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Unbeknownst to many women, varicose veins are often more than a cosmetic problem. Spider veins and larger varicosities can also lead to leg pain, sores, ulcers, night cramps, ankle swelling and leg heaviness that patients do not know to attribute to their unsightly varicose veins. Although it’s estimated that varicose veins affect about 75% of all adult women, and a significant number of men too (17%), many have opted in the past to avoid treatment because of the pain, side effects and scarring associated with traditional treatments.
Until recently the primary option for varicose vein removal was a surgical procedure called “stripping and ligation,” during which the affected veins would be removed invasively. However, this approach requires general anesthesia, and often leads to scarring and an eventual return of varicosities. According to Joshua Fox, M.D., a leading dermatologist and founder/director of Advanced Dermatology, two new approaches – Sclerotherapy and Laser Therapy – are leading more and more patients to pursue relief from varicose veins.
“These breakthroughs are a boon to those who have shunned traditional surgery for varicose veins,” Dr. Fox says, “But they also have created new questions in the minds of patients about how each process works, and which procedures are appropriate for their specific conditions.”
Dr. Fox explains that with Sclerotherapy, a solution is injected into the veins, causing them to collapse, turn to scar tissue, and eventually become absorbed by the body. “Sclerotherapy eliminates the need for invasive surgery and the resulting scars and recovery time,” Dr. Fox says. “However, it usually takes up to six months for the sclerosed veins to disappear completely.” While sclerotherapy has been used for a number of years, the procedure was known to be painful, particularly during the injection process. However, newer solutions, anesthetic techniques and instrumentation have made the procedures almost pain-free.
Laser treatment involves the application of light changing to heat through the skin via the laser to the affected vein and/or valve. The latest in laser treatment uses an endoscopic laser, which results in little or no scarring or recurrence of the varicosities. The relief from pain or tenderness occurs usually in one day. The laser is used to shrink and seal the vein wall, and very strong bursts of light transmitted by the laser cause the vein to slowly fade and disappear. Again, the veins are normally reabsorbed by the body within six months and disappear.
Dr. Fox notes that, while every case is unique and should be treated according to an individualized protocol by the patient’s physician; there are some guidelines that can clarify whether Sclerotherapy, Laser treatment, or a combination of the two is most appropriate:
1. The size of the vein – Spider veins are usually a network of hair-thin veins that look like a spider web, a tree with branches, or a starburst. They usually respond well to Sclerotherapy, while larger varicose veins that appear deeper in the skin tend to respond better with laser therapy.
2. The location of the vein – Spider veins are usually found on the legs, a result of myriad factors including diet and fitness levels, hormonal changes like in pregnancy, heredity and a sedentary lifestyle or job. But sometimes, these ultra thin veins appear on the face. “Facial varicosities are usually very thin, and very close to the skin’s surface, and so we would be likely to use a laser, or a combination of Sclerotherapy and Laser therapy, for those cases,” Dr. Fox notes.
3. The level of discomfort the veins are causing – “Treatment of varicose veins is rarely considered strictly a cosmetic surgery,” Dr. Fox explains. “There are many lifestyle changes we recommend first to alleviate the symptoms of varicosities, from wearing tight stockings over the affected area to undertaking a regular exercise routine. It’s only when these measures fail, and the patient is experiencing discomfort, that we take a minimally invasive surgical approach.”
Dr. Fox advises patients seeking treatment for varicose veins to consult with a board-certified dermatologist or dermatological surgeon. “These procedures often require multiple office visits, utilizing highly specialized equipment and supplies, and sometimes involving a combination of therapies and approaches – factors that may not always be taken into consideration by other practitioners.”