I am wondering if having sclerotherapy on slightly bulging leg veins on shins (not varicose--I have been told they are athletic veins) would be successful--or if it is only successful on spider veins. The nurse who plans on doing the treatment will use a foam solution (detergent) and will use a light to find the veins. Feedback would be greatly appreciated.
Sclerotherapy on Slightly Bulging Leg Veins?
Doctor Answers 10
It would be my advice to avoid treating healthy, non-varicose veins. Just because they are visible does not mean they are abnormal. I tell my patients that normal functioning veins (non-varicose veins), including the ones on front of the shin bone (the tibia), should be left alone and not be treated with sclerotherapy. Why kill a healthy functioning vein? You are just putting your leg at unnecessary risk by performing a treatment that is aimed at a healthy and happy vein. I would suggest you avoid such a intervention.
Web reference: http://www.AustinVaricoseVein.com
Varicose veins are common in distance runners, because the peak pressure on the valves can lead to valvular incompetence. I suggest finding a member of the american college of phlebology (ACP) who understands treating more than just spider veins. You may need an ultrasound study of your veins to see if the valves in these veins are faulty. Depending on the size, they can respond to foam sclerotherapy, which is sometimes done under ultrasound-guidance. Another option may be endovenous laser therapy. There are great minimally-invasive treatments for leg veins and the line between medical and cosmetic treatments sometimes overlap, so consult with someone who understands venous disease.
Atheletic veins?? these are varicose veins, if they are big then you need a workup to make sure the vein valves are working well.
Excision and ligation is better than sclerotherapy in large veins. Sclerotherapy works but can cause a lot of inflamation and discomfort. Excision is done through a small incision. Large varicose veins are also treated with endovascular laser or endovascular ultrasoundthat delivers energy to destroy the inside wall of the vein and causes it to collapse and resolve.
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If the veins are not too large, sclerotherapy should be effective. It may take multiple treatments to achieve the result however. Athletic legs don't preclude the possibilithy of vericosities.
It is always a safe approach to first check the venous system, when veins are large, raised, bulging, to make sure that there is not a reverse connection between the superficial and deep systems of the veins. This is done by Duplex ultrasound. Many vascular surgeons, some dermatologists and plastic surgeons also do this. If there is not a reverse flow problem, than there is a higher level of comfort to proceed ahead with treatment.
It sounds as if you have blue or reticular veins which usually respond very well to foam sclerotherapy. This is the treatment of choice for these kinds of veins. Sclerosing solutions that can be foamed are in the detergent family and are usually polidocanol or sodium tetradecyl.
These are areas where the skin is thin - on the bony part of the shin (medially) and on the muscular side (lateral aspect) where these veins cross over the tibia. It is very painful to do microphlebectomy here whether the vein is small or moderate in size or large and bulging and I avoid microphlebectomy here at all cost because it is very painful - therefore, I used sclerotherapy here regularly as it is nearly painless and very well tolerated and effective. You can call it whatever you want (athletic veins), but if they bother you from a cosmetic standpoint, you should get them treated with sclerotherapy.
Web reference: http://www.VeinGuide.com
If these veins are isolated vessels (you don't see other spider veins on the ankle, etc), they can be very effectively treated with sclerotherapy. I agree with using a foamed solution-- as the increased contact time with the vein wall will give you better result than with with a liquid solution. You should wear compression stockings for 1-3 weeks afterwards to ensure optimal resolution of the veins. Foam sclerotherapy is an advanced technique-- complications including open sores (ulcers), blood clots, hyperpigmentation, even rare cases of visual changes, etc have been reported. It is important to use the right concentration of foam and the right technique to minimize complications. I would go to a board certified physician with significant experience in vein treatment and not a nurse for this.
Best,
Dr. Mann
Sclerotherapy should be effective on these veins, but I would recommend performing these procedures with a knowledgeable surgeon who is a diplomate of the American Board of Phlebology.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.
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