Vein Treatment

Dilated leg veins and prominent small capillaries and veins on the legs are a common cosmetic problem, and sometimes lead to aching and discomfort in the legs.

The origin of these visible skin vessels is related to a number of factors - they are more common in women due to hormonal effects, and commonly arise during or after pregnancy with the extra venous pressure within the legs at that time, combined with high hormone levels. They are also more common in people who spend a lot of time standing - teachers and shop assistants are at risk. Damage to the venous vascular system due to deep vein thrombosis (DVT) plays a role in some cases.

Genetic factors play a role, with mothers and daughters commonly affected.

What does the treatment involve?
The treatment of visible leg vessels is dependent on an assessment of the extent and size of vessels involved. Significant varicose veins result from incompetence of valves in the veins of the deep circulation. To achieve good results in this case requires surgery to the larger vessels, or more invasive therapies such as ultrasound guided injection or ambulatory sclerectomy.

To improve smaller varicose veins and capillary dilatation (such as spider veins), sclerotherapy and laser therapy and are commonly used.

Sclerotherapy

Sclerotherapy involves a series of tiny injections of a solution designed to irritate and then close off the offending vessels. Vessels less than 2.5mm in size can be targeted using this technique.

What is the treatment like?
Most patients experience minimal discomfort during the procedure. The area is cleaned and the veins injected with a sclerosing solution using a very fine needle. The veins turn white whilst the solution is being injected and then appear red and swollen several minutes after as the solution irritates the vessel wall. This is repeated until all the troublesome veins have been injected. Best results are obtained by 2 - 4 treatments.

What should I expect after the treatment?
After Sclerotherapy there is usually some redness and swelling along the course of the treated veins. This may persist for a few hours, days or longer depending upon the size of the treated veins. Less commonly, there may be some bruising.

You will need to wear compression stockings for a period after treatment in most cases. Vigorous exercise should be avoided for one week after treatment, although walking daily is encouraged. You cannot fly or drive long distances for 10 days after treatment.

Sclerotherapy results in a gradual improvement in the appearance of visible vessels over a period of 6 weeks after treatment. Not all people respond to Sclerotherapy though, and non-response or recurrence occurs in a proportion of cases.

Laser Therapy

Laser treatment is a valuable addition to sclerotherapy, although its overall effectiveness rate is lower due to recurrence. The 1064 long-pulse YAG laser is useful in treating resistant vessels and venules (dark vessels) or matting. Laser treatment is best performed in lighter skin types and untanned skin. Dark skin carries more risk of hyperpigmentation (darkening of the skin) or pigment loss (white spots) following treatment.

What are laser treatments like?
The veins to be treated are identified, before pulses of light (laser) energy are delivered along the length of the vessel, larger veins first. The light energy causes the blood within the vein to coagulate, eventually destroying the vessels, which are then absorbed by your body. Most patients report little discomfort, though some experience a mild burning sensation with each pulse.

What should I expect after the laser treatment?
You may experience some redness and swelling of the treated area, which should disappear within a few days. Generally, the veins will turn a purple color that resembles a small bruise, and then gradually fade within 5-10 days. Some redness or purple discoloration may persist for several weeks, or longer. The redness will gradually lighten to a pink tone, and then to a lighter, more natural color.

Although sclerotherapy and laser treatment of leg veins may not erase all imperfections in the skin, most patients are satisfied with the results. It is important to remember, however, that this treatment does not deter the normal effects of aging and will not prevent the occurrence of new spider veins.

Skin Resus, Floreat Forum, Perth  Western Australia