TREATMENTS FOR SPIDER AND VARICOSE VEINS.
Varicose and smaller spider veins affect an estimated 80 million adults in the U.S. Even shapely legs can look less attractive with bulging blue veins or a network of spider veins. In fact, a recent survey indicated that American women are more concerned about leg veins than almost any other cosmetic problem.
The exact cause of spider and varicose veins is unknown, although heredity, pregnancy and hormonal changes are believed to be contributing factors. As people age, these unsightly veins become more common and often more pronounced. Forty-one percent of women aged 40-50 years old have varicose veins, increasing to 72% of women aged 60-70 years old. Among men aged 30-40 years old, 24% have varicose veins, increasing to 43% among 70-year-old men.
While usually a cosmetic condition, varicose veins may also pose a health risk. In fact, six million workdays each year are lost due to complications from varicose veins. The abnormal circulation resulting from varicose veins may cause ulcers, and it is estimated that nearly 100,000 Americans are totally disabled by the condition.
WHAT ARE SPIDER AND VARICOSE VEINS?
Spider veins are formed by the dilation of a small group of blood vessels located close to the surface of the skin. Although they can appear anywhere on the body, spider veins are most commonly found on the face and legs and look like red or purple sunbursts or web patterns. Spider veins are also referred to as telangiectasia or broken capillaries. They usually pose no health hazard but may produce a dull aching in the legs after prolonged standing.
Varicose veins are swollen or enlarged blood vessels caused by a weakening in the vein's wall or valves. They are located somewhat deeper than spider veins, are sometimes raised, and often appear blue. The origin of these varicose veins may be hidden under the skin. Advanced cases of varicose veins can be harmful to a patient's health because they may be associated with the development of one or more of the following conditions:
* Venous stasis ulcers, which can result when the enlarged vein does not provide adequate drainage of fluid from the skin. The swollen skin receives insufficient oxygen and an ulcer forms.
* Phlebitis, which is an inflammation of the vein.
* Thromboses, which are blood clots forming in the enlarged vein.
WHO IS QUALIFIED TO TREAT SPIDER AND VARICOSE VEINS?
Dermatologic surgeons have extensive training and experience in the diagnosis and treatment of vein disorders. As specialists in diseases of the skin, dermatologic surgeons are uniquely qualified to select the treatment method or combination of methods that works best in a particular situation and provides the optimal cosmetic results.
HOW ARE VEINS TREATED?
A number of surgical treatment options are used to improve vein conditions. All treatments are intended to remove or destroy a defective vein so that its function can be quickly taken over by healthy veins. In most cases, leg compression is recommended with one or more treatment method.
Sclerotherapy is a safe and effective procedure that can be performed by dermatologic surgeon in the doctor's office with minimal discomfort. A concentrated saline or specially developed chemical solution is injected with a very small needle into the spider or varicose vein. The sclerosing (hardening) solution causes the vein to close up or collapse and become scar tissue that eventually is absorbed by the body. The work of carrying the blood is shifted to other healthy blood vessels nearby.
Sclerotheraphy generally requires multiple treatment sessions. One to three injection sessions are usually required to effectively treat any vein, and 10 to 40 veins may be treated in one session. The same area should not be retreated for four to six weeks to allow for complete healing, although other areas may undergo treatment during this time. Occasionally diagnostic tests such as ultrasound or plethysmography may be recommended to enhance the results of treatment.
Post-treatment therapy includes wearing compression bandages or support hose for two days to three weeks following treatment. Walking and moderate exercise may also help speed recovery. The treated blood vessels generally disappear over a period of six months. Although sclerotheraphy works for existing spider veins, it does not prevent new ones from developing.
ARE THERE ANY SIDE EFFECTS FOLLOWING TREATMENT?
Most patients report few, if any minor side effects from sclerotherapy, which usually disappear in time. Temporary reactions can include a slight swelling of the leg or foot, minor bruising, itching, redness, a small erosion or moderate soreness. Rarely, a scar may result.
WHAT OTHER TREATMENTS ARE USED FOR SPIDER AND VARICOSE VEINS?
* Ambulatory Phlebectomy: This technique involves removal of an undesired vein through a series of tiny punctures or incisions along the path of the enlarged vein. Using a specially designed instrument to "hook" the varicose vein into the dermatologic surgeon's view, the damaged vein can be removed entirely by gently pulling from tiny puncture to puncture. This safe, outpatient procedure can treat large varicose veins, as well as small spider veins, with minimal risks, reduced side effects and decreased recurrence.
* Electrodesiccation: The veins are sealed off with the application of electrical current.
* Laser surgery and intense pulsed light therapy: This relatively new approach may be effective for certain leg veins and facial blood vessels. The heat from the high intensity laser beam or intense pulsed light device selectively destroys the abnormal veins.
* Surgical ligation and stripping: This method involves making an incision in the skin and either tying off or removing the blood vessel. The procedure may require the use of general anesthesia, is usually performed by a vascular surgeon in the hospital, and is generally reserved for larger veins.
THE AMERICAN SOCIETY FOR DERMATOLOGIC SURGERY (ASDS)
The ASDS provides grants, training and continuing education for its members, in new dermatologic surgical techniques and procedures. Represented in the American Medical Association House of Delegates, the Society was formed in 1970 to promote excellence in the subspecialty of dermatologic surgery and to foster the highest standards of patient care.
FOR MORE INFORMATION
For more information on the treatment of vein conditions and to obtain a referral list of dermatologic surgeons offering treatment in your geographic area, call the American Society for Dermatologic Surgery's toll-free consumer hotline, 1-800-441-2737, during weekday business hours (CST) or visit our Web site at www.asds-net.org. Thank you for your interest.