What are Spider Veins?
Spider veins appear as red or purple sunbursts on the skin surface, and can occur on the face, legs or ankles. They can itch, burn or ache, and can be found alone or in combination with varicose veins. They are not a health risk alone, but are often a cosmetic concern. Most spider veins are treated with a combination of sclerotherapy and laser ablation. These combined treatments offer the best long term results. 
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What are Varicose Veins? 
Veins normally function to return blood to the heart. Valves in the veins close after blood travels up the vein, preventing blood from backing up (refluxing) down the vein. Valves can become abnormal, or incompetent for a variety of reasons, including trauma, pregnancy, or hereditary factors. Once a valve becomes incompetent, the vein below the valve is exposed to higher pressure, and can become larger (dilate). Other valves and veins nearby are exposed to the higher pressure and can also dilate. Varicose veins commonly appear on the legs as raised, often ropy, enlarged veins. They can cause the legs to swell, throb or ache, and in severe cases, can lead to inflammation, ulceration and even blood clots. Varicose and spider veins are common and cause a variety of symptoms in both men and women. It is estimated that 80 million Americans are affected by either spider or varicose veins. For women age 35-59, approximately 50% are affected and this percentage increases with age. The symptoms caused by varicose and spider veins range from a cosmetic nuisance to an aching, heavy or crampy sensation, to a painful condition which limits enjoyable activities or even the ability to work. The most severe cases can lead to significant swelling and ulcer formations on the legs. 
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What causes varicose and spider veins? 
Heredity is the number one factor causing varicose and spider veins. Women are more likely to suffer from varicoseveins, especially because of pregnancy and hormonal factors. Pregnancy causes increases in hormone levels and
blood volume, which in turn causes veins to enlarge. In addition, the enlarged uterus causes increased pressure on the veins. Varicose veins due to pregnancy may improve within several months after delivery, but never go away. Other predisposing factors include occupations involving prolonged sitting or standing, obesity, trauma, and intense weight training exercising. 
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What is the best treatment for varicose or spider veins? 
A variety of treatment options can be used that involve different procedures, these include endovenous laser therapy, injection sclerotherapy, micro-incisional phlebectomy or resection, and even ligation and stripping. A personalized treatment plan will be recommended by our board certified surgeon during your initial free consultation. 
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What is Vein closure by laser? 
This is an exciting new laser procedure that involves placing a thin laser filament into the vein through a needle puncture in the lower leg and uses laser energy to heat the vein from inside, causing it to close down. Closure by laser has a 98% rate of completely closing down the vein. The laser procedure can be performed on most patients whose varicose veins are due to an incompetent saphenous vein. Each patient will be evaluated by our surgeon to determine which treatment is best for them. 
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Does this replace vein stripping? 
Surgically removing veins, or "vein stripping", is sometimes needed, but the method currently used is much different from many people’s idea of vein stripping. The ambulatory micro-incisional phlebectomy procedure is done under local anesthesia in our office and is much less traumatic to the leg than traditional stripping, and leaves minimal to no scarring. Patients walk out of the office, and most are able to resume work and their normal activities within just a few days. 
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What is injection sclerotherapy? 
An FDA-approved solution called Sotradecol® is injected into the vein through a microneedle, to induce an inflammatory reaction which causes the vein to seal shut and gradually shrink away and disappear. Once the vein is sealed, blood is forced into healthier veins. Sotradecol® gives much better results and is far less painful than the traditional hypertonic saline injections. 
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Why not just inject all the veins? 
That method alone results in a higher chance of varicose veins returning. We do not use injection sclerotherapy for very large veins. We will offer the best treatment for each individual's vein problem, which can sometimes require minor surgery to get the best long-term result. 
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Who are candidates for treatment? 
Any individual who has unsightly spider or varicose veins is a candidate, and both large and small veins can be treated effectively. Best results with spider veins are seen in fair skinned individuals. Tanning or prolonged sun exposure should be avoided both before and after treatment.
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How many treatments are required? 
The number of treatments to provide you with the results you want to achieve will be determined during your initial consultation session, at no cost, where a personalized treatment plan will be developed. For most large bulging veins, 
one treatment is all that is needed. Spider veins do require several treatments. The average person requires 3-5 sessions spaced 4-6 weeks apart in order to get resolution. 
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Will it hurt? 
Most patients experience little or no pain, and any discomfort lasts only a fraction of a second. Topical anesthesia or ice packs can be applied for pain sensitive patients. While the amount of post treatment pain varies from one patient to another, most require only Tylenol or ibuprofen for any discomfort. 
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What about side effects? 
Most treatments have minimal side effects and recovery time. Patients often experience slight redness or bruising following treatment, but this goes away within a few days. 
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What about Post-Procedural care? 
The overwhelming majority of patients treated for varicose veins or spider veins walk out of the office and return to normal daily activities including work within two days. While the amount of post treatment pain varies from one patient to another, most require only Tylenol or ibuprofen for any discomfort. Complete recovery, including resolution of bruising, takes from 4-6 weeks. Detailed written and verbal instructions will be provided to each patient both before and after treatment. 
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Can you treat unsightly veins on my face?
Yes, laser therapy may be the appropriate treatment method to reduce the appearance of these veins, both on your face and legs. 
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