Treatment of spider veins

Your physician will first look for the source of the spider veins. This may be done with an ultrasound or special light to highlight veins beneath the skin.

There are two modalities used for spider vein treatment:


Blood has a high affinity for laser light at certain wavelengths. Your physician may chose to use a laser if you have skin type I-IV and have not been tanning. Lasers help to hasten the resolution process and prevent a common occurrence called staining. (Temporary pigmentation changes after sclerotherapy.)

Another laser-based therapy is called intense pulsed light or broad band light. This is more effective for the smaller reddish veins and small veins of the face.


Almost all spider complexes will need sclerotherapy even if a laser is used. Sclerotherapy is the injection of a solution into the vein to cause thrombosis of the vein and eventual resolution. The most common drug used is Sotradecol. Different strengths are used depending on the size of the vein being treated. In most cases, multiple treatments are needed. Side effects are rare with the common one being staining as mentioned before.

What to Expect From Sclerotherapy

Sclerotherapy can enhance your appearance and your self confidence, but it’s unrealistic to believe that every affected vein will disappear completely as a result of treatment. After each sclerotherapy session, the veins will appear lighter. Two or more sessions are usually required to achieve optimal results.

You should also be aware that the procedure treats only those veins that are currently visable; it does nothing to permanently alter the venous system or prevent new veins from surfacing in the future.

Before you decide to have sclerotherapy, think carefully about your expectations and discuss them with your doctor.

Risks Related to Treatment

Serious medical complications from sclerotherapy are extremely rare when the procedure is performed by a qualified practitioner. However, they may occur. Risks include the formation of blood clots in the veins, severe inflammation, adverse allergic reactions to the sclerosing solution and skin injury that could leave a small but permanent scar.

A common cosmetic complication is pigmentation irregularity – brownish splotches on the affected skin that may take months to fade, sometimes up to a year. Another problem that can occur is “telangiectatic matting,” in which fine reddish blood vessels appear around the treated area, requiring further injections.

You can reduce the risks associated with treatment by choosing a doctor who has adequate training in sclerotherapy and is well versed in the different types of sclerosing agents available. A qualified doctor can help you select which type of sclerosing medication is most appropriate for your needs.

Planning Your Treatment

During your initial consultation, your legs will be examined. Your doctor may draw a simple sketch of your legs, mapping out the areas affected by spider veins or other problems. During the examination, you will be checked for signs of more serious “deep vein” problems, often indicated by swelling, sores, or skin changes at the ankle. A hand-held Doppler ultrasound device is sometimes used to detect any backflow within the venous system.

If such problems are identified, your surgeon may refer you to a different specialist for further evaluation. Problems with the larger veins must be treated first, or sclerotherapy of the surface veins will be unsuccessful.

Your doctor will ask you about any other problems you may have with your legs, such as pain, aching, itching or tenderness. You will also be asked about your medical history, medications you take, or conditions that would preclude you from having treatment. Individuals with hepatitis, AIDS or other blood-borne diseases may not be candidates for sclerotherapy. Patients with circulatory problems, heart conditions, or diabetes may also be advised against treatment.

Sources: Vein Affiliates, Veins Online

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