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LEG VEINS
Dilated blood vessels, also called varicose or spider
veins, have a red or blue or purple colour and appear
on the surface of the body, particularly the legs. On
the face and upper body their character is slightly
different to those on the lower body, as are their causes.
These vessels can be unsightly and can produce a dull
aching of the legs after prolonged standing. If their
presence is distressing, they can be treated by injection
of a solution that will cause them to disappear, or
at least become much smaller.
WHAT CAUSES THESE BLOOD VESSELS
TO BECOME VISIBLE?
The cause is not known, except that in many cases they
seem to run in families. Surface veins occur in both
men and women, but much more frequently in women. The
hormone oestrogen may play a role in their development.
They may also occur after a blow to a certain area of
the body or as a result of wearing tight girdles or
hosiery held up by tight bands.
CAN THEY BE PREVENTED?
There is no proven method of prevention. Wearing support
stockings may prevent some dilated blood vessels from
developing in some people. Maintaining a normal weight
and regular exercise may also be helpful. Avoid wearing
high heeled shoes as these affect the proper functioning
of the larger veins, and avoid prolonged standing.
HISTORY OF SCLEROTHERAPY
In the majority of cases, a procedure called sclerotherapy
is used to treat these blood vessels, in which a solution
called a sclerosant is injected, using a very fine needle,
directly into the blood vessel. This procedure has been
used in various forms for veins since the 1920s but
has only been associated with an acceptably low side
effect rate in the more recent past.
HOW DOES SCLEROTHERAPY WORK?
The solution irritates the lining of the vessel, causing
it to swell and stick together. Some vessels will fade
from view, eventually becoming barely or not at all
visible.
A few vessels will need a second treatment, and a few
will not be accessible for injection at any given treatment
session because they will have been covered by the tape
used to pressurise other veins treated during that session.
Depending on its size, a single blood vessel may have
to be injected more than once, but in any one treatment
session a number of vessels may be injected.
The solutions used vary somewhat with the size of the
vessel to be injected, and your doctor will be able
to decide which veins are best treated with which solutions.
Larger varicose veins often underlie spider veins. In
such cases it is thought that it is best to treat these
vessels first.
Sometimes sclerotherapy is the appropriate therapy
for these veins, but sometimes surgery is required.
The type of treatment necessary is determined by clinical
examination and vascular ultrasound examination which
gives a precise diagnosis of any major superficial vein
abnormalities.
If the varicose and reticular veins are treated first,
often the spider veins that were connected to these
will disappear over the following weeks without themselves
being injected. Because of this it may be advisable
to space out the visits to allow maximal resolution
of veins following each treatment, thereby minimising
the number of treatments required.
ARE THERE SIDE EFFECTS TO SCLEROTHERAPY?
Even when a highly experienced doctor is performing
the treatment, there are a number of possible side effects.
These include various skin markings or injury, localised
swellings and bruising or tenderness or itch. Occasionally
a darkening of the skin occurs which may take up to
12 months to resolve.
Most of the side effects are minor, and confined to
the area which has been treated. Your doctor will give
you a more detailed explanation of all possible side
effects before the commencement of your treatment.
WILL TREATED VEINS RECUR?
The veins treated adequately by sclerotherapy will
not recur, unless they are extremely large before treatment.
However, the underlying weakness in the vein walls is
not corrected, and therefore new vessels will possibly
continue to appear at the same rate as before treatment.
These of course can be treated as they occur. The problem
of venous disease is generally a progressive one, and
unfortunately most of the causative factors are either
not known, or not treatable.
WHAT DO I DO AFTER LEG VEIN TREATMENT?
Generally you will be required to wear some form of
support or pressure garment for a period of time, usually
a week. Failure to do this may compromise the effectiveness
of the treatment, so the inconvenience of a leg bandage
for a week should be factored in to the timing of your
appointment. You should also be able to do regular walking
after your treatment, as this promotes the emptying
of the leg veins, including the ones treated.
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