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Sclerotherapy Treatment Adelaide

How are surface leg veins treated?

Spider veins are unsightly abnormal veins and do not serve a biological purpose. By far the best method of eradicating or reducing “spider veins” on the legs is with Microsclerotherapy. This treatment is conducted by injecting the ‘spider veins’ with small amounts of irritant solutions, and is considered the gold standard treatment of leg ‘spider veins’.

Which veins can be treated?

There are 3 types of abnormal veins, frequently seen in combination. ‘Spider veins’ (telangiectasia) are the fine red capillaries. The larger blue veins are called ‘reticular veins’ and are slightly deeper. Varicose veins are larger, bulging veins. At the initial consultation the veins are assessed and the most suitable method(s) of treatment are discussed.

 

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What causes these unsightly veins?

Abnormal veins have weak walls. Back flow from larger veins into smaller capillaries causes the formation of ‘spider veins’. A definitive cause is not known. They are often hereditary. Women develop this problem earlier to a greater extent than men, and there is no doubt that they are effected by hormonal changes —  adolescence, pregnancy and menopause. The low-dose Pill prescribed today is thought to have little effect. Prolonged standing may aggravate veins but does not primarily cause them.

What happens during a sclerotherapy treatment?

A tiny needle is introduced into the vessel being treated. It penetrates the skin less than 1  mm. The vessel is then filled with a sclerosant solution. The solution causes irritation to the lining of the vein, the result of which ultimately obliterates the vessel. One treatment session may  involve dozens of injections, but the procedure is only mildly uncomfortable—a pain level similar to leg waxing or eyebrow plucking. A medical compression stocking must be worn after treatment to achieve the best outcome, usually for about 7 days. This will be discussed at your initial consultation. An average treatment session is 30minutes and is performed in the consulting rooms. For many patients all veins can be injected in one treatment session. However, if the veins are numerous and the volume of injected solution could exceed toxic levels, two or more treatments may be necessary.

What can I expect after treatments?

For about two weeks the vessels may appear more prominent. The injection sites look like insect bites for a few days but do not itch. The veins then begin to break up and fade, and continue to shrivel for eight weeks or more. The larger the vein, the longer the resolution process takes. After six to eight weeks any residual veins can be re-injected. An average of one to three treatments is needed for approx 80% clearance of all veins depending on their initial severity. Maintenance treatment can be expected three to five years later, as the development of new or recurrent veins cannot be prevented. It is quite safe to pursue all normal activities including driving a car after the treatment. There is rarely significant discomfort afterward, although for patients where large numbers of veins or large veins have been treated there may be some aching. Pain severe enough to need analgesics should be reported to the doctor. If many veins below the knees are treated, the ankles may swell for a few days. This is not dangerous, and can be left to resolve by itself or aided by wearing a bandage or elastic stocking if desired. It is not usually necessary to have time off work. After all treatable veins have been injected, there are frequently a few tiny pink vessels left. These are impossible to inject further as they are too small. Rarely do they respond to laser therapy. Patients undergoing this treatment should have realistic expectations that whilst 80-90% clearance is commonplace, 100% disappearance of all veins is rare.

Are there any complications, side effects or treatment failures?

  1. Allergic reactions are extremely rare with both saline and Polidocanol (it has an allergy rate of about 1:10,000). If you have an allergic predisposition you should report this to your doctor before any treatment.
  2. Larger veins may develop small blood clots within them. This is part of the treatment process and is in no way dangerous. These clots do not break off and travel. If this occurs, and becomes sore, it is best to return to have them removed, which is easily performed. This procedure is free of charge and hastens the disappearance of the veins. Sclerotherapy should not be performed within 6 weeks of undertaking a long haul flight (e.g overseas) as the risk of developing deep vein thrombosis (DVT) may be increased. The risk of DVT otherwise is extremely low, but any pain or swelling of the calf should always be reported promptly, and investigated.
  3. If larger, blue veins are treated, abrownish stainmay sometimes replace them, much like a resolving bruise. This pigmentation can take many months, and on rare occasions, years to finally disappear.
  4. A condition called matting develops in about 5% of patients. A pink blush replaces a cluster of spider veins. This usually vanishes spontaneously over 3 to 6 months, but occasionally requires a repeat injection.
  5. Microscleotherapy is ineffective if major varicose veins feed the spider veins. It is therefore necessary to have these veins treated first. On occasion a Duplex ultrasound scan is required to accurately evaluate the veins. It is a painless ultrasound scan. If treatment of  varicose veins is necessary before the ‘cosmetic’ veins can be injected treatment options are discussed at the initial consultation.

Do the spider veins re-appear?

The natural history of people prone to these blemishes is that more will gradually develop with age and time. Many patients return every couple of years for a ‘maintenance’ treatment. There is no limit to the number of treatments that can be safely performed however, if recurrence is rapid then investigation for underlying varicose veins should be considered.

What is the cost?

Prices start from $330.00 including GST. For many treatments there is no rebate from Medicare or Private Health Funds. (some exceptions do exist, which, are discussed at the initial consultation). Payment must be made on the day of treatment by cah, Eftpos, Visa or Mastercard.

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