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It's estimated that at least half of the adult female population is plagued with this common cosmetic problem. Spider veins are those small clusters of red, blue or purple veins that generally appear on the thighs, calves and ankles. Spider veins are caused by abnormal blood flow and weakening of the blood vessel wall. Anything that puts pressure on the veins, such as gaining weight, sitting or standing for long periods of time, or pregnancy can contribute to their development. Today, many doctors are treating spider veins with sclerotherapy. A concentrated saline solution is injected with a small needle into the vein. This solution causes the vein to harden and turn to fibrous tissue that is gradually reabsorbed by the body.

The Procedure

Sclerotherapy is a relatively simple procedure that requires no anesthesia and takes between 15 to 45 minutes. Antiseptic will be applied and the solution will be injected into the affected veins with a tiny needle. Each injection covers about one inch of the vein. As the needle is injected and the solution released, you may feel a slight prick and burning sensation. Cotton balls and compression tape will be applied. Generally a second treatment will be required.

The Recovery

Following sclerotherapy treatment, the legs should be elevated for the rest of the day. You may be asked to wear a compression wrap for several days. Walking is encouraged to prevent clots from forming, but prolonged standing or sitting, and exercising should be avoided. Bruising and discoloration will gradually fade over the next three weeks. You should wait one month between treatments

The Best Candidates For Sclerotherapy

The best candidates for Sclerotheraphy are between 30 and 60 years old. If you are breastfeeding or pregnant you may want to postpone the treatment. Those with a blood-borne disease or condition affecting the vascular system are not good candidates.

The Risks

Risks include blood clots, severe inflammation, reactions to the solution and skin injury that could leave a small but permanent scar. Also “telangiectatic matting,” a new network of veins, may appear around the treated area, requiring further treatment. Discoloration and blotchiness is more common but usually fades over a period of time.

Background

Sclerotherapy was developed in the 1920s for the treatment of spider veins (telangiectasias), small purple and red blood vessels. Spider veins are hereditary, and while most commonly found on the thigh or lower leg, can form virtually anywhere on the leg, from the uppermost region of the thigh to the ankle. Occasionally, spider veins will appear on the face. Sclerotherapy has proven to be a very popular nonsurgical cosmetic procedure; see current American Society for Aesthetic Plastic Surgery (ASAPS) statistics.

Technique

The veins to be treated are marked while the patient is standing. Larger veins are usually treated first. A sclerosing solution is injected into the vein with a micro-needle. The solution causes the vein to turn white (blanch), and then gradually disappear. A typical treatment lasts from 30 minutes to an hour. Injection sclerotherapy can be an excellent alternative to surgery, provided the patient’s venous system is not affected.

Benefits

• No downtime—patients can immediately resume work and all normal activities. But the patient is advised to refrain from vigorous activities for the first 24 hours.
• Little if any discomfort.
• A safe, time-proven procedure.

Other Considerations

• Complete correction is not expected on the first treatment. Only about 50 to 70% of the treated vessels will be permanently gone. 3 to 4 treatments are generally required for optimal results.
• Patients may be asked initially to wear heavy-duty stockings to help keep treated veins closed and reduce bruising.
• On occasion, small clots can develop at the site of the injection.
• Color changes can occur in the skin where sclerotherapy has been performed.
• In some cases, laser treatments may be an alternative to sclerotherapy.
• If there is an underlying problem with the venous system, the veins will recur.