Medium and large spider veins on the surface of the legs, feet, or arms are best treated with sclerotherapy. Sclerotherapy involves the direct injection of a sclerosing agent into the spider vein using a very fine needle. The sclerosing agent irritates the lining of the vein wall, makes it swell shut, contract, and collapse.
The initial treatment session takes 15-30 minutes. Usually more than one treatment session is needed to reach your desired results. Subsequent visits are scheduled in 15-30 minute blocks of time. The number of treatments needed and the length of the appointment depends on the number of veins being treated and the resilience of the veins. Cost for this procedure is based on the number of veins being treated.
Prior to treatment, the spider veins and surrounding area are examined with a light that illuminates the veins. Your skin will be washed off with an alcohol swab before each injection. During the procedure you may feel some slight stinging or burning depending on the solution and concentration used. Usually you just feel a slight discomfort from the injection itself. After the solution is injected the area will be massaged to help distribute the solution to other parts of the vein. Afterwards you will be asked to walk around to increase the blood flow through the remaining healthy veins. Compression hose will then be worn for 24 hours to keep the vein collapsed.
Sclerotherapy Benefits
There are several benefits to having sclerotherapy. These include:
- Safe, virtually pain free, in-office treatment
- Minimally invasive
- Excellent cosmetic results, gets rid of unsightly veins
- Little risk of complications with no incisions, and no anesthetics used
- No “down” time, doesn’t interfere with normal daily activities
Sclerotherapy Risks
The most common side effects experienced with sclerotherapy are:
- Itching lasting 1-5 days
- Transient hyperpigmentation lasting 1-10 days
- Transient phlebitis (inflammation of the vein)
- Superficial blebs or wheals similar to hives
- Stinging or cramping at the injection site
- Raised reddened patches of skin
- Bruising, and tenderness over the vein treated for 7-10 days
Less common side effects include:
- Hyperpigmentation lasting 10 days to several months
- Superficial clot formation requiring aspiration in larger veins
- Mild allergic reaction to the sclerosing agent
- Blisters or ulcer formation (blisters may open up and become ulcers) without scarring
- In some cases sclerotherapy may not eliminate the vein(s)
- Neovascularization - usually temporary,(formation of new tiny pink veins)
Rarely more serious adverse outcomes can arise including:
- Permanent skin staining
- Deep ulcer formation and scarring
- Infection
- Keloid type scarring (very raised/thick scars, patients usually have a previous history of keloid scar formation and know if they are prone to these)
- Serious allergic reaction (anaphylaxis)
- Deep venous clot formation
- Pulmonary embolism (a blood clot that travels to the lungs)
- Post phlebitic syndrome resulting in permanent swelling of the leg(s)
- Death