Sclerotherapy for Leg Veins

What are spider veins?

Spider veins are blood vessels that lie near the surface of the skin on the legs and range in color from red to blue to purple. They can look like short, unconnected lines about the size of a hair or they can form a "sunburst" pattern that may resemble a spider web or branches of a tree.

Why do I have them?

Spider veins can result from faulty valves in deeper varicose veins, resulting in the backflow of blood and swelling of veins. Spider veins can also be triggered by hormonal changes that occur during puberty, pregnancy, and menopause. Long periods of standing or sitting, heredity, birth control pills, and hormone replacement therapy also may all play a role in the development of spider veins. An injury or tight garments held fast by elastic also seem to cause spider veins.

What is sclerotherapy?

Sclerotherapy is the most popular way to treat spider veins on the legs. It involves injecting small doses of a solution directly into the unwanted vein with a very fine needle. The solution irritates the vein, causing it to swell, stick together, and the blood to clot. This seals off the treated vein. Over a period of weeks, the treated vein turns into scar tissue that is absorbed by the body. Eventually the scar tissue becomes barely noticeable or invisible.

Don't I need these veins?

Your body doesn’t need spider veins. They are "extras," and there are plenty of other veins in the area that can carry the blood where it needs to go. So, there are no harmful effects on your circulation.

How do I prepare for my sclerotherapy treatment?

If you bruise easily, try to avoid taking aspirin, ibuprofen, or Vitamin E for two weeks prior to your treatment since these are blood thinners that can make you bruise more. Please do not apply lotions or creams to your legs the morning of treatment, and avoid shaving your legs 24 hours prior to treatment.

Studies show that wearing compression stockings during waking hours for up to 3 weeks following treatment may improve your chances of successfully clearing your unwanted veins. Compression hose may be purchased at your local drug store. Please ask our office to give you a prescription for them beforehand so you can bring them to your sclerotherapy appointment.

What does sclerotherapy feel like?

A treatment session generally lasts 20-30 minutes. Patients lie down on a table and get comfortable. The skin is prepped with alcohol, and then with no anesthesia required, a tiny needle is used to inject small amounts of solution into the veins. It barely feels like a stinging sensation and so patients are able to hold a conversation with the doctor the entire time that sclerotherapy is being done. When the needle is in the vein, you can see the solution flush the blood out of the vein, and then the blood slowly returns. Many veins are treated during one session, and afterward the veins may appear a little pink and inflamed. When the procedure is completed, cotton balls and compression tape are applied to the treated areas.

What can I expect after a sclerotherapy treatment?

Dressings should remain on for 24 hours. Patients can walk right away and resume regular activities, but avoid high impact aerobic activity for 48 hours after treatment to give the veins a chance to collapse. Strict sun avoidance on the legs for 6 weeks before and after treatment should be followed in order to avoid healing with brown spots.

Rarely, a small clot can develop at an injection site. This clot will not cause any internal problems, and can be drained 5-7 days after sclerotherapy.  Some bruising around injection sites can also occur and may take up to 2-4 weeks to resolve.

How many treatments will I need?

Depending on the size and number of veins, you may need 1 to 4 sessions at 6-8 week intervals. Larger-diameter veins clear quickly and may leave a temporary discoloration behind in their tracks. In contrast, tiny red veins the width of a hair may take longer to clear and may require more treatments. As new veins crop up down the road, some patients return yearly to treat any new veins.