Spider Vein Therapy
There are two treatments for spider veins, sclerotherapy and Laser or IPL™ (intense pulsed light) ablation. Some patients require a combination of both treatments for the best result.
 Dr. Gilbert uses an FDA-approved solution called Sotradecol® for sclerotherapy. This agent is injected into the spider vein through a small needle, causing the vein to seal shut. Once the vein is sealed, blood flows into healthier veins. The treated vein is absorbed and eventually becomes nearly invisible or disappears altogether. Sotradecol® gives much better results and is far less painful than the traditional hypertonic saline injections.
 Laser and broad band light treatment of spider veins is accomplished using the Sciton Profile Laser System, the Dornier 940nm diode laser or the Lumenis Quantum Intense Pulsed Light™ system. These laser and light systems produce highly vein-specific wavelengths, which safely pass through the skin and seal the targeted vessels. The Lumenis Quantum IPL™ system is used to treat very fine spider veins on the legs, chest and face.
Definition of Spider Veins
 Spider veins appear as red or purple thread-like structures on the skin surface, and can occur on the face, neck, chest and legs. In the legs they can be found alone or in combination with varicose veins. They are not a health risk alone, but are often a cosmetic concern.
Spider veins are generally an inherited condition occuring when small capillaires dilate on the surface of the skin. There are larger veins called reticular or "feeder" veins that are the source for spider veins. Spider veins can worsen during times of hormonal shifts (ie; pregnancy or menopause) and with injury (ie; trauma or standing/sitting for long periods).
Treatment of Spider Veins
Dr. Gilbert uses the revolutionary Diomed laser to close problem veins right in their office. We use both laser therapy and sclerotherapy. During your consultation, you will be given recommendations tailored to your specific condition which may include one or both of these treatments.
Common Questions
What is sclerotherapy?
Sclerotherapy is treatment for veins in which a sclerosing solution is injected in the veins causing them to seal shut. Sotradecol® is the primary solution used at Greenville Vein & Aesthetics and is injected into both the feeder veins and the spider veins.
How is Sotradecol different from hypertonic saline treatment?
To achieve the best results when treating spider veins; the "feeder" or reticular veins that have created the spider veins must be sclerosed in addition to treating the spider veins that you see on the skin's surface. Sotradecol® is used at a slightly stronger concentration to seal the larger feeder veins. Hypertonic saline generally becomes too diluted and is not able to seal these larger veins that cause spider veins.
What are the complications of sclerotherapy?
The most common complication is a minor skin irritation or itching at the injection site from the sclerosing agent. As with any injection, there is always a risk of infection or allergic reaction which are both extremely rare. Hyperpigmentation or staining of the skin called hemosiderin staining can occor but goes away without further treatment. Rarely skin ulceration may occur with sclerotherapy.
What is Hemosiderin staining or hyperpigmentation?
Hyperpigmentation occurs after sclerotherapy due to the blood pigment being trapped under the skin. The pigment change is subtle to dark depending on a person's skin type and natural tendendency toward staining. The pigmented area looks like a sun spot or liver spot over the area being treated. If you have large spider or feeder veins or concentrated clusters of spider veins close to the surface of the skin, you may get a darkening of the skin over those veins being treated. Most hyperpigmentation fades over time, ususally within 2-3 months but may take longer for dark staining (up to a year or more). Greenville Vein & Aesthetics determines a client's skin type and tendency to hyperpigment during your consultation. Our treatment recommendations will take into account your specific skin type. We take every precaution to minimize staining.
Is there anything I can do to prevent hyperpigmentation?
To decrease your risk of hyperpigmentation, you need to stay out of the sun for 6 weeks prior to sclerotherapy and 4 weeks after treatment. This keeps the pigment producing cells, that are naturally in your skin, dormant. Wear a physical sunblock that blocks UVA and UVB rays (Zinc Oxide or Titanium Dioxide). Keep in mind that clothing provides only about 5-8 SPF. If you are going to be outside for an extended period of time, wear sunscreen underneath your clothing.
What happens to the sclerosed "feeder" veins? Don't I need those veins?
You have hundreds of healthy veins in your legs that have already taken over the functions of the unhealthy veins that we sclerose. We treat only the veins that have dilated and are creating spider veins or are painful. These dilated veins are not functioning properly and are actually refluxing or flowing in the wrong direction.
Your body absorbs the sclerosed "feeder" veins just as it would a bruise. The sclerosing of these veins causes them to clot or seal shut. These clots are superficial and are not dangerous to you although they may become tender and lumpy under the skin as they are being absorbed.
Will my spider veins come back?
It is natural during the course of treatment for some "new" spider veins to grow. Don't be discouraged, for some individuals this is an inevitable part of the treatment process. We treat them with sclerotherapy and IPL or laser therapy.
Since we focus on eliminiating the "feeder veins" later recurrences of spider veins are minimized. Some individuals may need occasional "touch up" treatments 2-5 years after completion of their initial sclerotherapy.
How many treatments does it take for my spider veins to go away?
Spider vein treatment is a process. Spider veins do not appear overnight and they do not go away overnight unfortunately. The average person needs between 3-6, 30 minute treatments to get the cosmetic results you desire. Treatments can be scheduled as soon as 3 weeks apart. We recommend 3-6 weeks between treatments.
Spider Vein Therapy Before and After Photos - Click Here
Varicose Vein Therapy
Prevelence
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 40-50, approximately 41% are affected and this percentage increases with age.
Symptoms
The symptoms caused by varicose veins range from a cosmetic nuisance to an aching, heavy sensation, to a painful condition which limits enjoyable activities and even the ability to work. The most severe cases can lead to ulcer formation on the legs.
Definition of 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, and in severe cases, can lead to inflammation, ulcers and blood clots.
Treatment of Varicose Veins
 There are many new and exciting treatments for varicose veins. These include laser ablation of large veins, injection sclerotherapy and minimally invasive surgical treatments. These can almost always be performed in our office under local anesthesia.
Dr. Gilbert uses the revolutionary Dornier™ D940nm and the Diomed 810nm laser to close problem veins right in their office. Local anesthesia is used to numb the treatment area, where safe and effective laser energy is delivered into the vein wall, causing it to collapse and seal shut. Once the diseased vein is sealed, healthy veins take over and redirect the blood flow. Best of all, this technique requires no stitches and offers minimal or no scaring. Patients can even walk out of the office after treatment and resume their normal routine in just a few days.
Preoperative Investigation
 For the great majority of patients a single history and physical exam by our experienced surgeons is all that is necessary to establish the cause of the varicose veins.
At this initial consultation the doctor will perform a venous duplex ultrasound examination which will provide a detailed "road map" of the superficial and deep veins in the leg and can aid in the planning of the best course of treatment.
Common Questions
What is vein ablation by laser?
This an exciting new laser procedure that involves placing a thin laser filament into the vein through a needle puncture in the lower thigh and uses laser energy to heat the vein from inside, causing it to close down. Closure by laser has a 97% 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 a surgeon to determine which treatment is best for him or her.
Does this replace vein stripping ?
Yes. Surgically removing the great saphenous vein, or "vein stripping", is rarely needed. An ambulatory phlebectomy procedure is done under local anesthesia in our office for removal of the bulging varicose veins. It is much less traumatic to the leg than traditional varicose vein removal. Patients walk comfortably out of the office; most are able to go back to work within a few days.
What about just injecting 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 typically requires minor surgery to get the best long-term result.
Varicose Vein Therapy Before and After Photos - Click Here
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