Varicose Veins (cont.)

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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 procedure is generally less invasive than sclerotherapy and vein stripping (no insertion of needles or catheters is required). A possible problem that may arise after laser treatment is 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 a 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 vein stripping surgery.

What type of doctors provide treatments for varicose and spider veins?

Doctors who provide surgical treatments (vein stripping and laser ablation) include general and vascular surgeons. Sclerotherapy and laser treatment are often performed by dermatologists, though some general, vascular, and plastic surgeons also perform sclerotherapy treatment. Individuals may want to consult more than one health care practitioner prior to making a decision on a method of treatment. Be sure to ask the health care professional about his or her experience in performing the procedure you want.

What are the side effects of these treatments?

Patients should consult their doctor about the safety and potential side effects of each type of treatment. Thoroughly review any "informed consent" forms the doctor gives you explaining the risks of a procedure.

For surgical removal of veins, potential side effects include those for any surgery performed under anesthesia, including nausea, vomiting, as well as the risk of post-operative wound infection. Surgery may also result in scarring where small incisions are made, and the formation of blood clots is a potential complication as well.

For sclerotherapy, the side effects can depend on the substance used for the injection. People with allergies may want to be cautious. For example, sodium tetradecyl sulfate (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 the formation of 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 the 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 the 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.

Medically Reviewed by a Doctor on 10/3/2012

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Varicose Veins - Treatments Question: What treatments have been effective in treating or preventing varicose veins?
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