DESCRIPTION OF CONDITION:

Varicose veins and spider veins are two different types of vein disorders.  Both types of veins lie close to the surface of the skin however varicose veins are wide, abnormally swollen blood vessels and spider veins are thin vessels.  A patient may have only one or both conditions. (See Varicose Veins for additional information)

Spider veins are purple, blue or red in appearance and can appear on the legs and face.  Most commonly spider veins appear on the thighs and ankles.  Spider veins appear in three basic shapes:  linear, branch-like or in the shape of a spider, with a dark center point.   

SYMPTOMS:

The most common symptom of spider veins is stinging or itching.  Spider veins result from reticular veins, often called feeder veins, or from improper function of the major leg veins.  If the patient is also experiencing pain and swelling in the leg, a physician may use ultrasound to make a complete diagnosis.    

INCIDENCE AND CAUSES:

Nearly 70% of all women and 30% of men will develop some type of venous disorder. Spider veins are formed from pressure in the venous system.  This pressure causes the smaller blood vessels to enlarge, creating spider veins.   Although the exact cause of venous insufficiency is unknown, there are many contributing factors including:

• Heredity
• Pregnancy
• Hormonal changes
• Being overweight
• Standing or sitting for long periods of time
• Advancing age
• Injury
• Sun-exposure for veins on the face

ANATOMY:

                                                    Normal Venous Flow                                                       Abnormal Venous Flow

PROCEDURE:

During an initial consultation the physician will determine if the spider veins are caused by reticular veins or by a larger superficial leg vein that is functioning improperly termed venous insufficiency.  Venous insufficiency is a condition created when the valves, of one of a large superficial leg vein, is no longer work correctly preventing blood from flowing properly and allowing the blood to pool in the veins.  If the spider veins are related to venous insufficiency, the physician will treat this condition first to obtain the best results from the spider vein treatment.  Once the physician determines that venous insufficiency does not exist, the physician will discuss a detailed treatment plan with the laser.   

PRE-PROCEDURE PROTOCOL:

Skin pigmentation can be related to the effectiveness of any laser, therefore the patient should have no sun exposure 4 weeks prior to treatment to guard against blistering and scarring.

Although discomfort is mild, many physicians will cool the skin using

ice, a cool air device or topical anesthetic.  The duration and number of sessions will vary, depending on the severity of the condition and the location.  Many facial veins can be treated in one session however most conditions on the leg require 3 – 5 treatments that often last 20 minutes to ensure all spiders are treated.  These treatments are spaced 4 – 6 weeks apart.   

Many physicians use the “Double Injury” method when treating spider veins on the leg.  This technique treats the spider veins with the D940 SkinPulse S laser, followed by an injection of sclerosing solution into the associated reticular or “feeder” vein.  The initial use of the Dornier laser damages the vein allowing only a small amount of sclerosing solution to pass from the reticular vein to the spider vein.  The vein is then reabsorbed into the body like a bruise.  The benefit of the “Double Injury” method over sclerotherapy alone is faster resolution and a significant decrease in the risk of staining.  Staining appears as brownish discoloration of the skin.  (See Alternative Treatment Options). 

POST PROCEDURE PROTOCOL:

Once the procedure is completed, the physician will place a compression stocking on the treated leg to be worn 3 – 5 days.

As with any procedure, some mild side-effects might occur.  These side effects include slight redness to the skin tone or mild swelling in the treated area.  The physician may also require that compression hose be worn during the day for an additional week or two.

Although each individual physician will discuss their preferred post procedure routine, some common instructions are:

• Stay out of the sun and tanning beds
• Wear compression stockings for a minimum of 3 – 5 days
• Abstain from high pounding activity such as running or step aerobics for a period of 3 weeks
• Walk at a moderate pace, as it will aid in the healing process

ALTERNATIVE TREATMENT OPTIONS:

Sclerotherapy - A needle injects a solution that causes the lining of the vein to swell and eventually seal shut.  The vein will usually fade in a few weeks.  As with laser treatment this procedure will take three to five treatment sessions.  Staining, or brown discoloration on the skin is a possible side effect to sclerotherapy.  The staining is caused by the sclerosing solution and may take six months or longer to fade.  The price of each procedure customarily runs anywhere from $250 to $450 per session.