Telangiectasias (spider veins) are dilated superficial veins. They are often found on the face, generally appearing on the nose, chin or cheek area; and the legs, usually appearing on the thighs and ankles. Spider veins are usually the colour purple, blue or red, and appear in three basic shapes: linear, branch-like or spider-shaped, with a dark centre point.
Varicose veins are twisted, enlarged veins near the surface of the skin caused by weakened valves and veins in your leg. Valves in your veins help blood keep flowing from your legs, and when these valves stop working, blood collects in your legs and pressure builds up. The vein then becomes weak, big and twisted. Symptoms of varicose veins include pain, aching or burning in the legs, swelling, leg cramps or sores, itchy skin around the vein, and open wounds such as skin ulcers around the ankle.
There are a number of treatment options available, with some complementing another treatment, or used to treat larger veins. These treatment options include:Surface laser treatment: used to eliminate spider veins, with the laser beam pointed at the veins to be treated, and the laser light energy to close the veins. By injuring the veins with the laser first, the vein spasms and less sclerotherapy is required.Sclerotherapy: a needle is used to inject sclerosant, causing the lining of the vein to swell and eventually seal shut. This procedure may take three to five treatment sessions. Sclerotherapy is an appropriate treatment for small to medium sized reticular veins that feed spider veins, or small varicose veins that remain after the laser treatment of reflux in the large saphenous veins. UGS or Ultrasound Guided Sclerotherapy: if larger veins are present, a mapping ultrasound is organised to determine whether an Ultrasound Guided Sclerotherapy (UGS) treatment is needed. Using ultrasound guidance, a tiny needle is used to inject foamed sclerosant into the vein. The lining of the vein then swells and eventually seals shut. The vein will usually fade in a few weeks. Depending on the number of veins, one to three treatment sessions may be needed. EVLT or Endovenous Laser Treatment: if larger veins are present, a mapping ultrasound is organised to determine whether an Endovenous Laser (EVLT) treatment is needed. EVLT is a 30-45 minute in-office procedure with no down time or scarring. After the skin is numbed, the vein is accessed through a small incision and an introducer is inserted into the vein. The laser filament is inserted through the introducer. Once inside the vein, the placement of the laser filament is verified using ultrasound and by visualising the aiming beam. The laser is slowly withdrawn as it emits energy, with the laser energy sealing the vein shut.
After treatment of spider veins, it is recommended that compression stockings be worn for three to five days and for a week after treatment of larger varicose veins. 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.
After treatment of larger veins with UGS or EVLT, a repeat ultrasound will be done in 4 weeks to ensure that the treated veins are sealed. Occasionally, a treated vein will reopen, requiring a repeat injection of foam sclerotherapy. 98% of treated veins are sealed shut at 1-year follow-up.
We recommend that patients stay out of the sun and tanning beds for four weeks, before and after surface laser treatment. Wear compression stockings for a minimum of three to five days. Abstain from high impact activities such as running or step aerobics for three weeks. Walk at a moderate pace, as it will aid in the healing process.