Treatment Options → Endovascular Laser Ablation → Sclerotherapy → Microphlebectomy → Venous Leg Ulcers

What are spider veins and how did I get them?
Spider veins (telangectasias) are tiny red or purple veins in the very superficial layers of the skin. They usually are about as wide as a human hair (though they can be larger) and can occur throughout the legs as single veins or in large clusters. Though bothersome to some people, spider veins are harmless. We do not know what causes spider veins but certainly hormones and genetics play a role. Women are more likely to get spider veins than men – especially when pregnant and/or if other family members have them.  Also, people who spend a lot of time on their feet are probably more likely to get spider veins than others. Some people find wearing compression hose/stockings slows down the progression of spider veins but wearing the stockings may be mildly uncomfortable – especially during the summer.

Spider veins are not varicose veins though sometimes people with varicose veins can also have spider veins. Varicose veins are larger, ropey veins (about ? inch in diameter) that usually bulge and are associated with other, more severe symptoms (pain, swelling, achiness, heaviness, skin changes, and skin sores).  If you have any of these veins or symptoms, be sure to let us know.

What is sclerotherapy?
Sclerotherapy (pronounced sk-lair- o-therapy) is one of the most common, safe, and effective method for treating unwanted, abnormal veins on the legs. The treatment involves the injection of a small amount of a solution into the leg veins. Every patient is different, but several dozen injections are usually needed for each leg. Once injected, these solutions (a salt water solution, a detergent, or glycerin) mildly irritate the inside of the vessel.  After injections are completed, compression dressings and stockings are applied. Over the next several weeks, the small veins will collapse and usually leave no marks. Each sclerotherapy session is approximately 30 minutes, allowing for injections as well as dressing application.

Will it work for me?
While there are no guarantees that sclerotherapy will work for everyone our experience (and scientifically published data) suggests that approximately 90% of the population will respond to sclerotherapy. Unfortunately, there is no way to predict who will and who will not respond, but it is fairly safe to say that if you have had sclerotherapy with a good response in the past you will in the future as well.It is also important to note that most people need more than one session of sclerotherapy in order to get their desired results. Approximately 50-75% of the spider veins treated in one session will completely resolve with that treatment. Those veins that remain may need additional treatment in a second session. In some cases (i.e. patients with numerous spider veins throughout his/her legs) several sessions may be required to get the desired outcome.

Will my insurance pay for sclerotherapy?
Spider vein treatment is considered cosmetic. This means that the Vein and Laser Center cannot and will not write letters of medical necessity for spider vein treatment, sclerotherapy, or related expenses (i.e. compression hose).

What are the risks and alternatives to sclerotherapy?
Below is a list of possible risks or outcomes of sclerotherapy:

Bruising:

Temporary small black and blue marks.

Telangectatic Matting:

This is the growth of new, very tiny veins around veins that were injected. These veins usually resolve over several months, but are too small to be treated with additional sclerotherapy.

Blood Clots:

A collection of blood within a treated, superficial blood vessel is possible. It will feel like a small pea under your skin. This is not harmful and will resolve over time, but if needed, a small nick can be made in the skin to help drain this trapped blood. Call the Vein and Laser Center if you are concerned you may have this problem.

Hyperpigmentation:

or darkening of the skin. When you get a bruise, blood and the iron in the blood are deposited in the skin. It may look rusty brown in color and can get darker when exposed to the sun. Wearing the compression stockings as prescribed and avoiding sun exposure to any bruises you may get after the treatment may prevent or lessen hyperpigmentation. The hyperpigmentation usually fades with time but it could take many months to years to fade, and may never completely fade away.

Visual Changes:

Patients will sometimes note vision changes during or after sclerotherapy including seeing floaters or small blind spots.If they occur, these symptoms are temporary and will resolve.

Allergic Reactions:

Though extremely rare, an allergic reaction to the solutions used in sclerotherapy is possible. It is essential you communicate any allergies you have to the Vein and Laser Center medical providers. An allergic reaction can be as minor as a rash to something more severe, and potentially fatal anaphylaxis. For this reason, it is important you communicate any discomfort you are experiencing during the treatment. If you experience any untoward symptoms after you leave the Vein and Laser Center (rash, throat tightness, difficulty breathing), you should report to the nearest hospital emergency department immediately.

What kind of results can I expect after my sclerotherapy?
Initially your legs may look worse following treatment. Redness and some mild tenderness at the treatment sites may persist for several days following your sclerotherapy session. Bruising is very common following the treatment and will resolve over several weeks. Once the redness and bruising have resolved, most people are very satisfied with the treatment. You will note the maximal outcome of the treatment at about 6-8 weeks. It is at this point that you can decide when and if you will need additional treatments. It is important to note that while sclerotherapy is effective in treating the spider veins that are present on your legs now it will not prevent you from developing more spider veins in the future.

Are there any pre-procedure directions I should follow?
If you do not already have them, it is important to get the prescribed compression stockings. You will need to bring them with you to your sclerotherapy session. Lastly, do not apply lotion to legs prior to Sclerotherapy. Avoid the sun and tanning products four weeks prior to laser treatments.

What are my post-procedure instructions?

Dressing Care:

When you leave the Vein and Laser Center after your sclerotherapy session, you will have compression dressings on as well as the compression stocking(s). Leave all the dressings and the stocking(s) in place until the following morning. In the morning, remove the stocking(s) and all of the dressings. (Leaving the dressings on longer will not give you a better outcome and in fact, may increase your risk of infection). After you have showered and dried completely, put only the stocking(s) back on. No additional dressings are needed.

Compression Stockings:

The purpose of the compression stocking(s) is to insure that the treated veins heal shut and do not re-open. They may also aide in decreasing the amount of bruising you get. Therefore, wearing the compression stocking(s) as prescribed is very important to get the success of the procedure. After Sclerotherapy treatment, you will wear the compression stockings. For the following four days, you will wear the stockings during the day and off at night (for sleep).

Exercise:

We do encourage you to walk a minimum of 30 minutes daily following your sclerotherapy to promote the growth of new, healthy veins. After one week you may slowly return to your normal level of exercise, but be sure you are still wearing the compression stocking(s) as prescribed, even while exercising. Avoid squats or weight lifting during Sclerotherapy/laser treatments.

Follow-Up:

A follow-up office visit is not necessary, but we would be more than happy to see you after your sclerotherapy treatments to address any questions or concerns you may have. When scheduling your follow-up appointment as well as any additional sclerotherapy sessions, please keep in mind that the maximal outcome is about 6-8 weeks following treatment.