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Spider Veins
Spider veins are small varicose veins. They arise from very small veins that dilate in both diameter and length to become the cluster of irregular serpentine veins that are both unsightly and often painful. Probably 90% of people suffering from spider veins also have larger varicose veins. Of the remaining 10% who only have spider veins, the majority are suffering from the same underlying abnormality that causes the formation of all varicose veins - elevated blood pressure in the veins of the legs. Fewer than 5% of patients with spider veins have normal venous blood pressure. These unfortunate few simply have small veins that are genetically weak, or sun damaged, or suffer from some other obscure cause. The vast majority of people with spider veins have venous hypertension in the legs, when standing. If this underlying cause of their spider veins is not evaluated, treated, and eliminated, then treatment of the spider veins will usually be less than satisfactory and often completely unsuccessful. Furthermore, if not corrected, venous hypertension will cause the development of new spider veins on a regular and ever more frequent basis even after successful treatment of the current "crop" of spider veins. The treatment of spider veins is essentially the same as the treatment of larger varicose veins. Since there is an abundance of veins in the legs, the damaged spider veins can simply be eliminated. The destruction of these veins is most commonly accomplished through the use of injections directly into the veins themselves, or through the use of laser energy beamed onto the veins to apply heat to the point of destruction.
The injection of spider veins is called sclerotherapy. With this technique an agent is injected into the vein which chemically damages the vein from the inside. This causes the vein to clot. The clot is absorbed by the body over the ensuing several weeks to months and simultaneously the vein shrinks to become a tiny fibrous strand, no longer visible. The technique works very, very well but it does have it’s limitations, and understanding them can help to improve the overall results. When the vein clots, the clot is very visible through the skin and will remain so until the clot is completely absorbed. Therefore, in the immediate few weeks after a treatment, the vein will continue to be very visible. In addition to this, the vein becomes inflamed during this process and the presence of clotted blood in an inflamed vein can often result in a brown staining or darkening of the overlying skin. In the majority of patients this stain is only temporary, but in a few it may persist for a year or more and occasionally it may be permanent. To minimize this staining and to hasten the process of elimination of the clot, it is very helpful to attempt to minimize the amount of blood clot that forms in the vein at the beginning. This is best accomplished by compressing the vein for about 72 hours after treatment. With compression, the amount of blood in the vein is kept to a minimum while the vein is in the process of clotting and the size of the resulting blood clot is therefore much smaller. This is accomplished through the use of compression stockings after a treatment. External beam lasers are also useful for the treatment of spider veins. The laser light is more strongly absorbed by the hemoglobin in the blood than it is by the surrounding tissues. Therefore the blood becomes very hot and the heat damages the inside of the vein setting in motion the same process that occurs after a chemical injury to the inside of the vein.
Whether sclerotherapy or laser therapy is used, the potential exists to damage more than just the vein. Therefore the strength of the sclerotherapy agent or the strength of the laser beam must be adjusted to a level that does not cause injury to the surrounding tissues. For this reason, it may require more than one treatment to destroy a spider vein. Often both treatments are used sequentially, separated by several weeks in time, in order to destroy the veins with the smallest number of repeat treatments. Most patients will achieve an 85% reduction in the overall collection and/or size of their spider veins in three treatment sessions. At Perfect Legs, unlike almost any other office offering treatment for spider veins, a "session" means treating every spider vein in both legs, up to the maximum dose of sclerosing agent. Most other centers limit a session to 15 minutes or 30 veins or put some other limits in place. Because we believe in VALUE pricing and we recognize the importance of having satisfied customers who come back and tell their friends, sclerotherapy can be purchased in our packages for as little as $150.00 per treatment and laser for as little as $200.00 per treatment. Most other offices charge $400.00 for sclerotherapy and up to $700.00 for laser treatments. © 2005 F. J. Fazzio, Jr. MD.
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