Sclerotherapy for Leg Veins








What types of leg veins are there?

Dilated leg veins can be classified as:

Spider veins - red or purple fine veins.

Reticular veins - blue mid sized veins often feeding into the spider veins.

Varicose veins - large blue ropey veins often traversing the leg.  All these veins can contribute to unsightly and cosmetically dissatisfying appearance of the legs, as well as medical complications such as aching swelling, appearance of bruising, ulceration, eczema and pigmentation.


What causes unsightly veins?

There are 3 common contributors to dilated veins:

Hereditary  - those people with a family history of leg veins inherit a genetic tendency for the venous system to have increased pressure over time.

Pregnancy - related to both the increased venous backflow as the uterus grows and pushes on the venous system, as well as the increased blood volume in pregnancy.

Prolonged standing - at rest with our legs up, we have no pressure in the venous system. On standing the pressure increases dramatically to 100mmHg.

Walking gets the calf muscle pumping and drops the pressure to 30-40mmHg. 

With prolonged standing, the high pressures override the valves assisting in the return of blood, the valves then break down and blood pools in the leg veins.

Contrary to popular belief, crossing your legs has no effect on developing leg veins.

What is the mechanism by which veins develop?


Blood in leg veins normally travels upwards to the heart. Due to gravity blood tries to flow back down towards the feet.  However, normal veins have valves, which close to prevent abnormal flow towards the feet. It is the breakdown of these valves that leads to abnormal flow, which in turn leads to increased pressure in the vein. The increased pressure eventually causes the vein wall to expand and bulge, producing a varicose vein. Varicose veins serve no useful function to the body's circulation. Our body has the ability to establish alternative pathways to bypass the abnormal varicose veins.  When varicose veins are closed down, the circulatory system improves, as do many of the symptoms.  It is important to understand that varicose veins can be a progressive condition and that totally new veins can develop with time. Maintenance treatment is likely for most patients.

Can you prevent unsightly veins?

Due to the causes, there is very little that can be done to halt the development of leg veins. Wearing compression stockings/ support hose only delays their progression. Maintaining a healthy weight can also reduce backward pressure on leg veins.

What can be done? What is sclerotherapy?

There is a treatment available for these veins that does not require surgery or significant interference in one's lifestyle. The procedure is called sclerotherapy. A liquid solution called a sclerosing agent is injected directly into the veins, causing irritation and inflammation.  This makes the vein stick together and scar thus preventing blood flow in the vein.  This process takes 6-8 weeks to complete. Larger varicose veins can also be treated with this solution but often require the assistance of an ultrasound to enable effective vein closure and thus adequate treatment. The procedure involves a series of tiny microinjections into the veins of each leg under direct vision. You may feel a slight stinging or throbbing sensation that is brief and relieved with walking after the procedure.

Which areas can be treated?

Sclerotherapy is best for any areas in the lower legs, and can occasionally be used on the face although laser is a much more comfortable and preferred option here. Laser can be used on the lower legs also but has mixed success here.

What are the side effects?

Immediate reactions include;

  • Red lumps like mosquito bites over the injected areas. These tend to last 6-24 hours.

  • Some discomfort eased with walking and occasionally requiring simple analgesia.

  • Rarely patients have reported generalised muscle aches and a cough immediately after the procedure but this is very transient.

  • It is very rare and an uncommon situation that an allergic reaction may occur.

Temporary side effects include:

  • Bruising that can last 2-3 weeks, arnica or hiridoid cream can help.

  • Blood trapping, whereby blood gets caught when the vein closes down forming a brown tender lump along the vein. It can be cleared by putting a needle in the vein and squeezing the old blood out.

  • Matting, related to opening of smaller spider vein channels. These can be closed with fine injections at 6-8 weeks if this has not occurred already.

  • Brown pigmentation due to haemosiderin (iron) deposit from the leaky vein. This can take 3-6 months to fade but can be treated with laser if not resolved in 12 months.

Rare side effects include:

  • DVT, clot in the deep venous system seen in 1/7000 people.

  • Ulceration seen in 1/200 people usually elderly, heavy smokers, diabetics and injections along the shin area. These heal with dressings and may lead to scarring.

  • Thrombophlebitis, an inflamed and clotted superficial blood vessel usually responding to massage, anti-inflammatories and sometimes antibiotics

  • Numbness

  • swelling of the ankle

What are the possible consequences if I DO NOT have treatment?

 
Symptoms commonly associated with varicose veins include leg tiredness, heaviness, aching, throbbing, restlessness, tingling, itching, numbness and swelling.

Complications such as phlebitis, blood clots, dermatitis and ulcers can occur if veins are left untreated.

What can you do after treatment?

Following treatment, which takes 30-45 minutes per leg, you are free to carry on normal activities just wearing a compression stocking. Exercise is encouraged at least 30 minutes per day-any form that gets the calf muscle working.

Is sclerotherapy successful?

Sclerotherapy by injection is a very effective method of treatment. You can expect 50-80% improvement with a single treatment and improved success after a course of between 2-5 treatments. The recurrence rate of dilated veins can be up to 30% over time. This can be improved with avoiding stiletto high heels and prolonged standing, maintaining adequate body weight and regular exercise.

What is the cost?

This will depend on the extent of the leg veins. The cost is $770 per half hour of treatment. There may be an associated Medicare rebate for some veins of approximately $80 per session. The rebates from the Medicare safety net are capped for this procedure.

Why should I choose The Victorian Cosmetic Institute as my provider of sclerotherapy?

Our doctors are highly experienced in sclerotherapy. The first step is simply contacting us for your initial consultation, where we will discuss with you what is a realistic and achievable outcome, and what to expect from your treatment. Although most veins are treatable with us, some people with extremely large veins may require a referral to have endovenous laser treatment. Varicose veins larger than 2 mm may also not be able to be treated at The Victorian Cosmetic Institute.
 
Making that first phone call can be a confronting task - many of our patients have preferred filling out our online enquiry form. We can then contact you with an understanding of the results you are hopeful of achieving and ensure the treatment is appropriate.
 
It's as easy as clicking either of the buttons below and completing the provided form.
 
Otherwise, you can phone us directly on (03) 8850 0655 (Templestowe branch) or (03) 9707 0888 (Berwick branch)