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Spider Veins

Reviewed by Munish K. Batra, MD, FACS

Spider veins

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Telangiectasias afflicts about half the women in the United States. You may know this condition as "spider veins." It can also be called "sunburst varicosities."

Spider vein treatment (sclerotherapy) has been used for more than 40 years. The treatment has become increasingly useful for removing unwanted veins, which are commonly located on the thighs, ankles, and calves. The goal of the treatment is to remove unwanted spider veins permanently and remove the symptoms associated with spider veins.

Spider Veins Versus Varicose Veins

Spider veins are not the same as varicose veins. Spider veins are not necessary for the body, while varicose veins are necessary. Varicose veins are larger and darker in color. Varicose veins are often painful and can be related to a more serious medical condition. Separate treatment is usually necessary for varicose veins.

Spider veins can occur with hormonal changes, during pregnancy, weight gain, repeated prolonged sitting or standing, and the use of certain medications. Spider veins may appear in three different ways, all of which are near the skin surface:

  • very thin "spider web-like" veins
  • very thin "tree-like" veins
  • very thin lengthy single veins

Spider veins are known to burn, swell, and ache. They can be unsightly and interfere with your everyday life.

Best Candidates for Spider Vein Treatment (Sclerotherapy)

Candidates for sclerotherapy can range in age from 13 to 60. The best candidates are well-educated about the treatment, have realistic expectations, and are fully able to comply with aftercare instructions.

Conditions that Exclude Sclerotherapy

Candidates with certain medical conditions such as blood-borne, infectious, and cardiac diseases, as well as those with high blood pressure or diabetes, may not be able to receive sclerotherapy. Women who are pregnant are not candidates as the spider veins usually resolve naturally within months after childbirth. Nursing mothers are advised to postpone treatment until their breast-feeding term is complete. Candidates with varicose vein problems will be advised to address this problem before treating spider veins with sclerotherapy.

The Procedure

Spider vein treatment does not require anesthesia. Discomfort is minimal. Sclerotherapy is performed at the doctor's office or an outpatient surgical setting.

Please click here to view an animation about spider vein treatment.

Prior to the procedure, the doctor will ask you to follow specific instructions such as wearing shorts on the day of treatment and no use of moisturizers, sunscreen, or oil. Following your doctor's instructions carefully will help the procedure go more smoothly.

The doctor will provide a special leg compression stocking to wear after the treatment is performed. Compression garments are a normal recovery aid for many procedures. It is extremely important to wear this stocking to reduce the risk of bleeding or a blood clot.

The doctor will also discuss the type of solution (a sclerosing agent) that will be injected to collapse the vein. There are numerous solutions that can be used for the treatment. The doctor can best describe the choice of solutions and the appropriate solution for your condition.

Sclerotherapy is a simple technique in which a bright light is directed at the vein as the doctor injects a sclerosing agent into the vein with a very thin needle, which collapses the vein. The needle is very tiny and the injection locations are in close proximity. By collapsing the vein, it will be no longer visible and the uncomfortable symptoms associated with spider veins will subside. Typically, each inch of vein requires an injection.

A session lasts about 15 to 45 minutes. During one session, the injection can occur anywhere from five to 50 times. The treatment may be repeated to achieve optimal results. Patients return home immediately after treatment.

After the Procedure

Following each injection, a cotton ball and tape is applied to the injection area, which is to be removed after 48 hours. After the procedure, the leg compression stocking will be put on. For at least 72 hours, the compression stocking must remain on your legs to reduce bruising and reduce the risk of hyperpigmentation (discoloration of the treated area). Patients may experience slight leg cramping within the first two days. But this discomfort is usually not enough to require medication. Itching can also result and can be managed with medication.

The veins will appear worse before they improve. There will be bruising that reduces within a month. Patients will probably not want to wear clothing that shows their legs during this time. Patients are advised to walk often for the first several days after the procedure, but to avoid extended standing or sitting in order to reduce the risk of blood clots. The doctor will also instruct patients to cease weightlifting, squatting, jogging, and possibly other forms of exercise for 30 days.

Results can vary depending upon individual anatomy, personal care through the healing process, the specific sclerosing agent used, and the expertise of the doctor.

Complications and Risks

Complications are rare, but the risk for short-term and long-term complications does exist. The most common complication is brownish-red discoloration on the treated area that usually resolves itself within a year. Telangiectatic matting can also occur, which displays itself as red-colored blood vessels that require additional treatment to resolve. Other rare complications include deep vein thrombosis (blood clots), inflammation, allergic reaction to the injected solution, or scarring. There is a small incidence of recurrence or the appearance of new veins. Carefully following your doctor's aftercare instructions will reduce the risk of complications.

Consult a Qualified Doctor

Dermatologists and plastic surgeons may have experience with sclerotherapy. Choose a doctor who has extensive training and experience with a variety of sclerosing agents and who has considerable experience performing sclerotherapy. A qualified doctor will help you select the most appropriate treatment for your condition, increase the odds of success, and reduce the risk of complications.

Costs

Sclerotherapy cost includes two fees: facility fees and physician's fees. Costs vary over a wide range depending upon the doctor, your region, the type and extent of your procedure, and other factors. The fees can start from about $225 per syringe. Patients may require one or two syringes. The treatment may need to be repeated to produce optimal results.

If the cost of the sclerotherapy procedure is difficult for you, ask your doctor about payment plans and medical finance options. For financing options and tips, continue reading about Patient Financing.

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[page updated June 2008]