Get a Leg Up on Summer

A roadmap for treating legs that look like roadmaps

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Once the large veins are closed via EVLA, Nichols often uses sclerotherapy to close the smaller spider and reticular veins. Sclerotherapy involves injecting a medication in the veins that causes the veins to close and later be absorbed by the body, he says. In the past, doctors used a saline solution “that hurts like liquid fire,” Nichols says. He uses polidocanol (trade name: Asclera) instead, which also has built-in Novocain-like properties and numbs as the procedure continues.

“I used saline one time when the patient insisted I use it,” he says. “The patient was happy with the results but for the next treatment, she wanted to go with the option that didn’t hurt.”

The success rate for sclerotherapy is not as high as for EVLA, but the technique is effective in veins where EVLA won’t work. “We can use sclerotherapy in veins where we can’t do EVLA,” Nichols says. “For EVLA, the vein has to be fairly straight to get the laser to go along the course of the vein. The vein can look like a cloverleaf on I-264 and sclerotherapy treatment can still be successful.”

Swelling usually subsides 20 minutes after sclerotherapy, but it can take a few days to eight weeks for the treated veins to completely disappear, Nichols says.

Not worried about how your legs look? Keep in mind that varicose veins also can cause pain and health problems. Varicose veins can lead to swelling, heaviness and aching in the legs as well as fatigue, he says. More serious problems include external bleeding and potentially threatening blood clots, Nichols says. The 94-year-old woman he treated had a varicose vein that caused her skin to break down like a bed sore, he says.

One more reason to seek treatment now as the weather improves: your recovery will include walking, Nichols says. Get treatment soon and you’ll be back on your feet and in shorts well before bathing suit season.

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