Questions relating to cosmetic sclerotherapy of spider veins and reticular (blue) veins

How well does sclerotherapy work?
Sclerotherapy is the most effective method of treating spider veins and reticular veins on the legs. This is because the sclerosant is able to treat an entire network of veins not just those that are visible.

Aren’t lasers better than sclerotherapy?
Lasers and other light based treatments are significantly less effective and are more painful than sclerotherapy for treating leg veins. We do not use lasers to treat spider or reticular veins.

Does sclerotherapy hurt?
Most people are surprised at the minimal discomfort and are reassured after the treatments begin. For those patients who are more sensitive or are afraid of injections, a mild oral sedative may be taken before the treatment.

Is sclerotherapy dangerous?
The number of serious reactions to sclerotherapy is amazingly small when it is performed by a well-trained sclerotherapist using an appropriate sclerosant.

May I go out in the sun after sclerotherapy?
There should be no problem as long as normal sun precautions are taken.

Does sclerotherapy cause side effects?
Side effects from sclerotherapy are generally quite mild. The most common is a light brownish stain which typically resolves without treatment. Tiny reddish blood vessels can develop around the treated area. These usually resolve without treatment. Occasionally there is trapped blood in larger veins that will become inflamed. This is easily removed or may be treated with anti-inflammatory medications such as ibuprofen.

Do I have to wear compression hose after sclerotherapy?
Wearing graduated compression hose after sclerotherapy has been shown to improve the effectiveness of sclerotherapy and also decreases side effects. In general, compression hose should be worn at least one week after sclerotherapy although there is additional benefit when they are worn up to three weeks.

When may I resume normal activities after sclerotherapy?
Normal activities may begin immediately after sclerotherapy. Running and weight lifting are avoided and graduated compression hose should be worn over night the first night and during the day for at least one week.

How fast does sclerotherapy work?
Generally most of the improvement will be noticed within the first month after treatment. However, continued gradual improvement for several months will likely occur.

Will sclerotherapy get rid of my veins permanently?
The veins that are treated and disappear are gone permanently. Over time new visible veins may gradually develop. This varies tremendously from person-to-person. Periodic touchup sclerotherapy will control this problem.

How many treatments will I need?
This varies depending on the extent of the veins that are to be treated. For most people three to five treatments will be needed. Minor problems or touchup treatments usually require one or two treatments.

Who does the sclerotherapy treatments?
Dr. Crowther does all sclerotherapy (and all other) treatments in this practice.

Will insurance cover sclerotherapy treatments?
Medical insurance generally will not pay for cosmetic sclerotherapy.

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Questions relating to treatment of varicose veins

What are varicose veins?
Varicose veins are usually considered to be more than 3 mm (about1/8 inch) in diameter when a person is standing and typically bulge above the surface of the skin. They commonly appear to be twisted or tortuous. Veins under pressure stretch and are forced to coil up to accommodate the added length.

What is the best way to get rid of my varicose veins?
There is no one best way to get rid of all varicose veins. There are several good alternatives for effectively treating varicose veins that include endovenous laser ablation, microphlebectomy and sclerotherapy. These can be done in an office setting and allow the patient to return to normal activity within one to two days. The difference treatment modalities will be discussed after your veins have been mapped using duplex ultrasound.

Are there any side effects caused by varicose vein treatment?
The minimally invasive techniques now being used to treat varicose veins are very well tolerated by most people. Occasionally there is some discomfort and bruising after the procedures. Typically this does not limit the patient’s activities. In some cases a brownish pigmentation is noted over the area of the treated veins. This usually resolves without treatment.

When may I resume normal activities after varicose vein treatment?
Walking is done immediately after the procedure and light walking is encouraged the first day after the procedure. Normal activities aside from jogging and weight lifting may be resumed within one to two days. Bandaging is usually worn for two days and then graduated compression hose are worn for one to two weeks.

Where is vein treatment done?
All of the minimally invasive procedures are available on an outpatient basis in the Exclusive Vein Care clinic.

What is vein stripping?
Vein stripping is a category of surgical techniques that have been used for many years to remove varicose veins. More discomfort, larger incisions, often hospitalization and longer recovery periods are reasons vein stripping is performed much less often these days. This method of vein removal is being used much less now that minimally invasive techniques are available.

What happens to the blood after the veins are removed or closed?
Veins have many interconnections so the blood is rerouted from diseased veins that have been closed into veins that are functioning properly. This prevents blood from flowing back down the leg through veins that have failed. Blood that flows backwards through failed veins is called venous reflux.

Is any follow-up care required after varicose vein treatment?
It is highly important that the patient be reevaluated regularly after treatment. It is common for previously undiagnosed vein problems to be unmasked after the largest diseased veins are treated. It is also important to monitor the effectiveness of any treatment that has been done. Treatment of venous reflux is easiest early before severe problems are allowed to develop.

Will insurance pay for varicose vein treatment?
In many cases varicose vein treatment is covered by insurance if there are related significant prolonged symptoms. Most insurance companies and Medicare require that conservative treatment with graduated compression be documented for two weeks up to three months. Individual situations can be discussed during the initial consultation.