SKIN Specialists Leg Vein Therapy utilizes a combination of treatments as needed to treat leg veins. Sclerotherapy is the standard of care when treating reticular veins and telangiectasia, called spider veins, of the legs. A very small needle is inserted into the blood vessel where a small amount of a sclerosing agent is gently injected. This causes inflammation within the lining of the blood vessel, which causes the vessel to shrink down, close and gradually disappear. This process may take from a few weeks to several months. In addition to sclerotherapy, an Nd-YAG 1064nm laser may be used for medium sized reticular vessels that are too small, deep or twisted to inject. A small spot of laser light travels through the skin and is absorbed by the blood within the vein. The resulting heat coagulates or clots the blood and destroys the function of the vein without affecting surrounding tissue. Over time, the vein is absorbed by the body and disappears. Finally, Intense Pulsed Light (IPL) is used for smaller superficial blood vessels, also known as matting. As with the laser, IPL uses precise pulses of light energy that are absorbed by the blood vessel, heating it to the point where it is destroyed. Following treatment, the vessel slowly clears and is re-absorbed by the body.
- Pre-operative: Purchase support hose and bring to each session. Before treatment, do not shave your legs for at least three days or apply moisturizer or cream to the legs for at least 24 hours. Avoid aspirin, ibuprofen or other anti-inflammatory drugs for 48-72 hours. Tylenol, however, should not affect the procedure. Wear loose fitting slacks or bring shorts to each session.
- Post-operative: Cold packs, Aloe Vera or other cooling topical agents may be used to ease discomfort and Tylenol is also an option. Keep band-aids on the injection sites until the following morning. Wear support hose during awake hours for two weeks for best results. Walking the day of treatment is encouraged and avoid sitting for long periods. Avoid hot baths or showers for two days after treatment but lukewarm is acceptable. Avoid strenuous activities or high impact exercise for one week if possible. Do not scratch the injection sites.
- Side effects: After the procedure, itching may occur for 1-2 days and there may also be temporary redness and flushing at the injection site. Bruising may occur lasting several days or weeks. Less common effects include small blood clots in larger vessels that can be removed by puncture; and pigmented spots that usually heal spontaneously but may remain discolored for several weeks up to one year. A bleaching agent can be used to lighten these areas. Rarely, there is an allergic reaction to the sclerosing agent, including a bloody blister that can be promptly treated; lightheadedness and cardiac arrhythmias.
LASER AND IPL THERAPY
- Pre-operative: In addition to those detailed for sclerotherapy, you must make a commitment to stay out of the sun. Sun exposure is to be avoided three weeks before AND three weeks following treatment. A total sunblock, not sunscreen, should be applied if it is absolutely impossible to comply. If there is sun exposure, there are certain complications that may occur that should be discussed fully.
- Post-operative: Cold packs, Aloe Vera or other cooling topical agents may be used to ease discomfort and Tylenol is also an option. Wear support hose during awake hours for one week for best results. While most normal activities may be resumed immediately, avoid strenuous exercise for the first 24 hours after treatment. Sunscreen should be applied to treated areas that are exposed to the sun as long as the skin is not broken. Avoid hot baths or showers for two days after treatment but lukewarm is acceptable.
- Side effects: Pain is generally mild. Some swelling and bruising can occur around the treatment site that usually resolves rapidly. Post treatment hyperpigmentation can be seen for 1-3 months and the incidence of hyperpigmentation increases with the size of the treated vessel. If the skin is broken or a blister appears, apply an antibiotic ointment and contact the office immediately. A soothing ointment like Aquaphor may also be applied. The area should be kept lubricated to prevent crusting or scabbing of tissue. Limiting sun exposure will greatly minimize the risk of complications.