Small, dilated veins known as "spider veins" or "venulectasias" occur most commonly on the legs of women as a result of aging, genetics, and hormonal influences. Sclerotherapy, performed by Dr. Mann or Sherri Nassar, FNP, is a procedure that involves injecting these small veins with a solution that irritates the vessel wall, causing inflammation and eventual collapse of the unwanted veins. Veins then disappear over a 4-6 week time period. Sclerotherapy is a 45-60 minute treatment with minimal pain. Typically, a series of 2-5 treatments is necessary depending on the extent of the problem. Large varicose veins cannot be successfully treated with sclerotherapy and typically require surgical removal either by vein stripping techniques or endovenous laser ablation.

FAQs:
What are the alternative treatments for spider veins?
Sclerotherapy is considered the "gold standard" for the treatment of spider veins on the legs. However, results can vary from one individual to another, and, in some instances lasers and intense-pulse-light therapies may be more effective. Like sclerotherapy, these treatments require multiple sessions.

Who should not be treated?
Patients with any of the following should not be treated: active thrombophlebitis or infection, bleeding or clotting disorders, poor circulation, diabetes, those confined to bed rest, history of a pulmonary embolus, clots in the legs or extreme swelling of the feet and legs. Patients taking blood thinners such as nonsteroidal anti-inflammatories (ibuprofen, Advil, Motrin, Aleve), Aspirin, warfarin (Coumadin), or heparin are at increased risk of bleeding and bruising. Please inform us if you are taking any of these medications.

How many treatments will I need?
Sclerotherapy almost always requires multiple treatments. Depending on the extent of your spider veins, 2-4 treatments are usually required to achieve satisfactory results. Treatments typically occur 4-6 weeks apart. Results do vary from one individual to the next and final outcomes cannot be guaranteed prior to any treatment.

What are the most common side effects of sclerotherapy?
1. Itching

2. Bruising: Immediate bruising is expected and takes several weeks to resolve.

3. Hyperpigmentation: In most patients, the treated veins become darker immediately after the procedure. Ten percent of patients who undergo sclerotherapy notice a discoloration with light brown streaks along the veins that persist for 4-12 months. This is more common in patients with medium to dark skin types. This discoloration is made worse with sun exposure. Occasionally, small superficial clots will form in a treated vein causing temporary discoloration.

4. Pain/Stinging: Mild pain and stinging are expected during the treatment. Rarely, patients will experience muscle cramping in the leg being treated. Veins may be tender to the touch for 1-7 days after the treatment.

5. Telangiectatic Matting: 2-4% of all patients and 18% of women on estrogen therapy will develop tiny new blood vessels in the treated areas. Usually these go away within 4-6 months, although they can be permanent.

6. Ankle Swelling: 2-5% of patients develop ankle swelling that goes away within a week and is improved by wearing compression stockings.

7. Ulceration: Small ulcers develop in <1% of patients who receive sclerotherapy. Ulcers are usually small, open, weeping sores at the injection site that heal over 1-2 months. The scar that follows may be permanent although often fades.

How much does sclerotherapy cost?
Sclerotherapy generally costs between $250-$450 per treatment, depending on the extent of the problem.

Will my insurance pay for sclerotherapy?
Insurance companies almost never pay for sclerotherapy treatment for spider veins. If there are large, painful varicose veins that need further evaluation, we will refer you to a general surgeon who can discuss treatment options and insurance coverage.

Most patients with spider veins are very pleased with their sclerotherapy results. If you have any questions, please call our office at 406.587.4432 to schedule a free sclerotherapy consultation.

For pre and post sclerotherapy instructions, click here.



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