Varicose Veins (cont.)
Can laser be used to treat varicose and spider veins?
Spider veins and small varicose veins can be treated with
laser treatment applied from the surface of the skin. The laser applies an
intense energy that essentially destroys the small blood vessels in the surface
of the skin. Results are variable, and multiple treatments may be necessary to
have some benefit. This is generally less invasive than sclerotherapy and vein
stripping (no insertion of needles or catheters are required). Possible problems may involve a
temporary discoloration of the skin.
Larger varicose veins may be treated with endovenous
(inside the vein) catheter ablation or laser surgery. This
basically involves inserting a probe (or catheter) into the large vein in the
lower leg (saphenous vein) and closing
the vein by applying heat generated through laser. This technique has proven to
be less painful, and it also has a faster recovery time compared to the vein
stripping surgery.
What type of doctors provide treatments for varicose and spider veins?
Doctors providing surgical treatments (stripping and laser ablation) include
general and vascular surgeons. Sclerotherapy and laser treatments are often
performed by dermatologists. Some general, vascular, and plastic surgeons also
perform sclerotherapy treatments. You may want to consult more than one doctor
before deciding on a method of treatment. Be sure to ask the doctors about their
experience in performing the procedure you want.
What are the side effects of these treatments?
A patient should carefully question the doctor about the safety and side
effects for each type of treatment. Thoroughly review any "informed consent"
forms your doctor gives you explaining the risks of a procedure.
For surgical removal of veins, the side effects are those
for any surgery performed under anesthesia, including nausea,
vomiting, and the
risk of wound infection. Surgery also results in scarring where small incisions are made and
may occasionally cause blood clots.
For sclerotherapy, the side effects can depend on the
substance used for the
injection. People with allergies may want to be cautious. For example,
Sotradecol may cause allergic reactions, which can occasionally be severe.
Hypertonic saline solution is unlikely to cause allergic reactions. Either
substance may burn the skin (if the needle is not properly inserted) or
permanently mark or "stain" the skin. (These brownish marks are caused by the
scattering of blood cells throughout the tissue after the vein has been injected
and may fade over time). Occasionally, sclerotherapy can lead to blood clots.
Laser treatments can
cause scarring and changes in the color of the skin.
How long do varicose vein or spider vein treatment results last?
Many factors will affect the rate at which treated
varicose veins recur. These include the underlying diagnosis, the method used
and its suitability for treating a particular condition, and the skill of the
physician. Sometimes the body forms a new vein in place of the one removed by a
surgeon. An injected vein
that was not completely destroyed by sclerotherapy may reopen, or a new vein may
appear in the same location as previous one.
Many studies have found that varicose veins are more likely to recur
following sclerotherapy than following surgery. However, no treatment method has
been scientifically established as being free from recurrences. For all types of
procedures, recurrence rates increase with time. Also, because venous (vein)
disease is typically progressive, no treatment can prevent the appearance of new
varicose or spider veins in the future.
Is one treatment for varicose veins or spider veins better than the other?
The method you select for treating venous disease should be based on the
physician's diagnosis, the size of the veins to be treated and the patient's:
- treatment
history,
- age,
- history of allergies, and
- ability to tolerate
surgery and anesthesia, among other factors.
As noted above, small spider veins
cannot be surgically removed and can only be treated with sclerotherapy. On the
other hand, larger varicose veins may, according to many studies, be more likely
to recur if treated with sclerotherapy.
Next: How can varicose vein be prevented? »
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