Spider veins on the leg usually appear in one of three patterns: (a) simple linear (b) arborizing, which appear branch-like, and (c) spider, which appear as a cartwheel shape with a dark center point.

Before treatment, spider veins are quite noticeable, contrasting sharply with the surrounding skin.

The skin is held taut while the injection of sclerosing solution is administered under bright light and magnification.

A cotton ball and compression tape are applied to each treated area. Elastic bandages or stockings may be used to help further the action of the injected medication.

One month after the first treatment, spider veins are distinctly lighter, yet still somewhat visible.

After two or more treatments, the leg appears noticeably clearer and more attractive.

Millions of women are bothered by spider veins - those small yet unsightly clusters of red, blue or purple veins that most commonly appear on the thighs, calves and ankles. In fact, it's estimated that at least half of the adult female population is plagued with this common cosmetic problem.

Today, many plastic surgeons are treating spider veins with sclerotherapy. In this rather simple procedure, veins are injected with a sclerosing solution, which causes them to collapse and fade from view. The procedure may also remedy the bothersome symptoms associated with spider veins, including aching, burning, swelling and night cramps.

What Are Spider Veins?

Spider veins - known in the medical world as telangiectasias or sunburst varicosities - are small, thin veins that lie close to the surface of the skin. Although these super-fine veins are connected with the larger venous system, they are not an essential part of it.

Spider veins usually take on one of three basic patterns. They may appear in a true spider shape with a group of veins radiating outward from a dark central point; they may be arborizing and will resemble tiny branch-like shapes; or they may be simple linear and appear as thin separate lines.

Varicose veins differ from spider veins in a number of ways. Varicose veins are larger - usually more than a quarter-inch in diameter, darker in color and tend to bulge. Varicose veins are also more likely to cause pain and be related to more serious vein disorders. For some patients, sclerotherapy can be used to treat varicose veins. However, often surgical treatment is necessary for this condition.

The Best Candidates for Sclerotherapy

Women of any age may be good candidates for sclerotherapy, but most fall in the 30-to-60 category. In some women, spider veins may become noticeable very early on - in the teen years. For others, the veins may not become obvious until they reach their 40s.

Spider veins in men aren't nearly as common as they are in women. Men who do have spider veins often don't consider them to be a cosmetic problem because the veins are usually concealed by hair growth on the leg. However, sclerotherapy is just as effective for men who seek treatment.

Risks Related to Treatment

Serious medical complications from sclerotherapy are extremely rare when the procedure is performed by a qualified practitioner. However, they may occur. Risks include the formation of blood clots in the veins, severe inflammation, adverse allergic reactions to the sclerosing solution and skin injury that could leave a small but permanent scar.

A common cosmetic complication is pigmentation irregularity - brownish splotches on the affected skin that may take months to fade, sometimes up to a year. Another problem that can occur is "telangiectatic matting," in which fine reddish blood vessels appear around the treated area, requiring further injections.

Planning Your Treatment

During your initial consultation, your legs will be examined. Your doctor may draw a simple sketch of your legs, mapping out the areas affected by spider veins or other problems. During the examination, you will be checked for signs of more serious "deep vein" problems, often indicated by swelling, sores, or skin changes at the ankle.

Your doctor will ask you about any other problems you may have with your legs, such as pain, aching, itching or tenderness. You will also be asked about your medical history, medications you take, or conditions that would preclude you from having treatment. Individuals with hepatitis, AIDS or other blood-borne diseases may not be candidates for sclerotherapy. Patients with circulatory problems, heart conditions, or diabetes may also be advised against treatment.

The Procedure

A typical sclerotherapy session is relatively quick, lasting only about 15 to 45 minutes. After changing into shorts, your legs may be photographed for your medical records. You will be asked to lie down on the examination table and the skin over your spider veins will be cleaned with an antiseptic solution. Using one hand to stretch the skin taut, your doctor or nurse will begin injecting the sclerosing agent into the affected veins. Bright, indirect light and magnification help ensure that the process is completed with maximum precision.

Approximately one injection is administered for every inch of spider vein - anywhere from five to 40 injections per treatment session. A cotton ball and compression tape is applied to each area of the leg as it is finished.

After Your Treatment

In addition to the compression tape applied during the procedure, tight-fitting support hose may be prescribed to guard against blood clots and to promote healing. The tape and cotton balls can be removed after 48 hours. However, you may be instructed to wear the support hose for 72 hours or more.

You should be aware that your treated veins will look worse before they begin to look better. When the compression dressings are removed, you will notice bruising and reddish areas at the injection sites. The bruises will diminish within one month. In many cases, there may be some residual brownish pigmentation which may take up to a year to completely fade.

Content courtesy of PlasticSurgery.org

back to top