Microsclerotherapy
“Gold Standard” treatment for small varicose veins and telangiectasia (spider veins) on the legs is sclerotherapy.
Sclerotherapy is a long established technique which involves meticulous injection of sclerosant into small venous blood vessels. Three classes of sclerosants are in general use around the world today. Though the method of each class of sclerosant is different, the end result is the same. Sclerosants target only the endothelial cells which layer the inside of the vein wall.
These cells are peeled away by the sclerosant allowing exposure of the underlying collagen in the vein wall. The injury causes the vein walls to scar and fuse together permanently closing off the vein and sealing off any further blood flow in the vein. The treated vein then develops into a hard fibrous cord.
This process is called sclerosis and is derived from the Latin word for hardening, scleroticus. The hard redundant scar tissue of the vein remnant is eventually removed by a process called apoptosis.
Spider veins develop as a result of back pressure from larger feeding veins which are seen slightly deeper under the skin. These feeding veins are called “Reticular veins” and they are usually easy to identify because they have a bluish colour and are often seen in a central position wherever there is a network of spider veins. In order to get successful results in treating spider veins, treatment of these reticular veins are also required. Poor results and complications of treatment such as “matting” are often the result of failing to identify and properly treat these reticular veins.
Treatment of spider veins with microsclerotherapy unfortunately does not provide an immediate benefit. It may require several months to complete a course of treatment depending on the extent of involvement.
Because very tiny needles are used the procedure is usually not too uncomfortable. It is usual for most patients to require more than one course of treatment. After one course of treatment there is usually a 60-80% improvement. For patients with a substantial number of spider veins then three treatment sessions spread over the course of three months are undertaken. The process that causes spider veins is a chronic condition, so there is a tendency for them to recur over a period of time, though the doctor will never be able to answer confidently how long this period will be. Therefore a maintenance treatment session may be required every few years similar to many other cosmetic procedures.
There is usually a typical sequence in the treatment of spider veins where initial microsclerotherapy is targeted at the deeper reticular veins which lie just under the skin. Subsequent sessions are directed at the small spider veins close to the surface of the skin. At The Leg Vein Doctor we use different types of sclerosing agents for the different levels in the skin in order to give the best results.
Treatment sessions usually take at least an hour if we are treating both legs at the same time. After treatment your legs are cleaned and compression stockings are applied. The stockings should be worn for 3 to 5 days, depending on the extent of treatment.
Following treatment there may be a period of a few weeks where there appears to be no obvious improvement and indeed there maybe areas of bruising associated with some tender lumps where the veins are undergoing the process of sclerosis. This is not to be unexpected.
To see some examples of achievable results following sclerotherapy please view the gallery. As with all cosmetic procedures results vary from patient to patient - we encourage you to discuss any questions you have regarding expectations during your initial consultation with Doctor Kemp or before booking in for treatment with our experienced reception team.