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Spider Vein Treatment (Sclerotherapy)

Sclerotherapy is a technique that uses a small needle to instill a specific solution (sclerosing agent) into varicose or spider veins in order to eliminate them creating a more desirable appearance. The solution irritates and destroys the inner lining of the blood vessel ceasing blood flow without damaging the surrounding tissues.

It is estimated that almost of all adult women have spider veins, which are red, blue or purple thread-like lines just under the skin. The condition is associated with increased pressure to the veins. Other contributing factors include injuries, medications that affect hormones, and a family history of spider veins. Although it is less common, men can develop spider veins as well. The condition usually appears after age 30, although it can sometimes develop as early as the teen years.

While unsightliness is the most common reason for removal, spider veins may also be removed to alleviate problems with restless legs, aching, burning, and/or cramps. Although treatment does not prevent the development of new spider veins, the removal of existing veins can dramatically improve the appearance of the affected area, providing a more youthful, healthy look and an even color pattern to the skin.

• How is sclerotherapy performed?
• How long does sclerotherapy take?
• What type of anesthesia is used?
• Where is the procedure performed?
• When can I return home and resume normal activities?
• How do I prepare for the sclerotherapy procedure?
• What precautions are necessary during recovery?
• What are the possible complications after sclerotherapy?
• What results can I expect after sclerotherapy?
• Choosing the right surgeon

How is sclerotherapy performed?

Your doctor will apply antiseptic to the area, then inject a solution into the affected veins with a very fine needle. Each injection covers about one inch of the vein. During the procedure, you may feel a slight pinch as the needle is inserted and a burning sensation as the solution is injected. Next, cotton dressing and compression tape will be applied to the area. After one area is injected and taped, the doctor will proceed to the next area.

Generally a second treatment will be required in order to complete the collapse of the vein. If you have many veins requiring treatment, multiple sessions may be required.

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How long does sclerotherapy take?

Sclerotherapy normally takes fifteen minutes to one hour, depending on the number and length of the spider veins. A series of treatments at bi-weekly or monthly intervals may be required.

What type of anesthesia is used?

Anesthesia is not necessary.

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Where is the procedure performed?

The procedure is performed on an outpatient basis, in the surgeon's office-based surgical suite or an outpatient surgical facility.

When can I return home and resume normal activities?

You should avoid activities that put pressure on the treated area (such as heavy lifting or jogging) for a few days. Your surgeon will give you further information regarding activity specific to your case.

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How do I prepare for the sclerotherapy procedure?

During your initial consultation, your surgeon will discuss the changes that you would like to make to your appearance. Since the appearance of your skin is a matter of personal perception and preference, you will need to discuss your concerns in detail so your surgeon can determine the appropriate alternatives. Please note that on the day of your treatment you will be asked to avoid using moisturizers, sun block or oil on the area to be treated. You should arrive dressed in comfortable clothing that exposes the area to be treated on the day of the procedure.

Prior to your treatment, the surgeon will perform a complete health history and physical. Knowledge of your allergies, medications and previous surgeries should be brought to your surgeon's attention at this time. It is also important to relay information regarding any discomfort you may be having, such as pain, itching or swelling. These symptoms may indicate more serious circulatory problem. If your surgeon assesses the potential for a more serious condition, you may be referred to a specialist for further evaluation. Any underlying condition should be treated before sclerotherapy treatment is begun.Specific instructions to assist you in preparing for this procedure will be given to you after the health history and physical is complete. Your surgeon may recommend that you avoid aspirin and alcohol, as well as herbal and anti-inflammatory medications, for two weeks prior to your treatment in order to minimize bleeding during the procedure. Your experience will be much smoother if you remain compliant with your surgeon's instructions.

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What precautions are necessary during recovery?

When the compression wrap is removed, you will notice bruising and discoloration. This will gradually fade over a period of several weeks.

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What are the possible complications after sclerotherapy?

Occasionally "telangiectatic matting," a new network of veins, appears around the treated area. If this occurs, these veins can also be treated with sclerotherapy. Discoloration and blotchiness is a more common side effect, but this usually fades over a period of time. Avoiding direct sunlight can minimize this. More rarely, sclerotherapy can lead to blood clots or inflammation in the veins. Allergic reactions to sclerosing agents have also been reported. Bruising is not uncommon and often will fade within a few days or, rarely, within a few weeks. In order to minimize these risks, it is important that you follow all of your surgeon's instructions, both before and after surgery.

If you have recently been pregnant, ask your surgeon about delaying the procedure, since spider veins caused primarily by pregnancy often resolve on their own.

You may experience temporary itching or cramping at the injection site. You will be asked to wear a compression wrap for several days. During this time you must keep the area dry. Your doctor may prescribe support hose to be worn for several weeks. This helps to keep the treated vein collapsed. It also reduces the likelihood of blood clots.

No procedure is without risks; however, the majority of complications known to be associated with sclerotherapy are minor when the procedure is performed by an experienced board certified plastic surgeon. It is always important to be informed about the possible complications before any procedure. Be sure to discuss any concerns you may have with your surgeon.

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What results can I expect after sclerotherapy?

Most patients report a high degree of satisfaction with the procedure and relief at no longer having to hide unsightly veins. The treated areas are noticeably clearer and in most cases the skin continues to improve with each successive treatment.

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