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170 N Henderson Road Suite 302

King Of Prussia, PA 19406

Frequently Asked Questions

As part of our ongoing effort to provide our patients and potential patients with the information they need to make informed decisions about the treatments we offer, please find below the answers to some of our most frequently asked questions. If you have additional questions, feel free to contact us for more information.

1. What causes varicose veins and spider veins?

  • a) Hereditary
  • b) Hormonal changes during puberty, pregnancy and menopause.
  • c) previous history of phlebitis,
  • d) occupations requiring prolonged standing
  • e) obesity.

2. What is the difference between varicose veins and spider veins?
Varicose veins are larger bulging veins (usually more than 3 mm) above the surface of the skin and often are tortuous.

Spider veins are tiny capillary like veins (usually less than 2 mm in size) and not bulging above the skin surface and often has a center which is a feeder vessel and “spider legs like” tiny capillaries arise from the center giving it the “appearance of a spider with legs” hence the name spider veins. Medically spider veins are called Venous Telangiectasias.

3. How can I treat unsightly or painful vein problems?
We have many different state of the art technologies for different types of veins which is tailored for each patient individually after the patient’s consultation and examination. If patient has Varicose veins they may first need to have a Venous duplex ultrasound and vein mapping to find out if the superficial venous system consisting of saphenous veins do or do not have presence of venous reflux i.e. presence or absence of “leaky valves”. Based on this assessment, it is decided if the patient will benefit from Endovenous Laser Ablation and/or Micro-Phlebectomy. For spider veins, the gold standard treatment is Sclerotherapy/Cryo-Sclerotherapy ™. An alternative or second line of treatment for spider veins on the legs is use of surface lasers. For spider veins on the face the gold standard or first line of treatment is use of surface lasers.

4. Are all vein treatments the same?
No. Please see above answer.

5. Can problem veins on my face or hands be treated like the varicose veins on my legs?
Veins on the face can be easily treated with surface lasers. On hands they are usually treated either with Sclerotherapy/Cryo-Sclerotherapy ™ or Micro-Phlebectomy for bulging veins.

6. Will I be able to walk right after my varicose vein treatment?
Yes and one can resume work and activities of daily living the next day.

7. Am I a good candidate for laser vein treatment?
Please see answer in Question #3.

8. Are the lasers used to treat vein problems the same as the ones used for your other procedures?
For Varicose veins when there are “leaky valves” in the Saphenous veins the laser used is inside the Saphenous vein to close it and this treats the source of the problem. For Spider veins which are cosmetic in nature, surface laser may be used.

9. Are rosacea and spider veins the same condition?
Rosacea is a condition in which spider veins on the face appear as well as diffused redness. However one may have isolated spider veins without the patient having Rosacea

10. What are the differences between laser treatment, Botox, and dermal fillers for wrinkle treatment?
Each modality of treatment may have its own role and different merit to help along in the overall improvement of wrinkles in different areas of the face. Certain Lasers may help skin tightening and also stimulates the cells that produce collagen to “fill in” and thereby helps with the wrinkles. Whereas other lasers may be for the redness due to spider veins, the sundamage and brown spots and reduce pore size and may improve texture of the skin. Botox helps relax the muscles and is primarily for the upper half of the face especially the frown lines, horizontal forehead lines and the crow’s feet around the eyes. The dermal fillers are to “refill” the lost collagen and fat in areas such as the cheek, laugh lines (nasolabial folds), upper lip vertical lines, Marionette lines going down from the corners of the mouth as well as to give volume to the lips when they have become thin due to loss of collagen. Sometimes all 3 modalities may be required for different areas of the face.

11. Is there a treatment for excessive sweating?
When anti-perspirants don’t work in some individuals, Botox can be used to reduce sweating in underarms which often lasts for a period of 12 to 15 months.

12. How does the Dermapen differ from laser treatments?
Dermapen is a fractional micro-needling device similar to the fractionated CO2 device with less redness and recovery period at a fraction of the cost. It helps skin tightening, skin rejuvenation, reduces fines and wrinkles, improves stretch marks, minimizes pore size and improves Keloid, surgical and acne scars.

13. Will insurance cover my procedure?
Insurance may cover Venous duplex ultrasound when done to check for “leaky valves” and blood clots as well as medical consultations for large varicose veins with symptoms or any vascular medical problem. The treatment of large bulging varicose veins with symptoms when treated using Endovenous laser ablation or Micro-phlebectomy may likely be covered but needs preauthorization from the insurance companies. Treatment of spider veins with any modality of treatment like Sclerotherapy/Cryo-Sclerotherapy ™ or surface lasers is not covered since it is looked upon as cosmetic. Any laser for the face for spider veins, wrinkles, hair, brown spots, Botox and dermal fillers are all cosmetic and not covered by insurance.

Frequently Asked Questions About Sclerotherapy

1. How long will I be there?
Approximately 30-45 minutes

2. How many injections can be done in one visit?
Approximately 15-20, depending on size of veins, location and general medical condition of each individual.

3. Will I be able to return to all my normal activities right after the injections?
Avoid aerobic exercises, weight lifting, jogging, running, tennis and impact exercises for 7 days. Normal walking is okay. If large varicose veins are done, you may be put into a support stocking for 7 days (which can come off at night), but you will be able to continue all activities .

4. Will I be able to drive home afterwards?

5. Is the procedure painful?
The solution may burn or sting as it goes in for a few seconds. Most patients says it feels “like a mosquito bite” at the time of the procedure.

6. How does the solution treat of the veins?
It inflames the veins, causing them to cease functioning, then the veins will be reabsorbed.

7. How long does it take until the veins go away?
Large varicose veins – 2 weeks Spider veins & 3-6 weeks

8. What happens if varicose veins are left untreated?
Varicose veins may lead to pain and swelling in the legs. Occasionally, complications may occur such as phlebitis and venous ulcer (especially around the ankles).

9. How often are the sessions?
Every 2-4 weeks in the case of large varicose veins and every 4-6 weeks in the case of spider veins.

10. Are there any side effects?

  • a) Pain which usually last 1-2 days
  • Bruising can occur for a period of 1-2 weeks.
  • Rarely brown staining can occur where the vein disappears. This is common with higher strengths of solution. This will normally disappear over time.

11. Will the veins come back?
Not the ones that we take care of, but new ones may appear at a normal rate.

12. Can I have the injections if I am pregnant?

13. Can I have the injections if I recently had a baby?
No, you should wait a minimum of 3 months after the baby.

14. Can I have the injections if I am lactating (breast-feeding)?
If you are nursing the baby, you must wait 6 weeks after you stop nursing.

15. What causes spider veins?

  • a) Hereditary
  • b) Hormonal changes during puberty, pregnancy and menopause.
  • c) Other causes such as previous history of phlebitis, occupations requiring prolonged standing and obesity.

16. Does it take more than one visit
Yes, it may take one or more sessions for a given vein since not all veins will accept the solution in a given session.

17. Can I go into the sun?
It is advisable to be as pale as possible when you come in so the doctor can see the veins and where they need to be treated. Use a sunscreen/sunblock (with SPF of 30 or higher) when you do go in the sun. You should wait for 2 days before going out in the sun after the sclerotherapy treatment.



comma-1 Very nice, knowledgeable doctor. Dr. Shah explained everything in a thorough, calm manner that put me at ease. Thanks Dr. Shah! comma-2

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