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Good quality support stockings are recommended after Sclerotheraphy, wear them before getting out of bed in the morning.
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Spider Veins Treatments at Dallas Vein Specialists

At Dallas Vein Specialists we believe that for spider veins, also called telangiectasias, of the legs the best results are obtained by the injection of a dilute concentration of a chemical sclerosant directly into the spider veins. This is called Sclerotherapy. Although laser treatments and intense pulse light (IPL) treatments have been touted as effective for spider veins, we do not recommend them. Laser treatments are painful, expensive, take much more time, and are much less predictable in results as compared with Sclerotherapy. Removal of spider veins by IPL is usually disappointing even after multiple treatments.

Principles of Treatment of Spider Veins of the Leg

At Dallas Vein Specialists the principles of successful treatment of spider veins includes the following:

  • Identify a treatable cause if present
  • Produce an irreversible injury to the spider vein
  • Compression after the treatment

Identify a treatable cause if present – Malfunctioning reticular veins, so-called “feeder veins” that appear to feed or supply spider vein clusters, or other superficial veins, such as the great saphenous vein that have failing valves and are causing venous high pressure, should be treated before the spider veins are treated, otherwise the results of spider vein treatment will be disappointing.

Produce an irreversible injury to the inside lining cells of the spider vein – This is done by injecting chemical solutions or by delivering heat energy to the spider vein. Chemical injection (sclerotherapy) through a small caliber needle in sufficient amount and concentration achieves an injury, which is followed by formation of small clots in the treated veins. Subsequent to this the body’s inflammatory process removes the vessel and the clot. This may take weeks to months depending on the size of the blood vessels and their location. Larger sized spider veins may take months to totally resolve, and this is especially true if they are located low on the ankle or on the foot. Of course the appearance will look much better after only a few weeks, but if one looks closely, residual clot may be seen well beyond most of the disappearance of the spider vein complex. These clots within the small spider veins do not migrate and are not a threat for breaking loose within the circulation and causing illness.

At Dallas Vein Specialists we use chemical injection (sclerotherapy) for most spider veins and, when indicated, for reticular veins as well. The sclerosing chemicals used are gentle and well tolerated. Patients usually feel little if any discomfort during the treatment. There is usually minimal or no discomfort afterwards.

My staff and I at Dallas Vein Specialists have been impressed with the benefits of treatment of spider veins using the VeinGogh device. The VeinGogh uses radiofrequency energy to produce “ohmic thermolysis”, a process that eliminates the vein using heat energy delivered at the point of a hair-like needle probe that is placed against the vein wall. This treatment is best for the small hair-like veins that are too small for injections. The treatment causes only some mild discomfort.

Compression after the treatment – At Dallas Vein Specialists we urge our patients to use compression on the treated leg for at least 1 week post treatment. There is some evidence that conscientious use of compression wraps or hosiery daily for at least 1 week improves the results of treatment. Our usual practice is to place the compression stockings at the conclusion of the treatment session. The patient is instructed to wear the stocking until the following evening so that the night of the treatment the patient sleeps with the stocking in place. Then the patient wears the stocking daily when not in the bed or bath. Hot showers are avoided for the first 48 hours. Usual activities may resume immediately, and vigorous exercise may be resumed in 48 hours.

Spider Veins of the Face

Facial telangiectasias or fine spider veins are common cosmetic concerns in both men and women. Again heredity plays an important role in most patients. These small hair-like veins may occur anywhere on the face but are commonly seen about and on the nose, around the nostrils, along the fold between the nose and the cheek, and on the prominence of the cheek. They are often resistant to treatment by laser or intense pulsed light (IPL). They are too small for injection but are ideal for the VeinGogh device. Using radiofrequency the VeinGogh delivers heat energy at the point of a small needle-like probe to the facial spider veins, which immediately disappear. Patient satisfaction has been high at Dallas Vein Specialists.

Cherry Angiomas of the Skin and Rosacea

The VeinGogh device has been effective in the complete removal of cherry angiomas of the skin. Cherry angiomas, also known as “Campbell de Morgan spots” are small bright red mole-like growths that can occur anywhere on the body but most commonly are noticed on the skin of the chest and abdomen. They are small, ranging in size from red dots to 1-2mm and rarely up to several millimeters in diameter. Microscopically they are a mass of tiny capillaries that form a papule on the skin surface. If injured they may bleed profusely. In eradication of them with the VeinGogh device bleeding has not been a problem.

Rosacea is a chronic condition characterized by redness of the cheeks, nose, forehead, or chin and small visible spider web-like blood vessels, telangiectasias, on the face. The VeinGogh device treatments have improved the facial appearance by elimination or reduction of the hair-like veins.