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S C L E R O T H E R A P Y Southern Arizona Laser & Vein Institute (SALVI) can eliminate unsightly spider veins in just a few easy treatments, leaving your legs virtually clear and free from the appearance of spider veins. What are spider veins? Occurring on both legs and/or the face, spider veins are small red and purple blood vessels that often resemble a spider s web, hence the name spider veins. Unlike varicose veins, spider veins are small and delicate, developing in the skin. Varicose veins, on the other hand, are large and swollen, existing below the skin level. What causes spider veins? Also called telangiectasias, spider veins occur isn t known for certain. Like varicose veins, similar risk factors are associated with the development of spider veins, including heredity, obesity, and predisposed lifestyle and occupational conditions, such as prolonged standing. More often, gender specific factors are earmarked as the cause for developing spider veins. Nearly 70% of all adult women will develop spider veins at some time during their life. Women are at risk because of hormonal changes experienced, such as menstruation, pregnancy, oral contraceptive use, hormone replacement therapy and the use or increased levels of estrogen. Other factors that place women at higher risk include heredity factors and obesity. Spider veins and varicose veins, though caused by similar factors, are very different and one condition does not lead to the occurrence of the other. Can spider veins affect my health in a negative way? Unlike varicose veins, spider veins are not harmful and do not pose any direct health threat. Although most often treated for cosmetic purposes, spider veins may cause symptoms, including dull aching, throbbing pain, night cramps, tiredness, tingling, and heaviness in the legs all of which may be worsened during menstruation and/or warm weather. Page 1 of 5 SALVI: Sclerotherapy

More about Sclerotherapy Developed in Europe in the early 1930 s, Sclerotherapy eliminates unsightly and embarrassing spider veins in the legs. Using an extremely fine and nearly painless needle, the treatment involves injecting a small amount of sclerosing solution into the affected veins. This causes the veins to gently dry up and become absorbed naturally by the body. Sclerotherapy still remains the overwhelming choice of doctors and patients for spider vein treatment because it is more effective, less expensive and less painful than any other treatment available, including laser. Sclerotherapy is an effective method for treating spider veins. Its benefits include the following: Eliminates appearance of unsightly veins Resumption of normal activity immediately following treatment Quick, simple and relatively pain free procedure Relief of associated symptoms In-office treatment Nearly immediate visible results What happens before and during treatment? Sclerotherapy involves the use of a fine needle to inject a solution directly into the affected veins. Once injected, the solution (sclerosant) eventually seals off the blood vessel and prevents blood flow to continue through the treated vein. Prior to treatment, Dr. Probstfeld will conduct a medical history to learn more about how long your symptoms have persisted and the severity of the problem. Before the procedure, he may make a recommendation to discontinue aspirin-containing medications or other medications that can cause excess bleeding. Your skin in the area will be thoroughly cleaned. Starting with the larger veins, a syringe with a small needle is inserted into the vein area. A small amount of sclerosing solution is injected directly into the vein. When the needle is removed, pressure will be applied immediately to the treated area, including kneading to help disperse the solution and reduce bruising. How many treatments will I need? In order to achieve the desired results, multiple treatments may be required. Treated veins will gradually disappear in three to six months. Page 2 of 5 SALVI: Sclerotherapy

Are there any pre-operative instructions I should know about in advance? Yes, please refer to Page 4 for pre-operative instructions for all of our Vein Treatments. What can I expect following treatment? Patients who have had Sclerotherapy report experiencing only slight discomfort once the procedure is complete. A slight to moderate burning sensation may be felt after each injection, but this tends to disappear within a few moments. A pressure bandage or elastic stocking may be applied to prevent any post-injection bleeding. Most patients are advised to return to normal activities immediately following their treatment, although vigorous activity will be discouraged for the first day. Walking is strongly encouraged because it increases the blood flow to the other veins. Slight bruising may appear, but will usually disappear within a week. Fair skinned patients tend to bruise more. Are there any post-operative instructions I should know about in advance? Yes, please refer to Page 5 for POST-operative instructions that will be provided to you at the time of your treatment. Is the treatment painful? Sclerotherapy is quite a painless procedure. Because the injected solution is very diluted, most patients experience only a slight stinging or burning sensation with each injection. This sensation often disappears on its own in just a few moments. Is Sclerotherapy Treatment covered by insurance? Insurance companies do not cover the costs associated with Sclerotherapy treatment because it is most often performed for cosmetic purposes. At the time of your initial consultation, our staff will discuss the prescribed treatment, associated costs, and payment arrangements, including your insurance coverage. Prior to your appointment, check your policy and/or call your insurance provider to find out what their coverage includes. For your convenience, SALVI accepts most major credit cards. Page 3 of 5 SALVI: Sclerotherapy

P R E - O P E R A T I V E I N S T R U C T I O N S F O R V E I N T R E A T M E N T Southern Arizona Laser & Vein Institute (SALVI) wants to ensure all your questions are answered before proceeding with your treatment. Feel free to contact our office in advance of your treatment if you have any additional questions. Pre-treatment Instructions: You may have a small meal before treatment. Avoid drinking coffee several hours before treatment. Do not wear any lotion or cream on your legs the day of treatment. Try to avoid sun exposure, tanning booths, artificial tanning for seven (7) days prior to treatment for improved cosmetic results. You should wear loose, comfortable clothing the day of your treatment, something that is easy to put back on after treatments. Jeans or other clothes that bind your legs or are difficult to take on and off should be avoided. It is recommended that patients wear flat flip-flops, sandals or shoes that can be easily slipped on after treatment. Tennis shoes, heels and boots are not recommended. Please arrange for transportation if you will be receiving a sedative at the time of treatment (particularly RadioFrequency Ablation {RFA} and Microphlebectomy) Eating fresh pineapple the day before and the day of your treatment may reduce bruising. Bring a list of your current medications, both prescriptions and over the counter medications, including vitamins and other supplements. Make sure all of your questions are answered or please bring a list of questions to review with the doctor before your procedure. All financial responsibility for treatment is your responsibility. You must bring compression stockings with you to your treatment appointment. For your convenience, compression stockings are available for purchase at our office in advance. More questions? Please call us at (520) 318-3004 so we can answer any questions or concerns you have prior to your treatment appointment. Page 4 of 5 SALVI: Sclerotherapy

P O S T - O P E R A T I V E I N S T R U C T I O N S A F T E R S C L E R O T H E R A P Y Southern Arizona Laser & Vein Institute (SALVI) wants to ensure you have all your questions answered before proceeding with your treatment. Feel free to contact our office before your treatment if you have any additional questions. Post-treatment Instructions: Avoid sun exposure and wear SPF30 sun block for one month after treatment on all treated areas that may be exposed to the sun. Please call us at (520) 318-3004 if you experience blistering or persistent pain. Wear your support hose continuously for ten days. Leave pressure bandage on for 24 hours. Treatment area should be gently washed twice per day with tepid water and mild soap. DO NOT perform heavy exercise for three (3) days after treatment. Walking is encouraged. DO NOT take HOT showers, baths, use hot tubs or saunas for five (5) days. Post-treatment Expectations: Expect some redness and swelling, which may convert to a brownish line for eight (8) weeks. Leg vein resolution usually takes about 12 weeks and sometimes as long as six (6) months. At the end of this process, some vessels may be gone while others may be lighter or not affected. On RARE occasions, spider veins may be replaced by a reddish/purplish spot, called telangiectatic matting or neovascularization. This result could be temporary or permanent and may be difficult to treat. Patience is the key to excellent results. Some veins resolve more quickly than others and improvement can be seen for up to a year. Remember no treatment is curative or preventative and you likely will develop more spider veins in the future. These, too, can be easily treated with Sclerotherapy. More questions? Please call us at (520) 318-3004 so we can answer any questions or concerns you have after your treatment. Page 5 of 5 SALVI: Sclerotherapy