Spider veins, or telangiectasia, are the tiny purple and red blood vessels found most commonly on the thighs or lower legs. They can also appear on the face. Spider veins are relatively inconspicuous on most people because they are confined to a small area. However, some people become distressed when larger areas of skin are affected or the veins become more noticeable.
Although not treated by our office, varicose veins are different from spider veins in that they are larger, raised veins. Varicose veins are often a bluish color and can become quite painful, producing a burning or throbbing sensation. Both varicose veins and spider veins carry blood back to the heart, yet in most patients neither varicose nor spider veins are necessary to the circulatory system and therefore can be eliminated. The procedure to eliminate bothersome spider veins is called sclerotherapy.
Sclerotherapy is a minimally invasive technique to eliminate unsightly veins. A concentrated salt water solution is injected into the dilated spider veins. This solution irritates the lining of the vessels, making the blood in the vein disappear. Multiple injections will be performed during your visit to treat as much of the affected area as possible.
Spider and varicose veins are caused by a dysfunction of the valves within the veins. Several factors play a prominent role in their development, including heredity, pregnancy, hormone replacement therapy, oral contraceptives, obesity, long periods of standing or sitting, and trauma. Although exercise, weight loss, and support hose may limit the number of new vessels, it will not get rid of them once they are present.
Most anyone is a candidate for sclerotherapy. However, if you take any blood thinning medication, aspirin, or non-steroidal anti-inflammatory drugs, your results will be less successful. Patients who are unable to be treated with sclerotherapy are those with a history of inflammation of the veins (thrombophlebitis), blood clots in the legs, diabetes, arterial or other vascular problems, or previous leg ulcers. Pregnant women are almost always advised to postpone treatment until six months after delivery.
Most patients need at least three treatment sessions, each spaced two months apart. Ultimately, the number of treatments needed depends on the size of the affected area, the size of the veins, and the number of veins that you wish to have treated. There is no set formula for how many treatments you will need. It will be easier to determine your treatment plan after your initial consultation and beginning your course of injections to see how well your body responds to the procedure.
Insurance companies do not pay for sclerotherapy if it is performed for cosmetic reasons. However, if you have varicose veins that are symptomatic and are causing pain and/or discomfort, there is often insurance coverage to have these removed.
Serious side effects, such as a blood clot in the treated area, scarring, or skin necrosis, are extremely rare. You are more likely to see temporary side effects such as:
Local swelling and bruising at the injection site and along the vessel. Swelling usually lasts no more than 24 hours. If you experience any bruising, it will fade within several weeks.
Change in skin color. This is rare and usually temporary. There is a very rare chance of permanent discoloration.
Tenderness at the injection site and along the vessel, which may persist for a few days.
A hive-like reaction at the site may occur immediately following the injection, usually lasting no more than 30 minutes.
Cramping similar to a "charley horse." This is seen in a small percentage of patients at the time of injection and resolves in a few minutes with massage.
After sclerotherapy treatment, your legs will be wrapped with pressure bandages to reduce bruising and help keep the treated veins closed. You should avoid contact sports, aerobics, and leg weights for the first three days after treatment. A 30-minute, moderately paced walk may be substituted for your regular workout. You should not have any significant pain afterward. You may elect to wear surgical compression stockings for the next three days to optimize your chances for a better outcome.
Sclerotherapy remains the treatment of choice for spider veins due to its high success rate, but if sclerotherapy does not fade veins completely, if the veins are too small to be treated, or if you are fearful of needles, special vascular lasers are also a highly effective treatment option. Dr. Enzer will discuss all of your available options during your initial consultation to help you decide which course of treatment is best for you.