.

In the Future, do the Treated Spider Veins Come Back?

Facial veins or leg spider veins should not come back after spider removal with either Sclerotherapy or laser vein therapy. However, your body will make new ones over time, at about the same rate as before. Remember, sclerotherapy or laser spider vein removal procedures are effective treatments that do not cure this condition and do not take care of your body's predisposition to make new spider and blue veins in the future.

How Do I Prepare Myself for a Spider Vein Removal Session?

In the week before your treatment, whether sclerotherapy or laser treatment, avoid tanning, avoid taking 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 a leg spider vein removal session.

Is Spider Vein Removal Covered by Insurance?

Unfortunately, spider vein treatment, whether with sclerotherapy or medical lasers is considered cosmetic in nature and the cost regardless of the technique used, is not covered by insurance plans.

Questions About the Cost of Spider Vein Removal or the Treatment?

You may reach our Los Angeles medical spa and vein clinic by clicking the "Contact us" button at the top of the page, or by calling 818-832-4500. Our receptionist will be delighted to assist you with any enquiries regarding cost, additional information, or scheduling a free consultation session with Dr. Dishakjian, a cosmetic surgeon and phlebologist.

Click sclerotherapy for spider vein removal or facial vein laser removal to learn more about these procedures.

You may also go to vein treatment options to learn about the vein treatment options that are available at the center. If you have additional queries or concerns, please don't hesitate to contact our office and arrange a free consultation with Dr. R. Dishakjian, the vein specialist doctor at the Center