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Services and Treatments Endovenous Laser Therapy (EVLT) | Injection Sclerotherapy | Microphlebectomies | Upper Endoscopy Colonoscopy | Vasectomies | Spider and Varicose Veins | Breast Care | Support Stockings | Other Office Surgeries Injection Sclerotherapy The Procedure Injection sclerotherapy is used for treatment of spider veins and small varicosities. It involves the use of an extremely fine needle to inject a tiny amount of a dilute solution (sclerosant) directly into the spider veins. The solution causes the lining of the vein to swell, eventually sealing off the blood vessels and preventing blood flow. At Steven D. Cox MD Inc., we use polidocanol as our sclerosant of choice because it is painless and effective. If spider veins are found in conjunction with varicose veins, and the valves in the saphenous vein are not functioning properly, an Endovenous Laser Therapy procedure may be recommended before sclerotherapy is undertaken. Pre-procedure instructions may include the elimination of certain medications which are known to aggravate spider veins, and the elimination or minimization of any medications known to cause excessive bruising or bleeding. After the skin is thoroughly cleansed with alcohol, a small amount of sclerosing (hardening) solution is injected directly into the spider vein using a syringe with a very tiny needle. The vein immediately disappears, then returns in about 10-15 seconds and is actually more prominent than it was before treatment started. The irritated vein then fades away over a few weeks. The solution displaces the blood within the vein, causing it to blanch or turn white. The solution then causes the vessel to become irritated and swell shut, prohibiting the blood from reentering the vein. The skin may be kneaded to help disperse the solution and reduce bruising. Each vein may require several injections and most disappear in a few weeks. After treatment, patients are not wrapped in compression bandages, but we place a cotton ball and tape over the injection site to provide local compression and protect your clothing. Light compression stockings are worn for 48 hours. Patients simply walk out of the office and immediately resume normal daily activities.
Benefits -Gets rid of unsightly spider veins. - No incisions. - Does not interfere with normal activities. - Safe, virtually painless, in-office treatment. - Walk-In to Walk-Out time is typically 30 minutes. The Risks Most patients experience no adverse effects; however, some minor side effects have been reported. One of the most common side effects of sclerotherapy (approximately 10% of patients) will develop a slightly brownish discoloration of the skin overlying a treated varicose vein. This is called “hyperpigmentation”. When it occurs, hyperpigmentation usually (80% of the time) will fade away with time. In some cases, the fading process can take more than 6 months. We have seen some areas of hyperpigmentation fade away completely after persisting for up to 24 months. In rare cases, the discoloration can be permanent. The best way to prevent hyperpigmentation is to evacuate any “trapped blood” that may accumulate 2 or 3 weeks after a treatment. Larger spider veins can sometimes collect “trapped blood” near the site of injection. Although not a major cause for concern, it is beneficial to remove this trapped blood within two or three weeks following the injection in order to allow the healing process to progress normally and to minimize the chances of developing hyperpigmentation. A slight blistering can occur in the surrounding skin when small amounts of the medicine seeps into the surrounding areas. These areas usually resolve in time without any specific treatment. An allergy from the sclerosant has been reported rarely, but we have never seen this in our practice. Nevertheless, we always inject a single vein as a “test spot” to rule out an allergy before we perform a full sclerotherapy procedure. Ulceration. This is a localized small breakdown of the skin surrounding an injection site. It will eventually heal leaving a small scar, and has been an extremely rare occurrence in our practice. Bruising around the treated area, which eventually disappears, can result if the veins are unusually weak. Fair skinned people tend to bruise more than dark skinned people. A small percentage of patients develop a network of tiny, pink vessels that turn white when pressure is applied. This condition, referred to as “telangiectatic matting” usually disappears without treatment; however, injection treatment or PhotoDerm may be necessary in some cases. The spider veins that have been treated properly will not recur. Other veins, which are now normal, may develop into spider veins in the future. This is why we want to follow-up with patients to help stop any problems when they are small, which is always more effective than trying to treat a problem that has been neglected for many years. In addition, wearing support hose is always recommended after treating spider veins to minimize the chances of developing new spider veins in the future. Aftercare Patients who have had sclerotherapy have rarely reported any discomfort. Some experience a slight to moderate itching or burning sensation immediately after the injection, but this disappears within a few seconds to a few minutes. Patients are usually advised to resume normal activity immediately, although vigorous activity is discouraged for twenty-four hours. Elevation of the legs is usually not recommended unless additional varicose veins have been treated simultaneously. of the legs is usually not recommended unless additional varicose veins have been treated simultaneously. FAQs What is sclerotherapy? Sclerotherapy is a procedure in which Dr. Cox or his vein treatment nurse practitioner, Joyce Cox CNP, injects a small amount of a medication directly into a spider vein. The spider vein then fades away over the course of a few weeks. Which veins can be treated by this method? Sclerotherapy works best for spider veins that are “not too small and not too large”. If the vein is too small to get even the smallest needle in the world into the vein, then attempt at treatment will often make the spider veins worse. In this situation, we may recommend waiting for a period of 6 to 12 months to see if the spiders “mature” and become large enough in diameter to expect good results. Alternatively, spider veins which are too small in diameter to accommodate even the world’s smallest needle can be treated with PhotoDerm, a high-intensity light. If the veins are too large to be treated with sclerotherapy, they can be most likely be treated with microphlebectomies. Is sclerotherapy painful? The injection of the medication is painless. There may be only a slight stinging or burning sensation caused by insertion of the needle. Since the needle is extremely small and since it only goes a short way under the skin, the procedure is virtually painless. Do I have any bandages or elastic wraps after sclerotherapy? We apply small cotton balls over the injection sites, followed by tape. We recommend light compression stockings for 48 hours. Will insurance pay for sclerotherapy? We have never found an insurance company that will pay for sclerotherapy. It is always considered a cosmetic treatment. We will not bill your insurance company, but we will be happy to provide you with a receipt should you want to file it with your insurance carrier.
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