Spider Veins (Sclerotherapy)

Spider vein treatment typically results in the elimination of up to 50 to 80 percent of varicose veins that are injected with the treatment solution. It is a minimally-invasive procedure that ensures minimal recovery time as the treated veins tend to fade within a few weeks.

Otherwise healthy people with venous insufficiency that is poorly controlled with compression stockings are the best candidates for sclerotherapy.

The eligibility of the candidate is decided based on the overall health of the patient and the area requiring treatment, in addition to the reason behind the clot in the vein. The dermatologist helps select the correct chemical sclerosing agent, which is then injected into the blood vessel to make it collapse.

This treatment is not suitable for pregnant women and females on birth control pills. Selected veins may not be treated using sclerotherapy if that vein could be put into use during future heart bypass surgery.

Sclerotherapy is performed in an outpatient procedure, under the supervision of an expert dermatologist or a cosmetic surgeon. In rare cases, patients may require hospital stay following the procedure.

During sclerotherapy procedure, a selected salt solution is injected directly into the vein with the help of a fine needle. This solution typically contains two sclerosants, namely sodium tetradecyl sulfate and polidocanol (Asclera).

The solution is usually in the liquid form. It works by irritating the lining of the vein, causing it to swell and block the flow of blood. Finally, the vein will become a scar tissue and disappear after some time.

Sometimes a foam version of the solution may be used, usually when a larger vein is involved. Foam is preferred over liquid in this case because it tends to cover more surface area than liquid.

You may experience mild discomfort and cramping for one to two minutes during the procedure, especially when larger veins are injected. Spider vein treatment usually takes approximately 15 to 30 minutes. The number of veins injected in one session depends on the size and location of the veins.

After the procedure is done, your doctor applies compression and massages the area to keep the blood out of the injected vessel and disperse the solution.

There are several variations of the sclerotherapy procedure. The doctor may decide to use laser or ultrasound during the procedure for better guidance and results. The sclerotherapy cost for such procedures is higher than simple injection approach.

You will be able to get up, walk around, and drive yourself home after sclerotherapy procedure. You can resume your regular daily activities on the same day of the procedure. Walking and moving your legs are encouraged to prevent the formation of blood clots.

After sclerotherapy, you will be instructed to wear support hosiery or bandages to “compress” the treated vessels for about two weeks. Your doctor will probably advise you to avoid strenuous exercise and exposing the treated area to the sun for two weeks after the procedure.

In addition, your doctor will ask you to avoid aspirin, ibuprofen, or other anti-inflammatory drugs for at least 48 hours. Tylenol may be used if needed. Usually, it takes three to six weeks to respond, and larger veins respond in three to four months. Spider veins or varicose veins will not reappear if the treated veins respond to sclerotherapy.

Usually, sclerotherapy works for most of the patients, but there is no guarantee for success. Any procedure where the skin is penetrated carries a risk of infection. But the chances of infection requiring antibiotic treatment is estimated to be less than 1 in 1,000.

A few patients may experience bruises, leg pain, blood trapping, and raised and red bumpy skin after the surgery. You must inform your surgeon if you notice any of these side effects.

Besides these, some allergic reactions to sclerosing solutions and local anaesthetics can also occur. They can be serious, but they are extremely rare. A different solution can be used for subsequent treatments when allergic reactions occur.