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Millions of women are bothered by spider veins - those small yet unsightly clusters of red, blue or purple veins that most commonly appear on the thighs, calves and ankles. In fact, it's estimated that at least half of the adult female population is plagued with this common cosmetic problem.
Today, many plastic surgeons are treating spider veins with sclerotherapy. In this rather simple procedure, veins are injected with a sclerosing solution, which causes them to collapse and fade from view. The procedure may also remedy the bothersome symptoms associated with spider veins, including aching, burning, swelling and night cramps.
Although this procedure has been used in Europe for more than 50 years, it has only become popular in the United States during the past decade. The introduction of sclerosing agents that are mild enough to be used in small veins has made sclerotherapy predictable and relatively painless.
What Are Spider Veins?
Spider veins, known in the medical world as telangiectasias or sunburst varicosities, are small, thin veins that lie close to the surface of the skin. Although these super-fine veins are connected with the larger venous system, they are not an essential part of it.
A number of factors contribute to the development of spider veins, including heredity, pregnancy and other events that cause hormonal shifts, weight gain, occupations or activities that require prolonged sitting or standing, and the use of certain medications.
Spider veins usually take on one of three basic patterns
- They may appear in a true spider shape with a group of veins radiating outward from a dark central point.
- They may be arborizing and will resemble tiny branch-like shapes.
- They may be simple linear and appear as thin separate lines.
Linear spider veins are commonly seen on the inner knee, whereas the arborizing pattern often appears on the outer thigh in a sunburst or cartwheel distribution.
Varicose veins differ from spider veins in a number of ways. Varicose veins are larger, usually more than a quarter-inch in diameter, darker in color and tend to bulge. Varicose veins are also more likely to cause pain and be related to more serious vein disorders. For some patients, sclerotherapy can be used to treat varicose veins. However, often surgical treatment is necessary for this condition.
The Best Candidates For Sclerotherapy
Women of any age may be good candidates for sclerotherapy, but most fall in the 30-to-60 year old category. In some women, spider veins may become noticeable very early on, in the teen years. For others, the veins may not become obvious until they reach their 40s.
If you are pregnant or breastfeeding, you may be advised to postpone sclerotherapy treatment. In most cases, spider veins that surface during pregnancy will disappear on their own within three months after the baby is born. Also, because it's not known how sclerosing solutions may affect breast milk, nursing mothers are usually advised to wait until after they have stopped breastfeeding.
Spider veins in men aren't as common as they are in women. Sclerotherapy is just as effective for men who seek treatment.
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 the doctor.
A typical sclerotherapy session is relatively quick, lasting only about 15 to 45 minutes. Approximately one injection is administered for every inch of spider vein, anywhere from five to 40 injections per treatment session. During the procedure, you may listen to music, read, or just talk to your practitioner. You will be asked to shift positions a few times during the process. As the procedure continues, you will feel small needle sticks and possibly a mild burning sensation. However, the needle used is so thin and the sclerosing solution is so mild that pain is usually minimal.
After Your Treatment
Tight-fitting support hose may be prescribed to guard against blood clots and to promote healing. It's not uncommon to experience some cramping in the legs for the first day or two after the injections. This temporary problem usually doesn't require medication.
You should be aware that your treated veins will look worse before they begin to look better. When the compression dressings are removed, you will notice bruising and reddish areas at the injection sites. The bruises will diminish within one month. In many cases, there may be some residual brownish pigmentation which may take up to a year to completely fade.
Getting Back to Normal
Although you probably won't want to wear any leg-baring fashions for about two weeks, your activity will not be significantly limited in any other way from sclerotherapy treatment.
A one-month healing interval must pass before you may have your second series of injections in the same site. After each treatment, you will notice further improvement of your legs' appearance.
Your New Look
Most patients are pleased with the difference sclerotherapy makes. The skin of your legs will appear younger, clearer and more healthy-looking. Often, patients are surprised at the dramatic difference in appearance between a treated leg and an untreated one.
Although sclerotherapy will obliterate the noticeable veins for good, it's important to remember that treatment will not prevent new spider veins from emerging in the future. As time passes, you may find that you need "touch-ups" or full treatments for new veins that surface. But even if you choose not to have further sclerotherapy, your legs will look better than if you never had treatment at all.