Spider Veins


Activity and excercise are an important part of good health maintenance and  well-being.  Unfortunately, sometimes embarrasment regarding  our varicose veins and spider veins make it  difficult for some of us to wear comfortable clothes. Also, discomfort, throbbing,  and stinging sensations can sometimes be associated with varicose and spider veins limiting normal activity.

WHAT IS A SPIDER VEIN?  Spider veins or "telangiectasias" are small veins under the skin usually developing from dilated blood channels connected to underlying veins. These  most commonly occur on the legs, sometimes on the face.  They are blue , bluish-red, or dark purple in color. They consist of dilated veins that are poorly  functioning. Being  smaller, thread-like, superficial, interconnected  in appearance  gives them the name of "Spider' veins, as opposed to larger , tubular or bulging "Varicose" veins.

WHAT IS SCLEROTHERAPY? Spider veins are smaller and are generally treated with a procedure called Sclerotherapy in which a solution called a sclerosant is injected into the veins eventually closing off the vein making it disappear.  Sometimes,  laser treatment can also be performed instead of  or in addition to  the Sclerotherapy treatment. During Sclerotherapy  the Doctor usually  uses magnification to help him/her see the  thread thin  veins to inject a small amount of special fluid (sclerosant) into the Spider vein.   This  "irritates" the vein and the infammation which ocurrs in the vessel wall causes the vein to permanently dissappear over the next  three to four weeks.

Medium to large varicose veins can accompany the smaller Spider veins in some persons. These  can also be treated with Sclerotherapy sclerosants  or  with Endovenous (internal  fiber-optic) laser. Generally for  individuals with significant numbers of  larger varicose veins it is recommended they  be referred to a  Doctor who has  experience performing the Fiberoptic laser Endovenous procedure to treat the saphenous vein.

For medium to smaller varicose veins,  a special technique using foaming sclerosant is  often used with medium size varicose veins and feeder blood vessels greater then 5 mm in size. Ultrasound (Duplex) are used for locating  and mapping  the more superficial varicosities and deeper  feeder vessels (perforators).

WILL SCLEROTHERAPY CURE MY SPIDER VEINS? The majority of patients having Sclerotherapy will have significant improvement in their visible spider veins. Generally  the patient experiences a 50% to 60% improvement per treatment session. An area with spider veins will have  up to 90% improvement with approximately three to six  treatment sesions. Rarely, less than 10% of the time, will patients not  reach  this desired goal.

HOW MANY SESSIONS WILL I NEED? The number of treatments to clear  or improve the condition differs from patient to patient, depending on the extent of the varicose and spider veins present. The average number of treatments is 3-4.

WHAT ARE THE POSSIBLE SIDE-EFFECTS AND COMPLICATIONS FROM SCLEROTHERAPY? The most common side effects after sclerotherapy include the following:

  1. Hyperpigmentation - in most patients, the treated veins become darker immediately after treatment. This usually fades in 2 - 4 weeks, however in rare cases it can persist 4 - 12 months or can be permanent (3%)
  2. Matting- Matting refers to the development of new tiny lines in the treated area. It may ocurr 2 - 4 weeks after the treatment and usually fades within 4 - 6 months. It ocurrs in up to 18% of women receiving estrogen therapy and in 2-4% of all patients.
  3. Trapped Blood - Occasionally, the closing of the treated vein is slow to occur and a small pocket of blood remains as a blue dot. The doctor can remove this with a small needle and the condition is not dangerous.
  4. In less than 1% of the cases, depending on the  sclerosant used, you may rarely have some of these side effects. 72% Glycerin is very popular in Europe and becoming more popular in the United States as it seems to be more effective than the Detergents in small reticular and spider veins.. Glycerin tends to have minimal  risks of matting, ulceration and bruising in spider veins and small varicosities. ....you can also have Itching , ulceration , Allergic reaction , Pain, Bruising , and phlebitis .

    Sclerosant chemicals used for injection may include:

    • Hypertonic saline (20% NaCl)  salt solution
    • Sodium tetradecyl sulphate  (detergent type solution)
    • Polidocanol (detergent type solution)
    • Glycerin 72% (sugar type solution)

Prior to the procedure the  patient has a consultation with the Doctor to review  veins of concern and  preparations.

  • Avoid Supplements : (Vit E, Fish oil , Ginko)  also Advil, Motrin and  optional Aspirin therapy is to be discontinued at least 7 to 10 days before the scheduled sclerotherapy procedure. Prescribed Blood thinner medications (Coumadin, Plavix, ...) and Doctor prescribed aspirin therapy are to be continued and NOT STOPPED . For  most individuals it is recommended to  decrease to risks of post-procedure complication bruising and   "Matting"  by preparing the body with certain supplements and vitamins...
  • ARNICA (herbal) tablets  orally 2 to 3 times per day SEVEN days before and SEVEN days after the Sclero treatment
  • BROMALIN 500 mg (mineral) tablets  2 to 3 times per day SEVEN days before and SEVEN days after the sclero treatment.
  • VITAMIN K cream 2X per day to treated areas for Seven days after Sclero treatment
  • Remember to wear loose clothing, shorts, Capris or skirt the day of the consultation and the day  of the treatment.
  • Also, remember to bring a wide Ace Wrap with you or a support stocking as recommended by the Doctor.
  • Remember not to apply lotion or creams to your legs the night before or the morning of your treatment
  • Do not shave your legs the morning of the treatment
  • Shower prior to the treatment as  you will be wearing the cotton ball dressing the Doctor applies and the Ace wrap overnight.
  • Eat normally the day of the Treatment.

Generally  sclerotherapy sessions are scheduled  according  to "Blocks" of time about  fifteen to twenty minutes long. During the session , the  doctor will  inject the Spider or small varicose vessels in a localized area such as the  back of the  calf, or front of the Right thigh or back of the  knee. The Doctor often uses magnification and special polarizing lenses to better visualize the fine thread-like Spider veins, The Physician can also use special Transluminator lighting instrument to visualize the deeper "feeder and perforating" veins connected to the spider veins. During the  Sclerotherapy session, the Doctor will  perform multple sclerotherapy injections, but because it is done with a very fine needle, the procedure  has minimal discomfort and many  of the  injections are painless. At  the end of the procedure, cotton balls with paper tape are applied on all the treated area. An "Ace Wrap" is then applied on the treated area. Some physicians recommend Support Hose type stocking (Grade two graduated compression hosiery)  to be purchased and used post treatment, especially if medium to larger varicose veins have been treated.

After the procedure, the spider veins may appear darker  and more prominent for one to three weeks and then they are expected to fade until they  disappear in the following one to two weeks. We recommend keeping the cotton balls and paper tape application on for twenty-four hours and then removed. The Ace wrap or support stockings(Grade 2 graduated compression hosiery) to be kept on for a total of four to five days. During that period of time daily ambulation(walking)  for thirty minutes and activity is recommended. Weight/strength training  and strenous activity such as running and Aerobics are  to be avoided for the  first five days. After this the Ace wrap or support stockings can be removed and regular activity resumed.