For decades and even centuries past, women have sought ways to eliminate the unsightly blue to red leg veins that appear as we all experience the aging process. These leg veins can be an extensive network of pale blue lines that worm their way down the sides and back of one or both legs like interstates on a highway map. These lead into smaller “spider veins” which are reddish blue to pink and appear exactly as they are named….like a multitude of spiders invading the legs. These “reticular veins” and “spider veins” are purely cosmetic in nature, although often they may cause pain, swelling, throbbing, or other discomfort. Approximately 35% to 40% of women have spider veins, and approximately 25% have deeper varicose veins. Spider, reticular, and Varicose Veins Glendale are largely inherited but can be caused by pregnancy, advancing age, obesity and prolonged standing. Many women typically deal with this problem by keeping the legs covered, using long skirts, dress pants, jeans, and panty hose. They are usually reluctant to be seen in a swimsuit, or in workout clothes that include above-the knee shorts.
However, it is not necessary to spend the rest of your life hiding your once beautiful legs…with a series of simple, safe, effective and virtually painless injections into these veins, they can be treated in such a way that they collapse and are absorbed by the body. However, this process takes time (several months) and it is not possible to achieve instant gratification, as is the case with some other medical aesthetic procedures such as Botox and Juvederm.
The process of eliminating these unsightly veins starts with a phone call to your local Vein Treatment Phoenix. Most physicians will offer free, no obligation consultations to patients, and spend 45 minutes to one hour discussing all aspects of symptoms, proposed treatments and answering all questions. Many patients find it hard to believe that the blue leg veins that took years and years to develop can be eliminated in as little as four months….but it is true! Each treatment lasts 30 to 45 minutes and are typically scheduled four weeks apart, and each treatment typically costs around $300. Patients must agree to wear graduated compression stockings for three to seven days after the treatment, which results in faster and more complete resolution of the veins. Therefore, in our climate here in Southeastern Wisconsin, fall and winter are the BEST time to start these treatments, as the compression stockings are not desirable for wearing in the warmer months.
During the initial consultation, a complete personal and family history is obtained, and a discussion takes place regarding areas of concern and what symptoms the patient is having. We then ask the patient to change into shorts or a robe, and we do a physical exam in the treatment room, in order to “map out” the veins needing treatment on a diagram that becomes part of the medical record. If the vein disease is extensive, typically a Doppler Ultrasound evaluation is performed in order to determine whether the deeper veins, such as the Greater Saphenous Vein (GSV) or the Short Saphenous Vein (SSV) are in good working order, or have “floppy” or incompetent valves. If these larger and deeper veins are incompetent, there is no value in attempting sclerotherapy, as the superficial veins will simply resist treatment due to the high pressures in the venous system. These patients are referred to a vascular surgeon for ultrasound evaluation and possible treatment of the deeper vein disease. Once this is accomplished, we can re-visit the possibility of attempting sclerotherapy of the more superficial veins.
If the patient is cleared for treatment of cosmetic veins, a treatment plan is mapped out on a calendar. There should be an estimate the number of treatments needed, which can range from 3 or 4 for mild venous disease, up to 10 or more for very extensive veins. These appointments should be scheduled 3 to 4 weeks apart, so I usually suggest that women begin to plan for next year’s spring break and summer vacation in the FALL!!
The treatments involve a series of tiny injections of sclerosant solution (Glycerin/lidocaine for the spider veins; STS foamed for the reticular veins) which is accomplished with very tiny (30 gauge) needles…an even smaller needle than is used to give you your TB skin test!! Patients report that the injections are much less painful than laser treatments to these veins.
For many years, hypertonic saline was used to inject these veins, however this is no longer the standard of care. Modern agents are much safer, much less painful, and far more effective. The hypertonic saline would typically cause a great deal of pain, as well as bruising, skin pigmentation, skin necrosis, and focal skin ulceration. With the modern agents that are now available, these side effects are very, very rare and virtually unheard of.
When the procedure is performed, the physician will have the patient lie on a treatment table and encourage them to relax…indeed, an occasional patient will fall asleep during the treatment. The entire procedure lasts about 20 to 30 minutes, and the physician will have the patient turn from side to side as the treated area should be positioned superiorly. The use of Tylenol is encouraged before and after the procedure, as this seems to help cut down the sting from the needle and the subsequent mild erythema. Most of the injections do not hurt at all, however an occasional injection may irritate a nerve and cause stinging. There may be itching at the injections site, however this typically resolves very quickly, within 5 to 10 minutes.
Some injectors like to apply cotton balls and tape to every injection site. Other injectors have found this to be ineffective, as the adjacent tape will pull on the skin and negate the effect of the pressure of the cotton ball. Most phlebologists prefer to have the patient put on their compression stockings immediately after the procedure, which they may bring from home, or can be provided by the physician’s office. The graduated compression stockings are a very important part of the process, as they reduce swelling and bruising, and keep the sclerosing solution in the veins for a longer time. Typically, patients are advised to wear them for a minimum of three to four days, and up to seven days, if they can tolerate it. The stockings should be worn when upright and ambulating, it is not necessary to wear them when recumbent or sleeping.
Some of the injection sites may show black and blue bruising, and this could last up to 2 weeks. Patients mus keep in mind that they must be patient, because the end results will be beautiful, more youthful appearing legs!!
Each follow-up treatment involves examining the treated areas of the legs, determining whether the future treatments should be modified in any way, and going to work on injecting any veins that are still present. Usually, the patients see amazing results as the weeks and months progress. Some veins can be resistant to treatments, and may require several treatments to get rid of them. Persistence and patience is the key. Rarely, there may be pockets of “trapped blood” between areas of vein that have collapsed. This is easy to fix, they simply are poked with a needle and the blood is pushed out of the vein, and eventually this vein segment also disappears.
We have not yet figured out how to completely stop the aging process all together, so there is a good chance that patients will need to come back once every few years for maintenance as veins naturally develop on their legs.