Unsightly veins on the thighs and the lower legs consist of three different types: varicose veins, venectasia and spider veins or telangiecasia. All Injection therapy treatments can be very effective but new vessels will continue to develop and regular follow-up is required to maintain the best result.
These are bluish, tortuous and bulge when standing and collapse flat when the leg is horizontal or elevated. They may extend from the groin to the inside of the ankle and from the back of the knee into the calf. Varicose veins are caused by the loss of function of valves in the veins which are stretched apart and no longer prevent blood in the veins flowing backwards towards the feet instead of only allowing flow towards the heart. These kinds of veins often follow pregnancy. However, every pregnant patient develops varicose veins. There has to be a genetic predisposition to them which is triggered often by pregnancy, weight gain or ageing.
Treatment of varicose veins consists of two parts:
- Ligation of the incompetent sapheno-femoral junction at the base of the long saphenous vein or the base of the short saphenous vein or ablation with laser or a heated probe of the vein and its junction with the deep veins. Many surgeons recommend multiple excision and stripping of the multiple varicosities which branch out from the main long saphenous and short saphenous veins. This procedure leaves unsightly scars on the legs and does not prevent recurrence of these secondary branching varicose veins.
- Injection sclerotherapy of the multiple varicose veins in the leg followed by a compression wrap for 5 days is highly effective at collapsing these veins and preventing their reoccurrence.
These are bluish veins coursing below the skin. They do bulge but are still unsightly.
Treatment: Injections sclerotherapy is effective in treating these.
Spider veins (telangiecasia) and matting.
As the name describes these consist of long spidery vessels that may either be blue or pink. They extend from a feeding vessel. They are common throughout the leg, often on the outer thigh knee, calf and ankles. Most are about 0.5 mm wide but another variant calling ‘matting’ has even smaller vessels that can be hard to identify.
Treatment : Injection sclerotherapy is performed with a 30 gauge needle, 3.5 X magnifying glasses and a surgical light to identify the spider vessels and introduce the needle into the feeding vessel. After treatment care of spider veins does not require a full-leg wrap as in the case of varicose veins.
Patients are checked at one week and at one month to evaluate any injections sites. Many patients require a second treatment after one week to treat varicosities and spider veins that have either failed to respond to treatment or are now more visible after eradicating some of the more prominent vessels. After one month, many of the veins that have been successfully treated will either manifest themselves as painful cords or dark blue streaks. The blood can be evacuated from these veins, to relieve any discomfort, and to speed up the healing of the veins and help to prevent staining of the skin caused by hemosiderin iron containing pigment absorbed from blood trapped in the treated veins.