Leg Veins/Sclerotherapy

Spider Veins are small enlarged superficial blood vessels that appear red or blue. They commonly occur on the legs, but frequently occur on the face or elsewhere.


These dilated blood vessels may be short, unconnected lines each about the size of a large hair, or connected in a matted, "sunburst" pattern. They may also look like a spider web or a tree with branches. Sometimes, they occur in a small area and aren't very noticeable, or they can cover a large area of skin and be quite unattractive.


Larger dilated blood vessels called varicose veins may be raised above the skin surface. They may occur along with spider veins.


Patients can have pain, ranging from a dull throbbing pain to a burning sensation. The larger vessels are more likely to cause discomfort, although smaller blue veins have been shown to cause pain.


If spider veins are unsightly or uncomfortable, they can be treated with laser, or by injection of a solution that will cause them to disappear or become much smaller. There is about a 50-90 percent chance for a greatly improved appearance.


What causes these blood vessels to become visible?


The cause of spider veins is not completely known. In many cases they seem to run in families. Identical twins can be affected in the same area of the body and to the same extent. The condition rarely occurs as part of an internal disease.


Spider veins appear in both men and women, but more frequently in women. The female hormones may play a role in their development. Puberty, birth control pills, pregnancy, or hormone replacement therapy often seem to bring them out. They may also appear after an injury, or as a result of wearing tight girdles, or from hosiery held up with tight rubber bands. Spider veins may also occur in association with large varicose veins.


Spider veins on the nose or the cheeks of fair skinned persons may be related to sun exposure.


Can spider veins be prevented?


Spider veins can't always be prevented. Wearing support hose may minimize unwanted blood vessels from developing. Keeping one's weight at a normal level and exercising regularly may also be helpful. Eating a high-fiber diet and wearing low-heeled shoes may also help. Sun protection is important to limit the number of unwanted vessels on the face.


How are unwanted blood vessels on the legs treated?


The injection method, a procedure called sclerotherapy is used to treat unwanted blood vessels. One of several kinds of solutions, called sclerosing solution, is injected with a very fine needle directly into the blood vessel. This procedure has been used for spider veins since the 1930's and before that for larger veins. The solution irritates the lining of the vessel, causing it to swell, stick together, and the blood to thicken. Over a period of weeks, the vessel turns into scar tissue that is absorbed, eventually becoming barely noticeable or invisible.


A single blood vessel may have to be injected more than once, some weeks or months apart, depending on its size. In any one treatment session a number of vessels can be injected.


How successful is sclerotherapy?


After several treatments, most patients can expect a 50 percent to 90 percent improvement. However, fading is gradual, usually over months. Disappearance of spider veins is usually achieved, but similar veins may appear in the same general area.


Can sclerotherapy or lasers be used on all skin types?


Yes. All skin types and skin colors respond equally well.


Will insurance cover the treatment of unwanted blood vessels?


Insurance rarely covers treatment of spider veins but may sometimes cover larger vein treatment. If the treatment is solely for cosmetic reasons, it will not be covered.


Are there side effects to spider vein treatments?


Even with a highly experienced physician performing the treatment, there are some possible side effects. They include:


Will treated veins recur?

It may seem that a previously injected vessel has recurred, when, in fact, a new spider vein has appeared in the same area.

Is a history of blood clots in the lungs or legs a reason to avoid therapy?

Not necessarily, but the procedure must be done with caution to lessen the risk of blood clots.

Are there other treatment methods?

For larger varicose veins, radiofrequency may be used instead of stripping. Great advances have been made in the use of ultrasound to guide injection of varicose veins not visible at the skin surface.

Surgically tying veins off (ligation), or pulling them out (ambulatory phlebectomy), are other procedures for treating unwanted blood vessels. These methods are usually reserved for larger varicose veins.

How are spider veins on the face treated?

There are several ways to treat spider veins on the face. Many different lasers and intense pulsed light have been used quite successfully.

What do I do after treatments?

We advise patients to "pump" the sclerosing solution out of the circulation by walking following the procedure.

We will bandage the injected areas and instruct you to "compress" the treated vessels. This may help seal the treated vessels, keep the blood from collecting under the skin, and reduce the development of dark spots. It also may reduce the number of treatments necessary, and the possibility of recurrence.

Between treatments, we recommend the use of compression or support hose. This may be particularly recommended for people who spend a lot of time on their feet or work in a standing occupation.

The treatment of spider and varicose veins can be successful. Treatment methods vary depending on the size and location of the abnormal veins.