Chris Pittman, M.D.
Undergraduate: University of Florida, Gainesville, FL; B.S. Medical: University of South Florida College of Medicine, Tampa, FL; M.D. Residency: St. Louis University Medical Center, St. Louis, MO Fellowship: University of California - San Diego Medical Center; Interventional & Vascular Radiology

What are Spider Veins?

Spider veins are tiny red or purple dilated blood vessels that form when veins become enlarged and swollen with stagnant blood.

Though smaller that varicose veins, spider veins are often darker and more noticeable. This is because spider veins are located just below the surface of the skin. More common in women, spider veins may be triggered by pregnancy or hormonal variations and sometimes result in itching, restless legs and minor aches and pains.

Although spider veins are mainly a cosmetic problem, they can also be an indication of more serious vein disease below the surface.

What to expect from Sclerotherapy (Spider Vein Treatment)

Sclerotherapy of spider veins is a relatively simple procedure that requires no anesthesia, so it is performed on an outpatient basis. A typical sclerotherapy session is relatively quick, lasting about 15 to 45 minutes. After changing into shorts you will be asked to lie down on the examination table and the skin over your spider veins will be cleansed with an antiseptic solution. Our vein care specialist will then inject the liquid sclerosing agent into the affected veins. Bright light and magnification are used to ensure that the process is completed with maximum precision.

Approximately one injection is administered for every inch of spider. During the procedure, you may listen to music, read, or just talk to your practitioner. You will be asked to shift positions a few times during the process. As the procedure continues, you will feel tiny needle sticks. However, the needle used is so thin and the sclerosing solution is so mild that pain is very uncommon. Any significant discomfort has been described as no worse than plucking eyebrows. Again, after treating hundreds of patients at Vein Care Specialists, no patient has stopped the procedure because of pain or discomfort!

Consultation

During your initial consultation, you will be asked several questions and your legs will be examined by our vein care specialist. Our vein care specialist will ask you about any problems you may have with your legs, such as pain, aching, itching or tenderness. You will also be asked about your medical history, medications you take, or conditions that would preclude you from having treatment.

You will be checked for signs of more serious deep vein problems, often indicated by swelling, sores, or skin changes at the ankle. A hand-held Doppler ultrasound device is sometimes used to detect abnormal veins hidden beneath the skin. For more serious spider vein cases, an ultrasound of your legs may be recommended to assist the doctor in customizing an individual treatment plan. Problems with the larger, hidden veins must be treated first, or sclerotherapy of the surface veins will be unsuccessful.

Before Your Treatment

You will receive instructions from our office and at this website on how to prepare for your treatment. Do not apply any type of moisturizer, sun block or oil to your legs on the day of your procedure. You may want to bring shorts to wear during the injections and pants to wear home after the procedure. When scheduling your procedure, you should be aware that your treated veins will look worse for a few weeks before they begin to look better.

After Your Treatment

Weeks after each sclerotherapy session, the veins will appear lighter. You should be aware that your treated veins will look worse before they begin to look better. You will notice reddish areas at the injection sites. The discolored areas will usually diminish within one month.

A one-month healing interval is typical before you are scheduled for additional sclerotherapy injections. After each treatment, you will notice further improvement in the appearance of your legs. Two or more sessions are usually required to achieve optimal results.

You should also be aware that the procedure treats only those veins that are currently visible; it does not prevent new veins from surfacing in the future. As time passes, you may find that you need "touch-ups" for new veins that surface. But, even if you choose not to have further sclerotherapy, your legs will look better than if you never had treatment at all.

The Best Candidates for Sclerotherapy

Women of any age are usually good candidates for sclerotherapy. In some women, spider veins may become noticeable as teenagers. For others, the veins may not become obvious until after the age of 35. Spider veins in men aren't nearly as common as they are in women. However, men do have spider veins and sclerotherapy is just as effective for men who seek treatment.

If you are pregnant or breastfeeding, you will be advised to postpone sclerotherapy treatment. In most cases, spider veins and varicose veins that surface during pregnancy will disappear on their own within three months after the baby is born. Also, because it's not known how sclerosing liquid may affect breast milk, nursing mothers are advised to wait until after they have stopped breastfeeding.

Patients with circulatory problems, heart conditions, or diabetes may be advised against treatment.

What are Varicose veins?

Varicose veins are a very common problem, generally appearing as twisting, bulging rope-like cords on the legs, anywhere from groin to ankle. Varicose veins are usually more uncomfortable and harmful to your health than spider veins. Spider veins are small red, blue or purple veins on the surface of the skin. Varicose veins are larger distended veins that are located somewhat deeper than spider veins. While many people have heard of varicose veins, very few truly understand the underlying cause, and the potential they have for developing into a serious medical problem. Severe varicose veins can compromise the nutrition of the skin and lead to eczema, inflammation and even ulceration of the lower leg.

Symptoms of Venous Insufficiency:

• pain in the legs
• feelings of fatigue
• heaviness
• aching
• burning
• throbbing
• itching
• cramping
• restlessness of the legs
• leg swelling

Vein disorders are not always visible; diagnostic techniques are important tools in determining the cause and severity of the problem. In addition to a physical examination, non-invasive ultrasound is often used.

What causes varicose veins?

Factors leading to varicose veins include heredity, gender, pregnancy, age and other factors. Some factors may speed up the development of this disease and make the veins worse, including prolonged standing, obesity, hormone levels, and physical trauma.

Women are more likely to suffer from varicose and spider veins. About 50% of American women may be affected. Hormonal factors including pregnancy, menopause, the use of birth control pills, estrogen, and progesterone affect the disease. It is very common for pregnant women to develop varicose veins. Pregnancy causes increases in hormone levels and blood volume which in turn cause veins to enlarge. In addition, the enlarged uterus causes increased pressure on the veins. Varicose veins due to pregnancy often improve within 3 months after delivery. However, with successive pregnancies, abnormal veins are more likely to remain.

What to expect from the procedure - EVLT® (Endovascular Laser Treatment)

A local anesthetic or “numbing medicine” is applied to the leg and the vein is entered with a very small needle. The laser fiber is inserted into the vein and produces laser energy that shrinks and seals the vein wall. Compression hose are usually worn for two weeks. Walking immediately after the procedure is encouraged. Normal daily activity can be resumed; just avoid strenuous physical activities such as high-impact aerobics or weightlifting for the first 72 hours.

There may be minor soreness and bruising. Any discomfort can be treated with over-the-counter pain relievers.

Benefits of EVLT®:

• Treatment in less than an hour.
• Can be performed in the doctor’s office.
• Up to 98% success rate.
• Immediate relief of symptoms.
• Return to normal activity immediately – with little or no pain.
• No general anesthesia or hospitalization.
• No scars, the procedure does not require a surgical incision, just a nick in the skin, about the size of a pencil tip, there are no scars or stitches.
• Many insurance carriers cover the Endovascular Laser Treatment, based on medical necessity for symptom relief.