With so much interest in medical procedures and so many medical television shows, I think every doctor in America will wind up on TV at some point. I had my first experience this past week when I was asked to perform leg vein treatments for the Today Show. After four hours of filming, Karen Trosset, Janice Lieberman, their cameramen and technical team produced a terrific six minute segment, making an unpalatable topic like sticking needles and lasers into people's legs interesting to the 8 a.m. Today show viewers. They also focused on how patients are often so embarrassed by their leg veins that they don't wear shorts or skirts and avoid activities like swimming which require exposing their legs. You can watch the full video segment here.
To keep within the concise time frame, a lot of footage and information was left on the editing room floor, and that included the footage on using sclerotherapy for the treatment of spider veins, which is one of the most popular procedures performed in my office. Spider veins are the wispy red superficial blood vessels found close to the skin that oftentimes have a true spider shape with the legs radiating from a central point. Spider veins differ from the varicose veins shown in the Today segment, which are usually larger in diameter, blue in color and tend to bulge out in the skin. Sclerotherapy for the treatment of spider veins involves injecting these vessels with solutions such as hypertonic saline or chromated glycerine, which scars the interior of the veins causing them to collapse. A typical treatment session takes about 15 minutes to perform in the office and is relatively painless due to the anesthetics in the injected solution. Immediately after each injection, a cotton ball and compression tape are applied to the skin.
A single treatment can be effective but usually one to three treatments are required, four to six weeks apart. Following each treatment session, the patient is instructed to wear compression stockings of 20-30 mmHg for 24 hours and then during the day for two weeks to improve the likelihood that the treated veins will remain closed. We sell the stockings in my office but I recommend that people buy an extra pair at a surgical supply store or online. Sclerotherapy only improves the treated vessels and does not prevent new varicose or spider veins from developing. Still, the treatment is highly effective with a recent exhaustive review showing a recurrence rate of 0.4-8.1 percent in the two years following the treatment. Most patients were extremely satisfied and had far fewer complications than patients who underwent surgical treatment.
With sclerotherapy, leg veins don't have to be a "blue menace" or even a mild nuance, and certainly shouldn't prevent people from showing off their legs this summer. More information on sclerotherapy treatments can be found here.
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