A non-surgical procedure, sclerotherapy is the most common treatment for both spider veins and reticular (varicose) veins. Spider veins are very small and very fine red, blue or purple veins. They are closer to the surface of the skin than reticular veins. They can look like tree branches or spider webs and move cover small or large area. Reticular veins can also be known as feeder veins. They are blue and green veins beneath the surface of the skin. Reticular veins enlarge because of increased pressure in the vein.

Our nurse practitioners inject a solution, such as Asclera or Sotradecol, into the vein that causes the vein walls to swell, stick together and seal shut. This stops the flow of blood and the vein turns into scar tissue. Over a period of weeks, the vessel turns into scare tissue and, eventually, the vein should fade. The same vein may need to be treated more than once, usually 6-8 weeks apart, depending upon its size. A number of vessels may be injected during your treatment session and each treatment session is approximately 30-40 minutes in length. A patient can expect to require 3-5 treatment session for up to 80% clearing of your unwanted spider veins. Your legs will continue to look better for months after the most recent visit.

This treatment is very effective if done the right way. Most patients can expect a 50-90% improvement. Sclerotherapy uses special solutions and injection techniques that increase the success rate for removal of spider veins. Sclerotherapy does not require anesthesia, and can be done in the doctor's office.

Q: Is there any pain with the procedure?

A: The injection uses a fine needle that causes a barely noticeable pinprick feeling. Some people experience a slight to moderate burning feeling immediately after the injection, but this disappears after a few seconds.

Q: What do I do after the procedure?

A: To improve the blood circulation in the deep veins, it is essential to walk after the treatment. A compression stocking is worn to reduce the risk of bruising and swelling or other complications. This may help seal the treated vessels, keep the blood from collecting under the skin, and reduce the development of dark spots. It may also reduce the number of treatments necessary, and the possibility of recurrence.

Regular exercise, weight control and the use of support stockings (if practical) are recommended between treatments and after treatments.

Q: Are there any side effects?

A: There are some possible side effects. They include:
  • Stinging or pain at the injection sites, swelling of the ankles or feet, or muscle cramps. This usually occurs when hypertonic saline solution is used. Hive-like reactions usually go away within 10-15 minutes after injection.
  • Red, raised areas at the sites of injection. These are similar to hives and response should disappear within a day or so.
  • Brown lines or spots on the skin at the sites of treated blood vessels. Darkened areas may result when blood escapes from treated veins and are probably formed from iron in the blood. These dark areas occur more often in patients who have larger veins treated or those patients that tan easily. In most cases, they disappear within a year, but may last longer.
  • Development of groups of fine red blood vessels near the sites of injection of larger vessels. About one-third of patients develop groups of vessels especially on the thighs. Most disappear by themselves, some need additional injection treatments or laser therapy; a few may last.
  • Small, painful ulcers at treatment sites either immediately or within a few days of injection. These occur when some of the solution escapes into the surrounding skin or enters a small artery at the treatment site, and can be successfully treated, but it is necessary to inform the vascular surgeon immediately.
  • Temporary bruises. Bruises usually occur after laser treatments and are probably related to the thinness of blood vessel walls. They usually disappear in a few weeks. Occasionally, bruising is seen with sclerotherapy.
  • Allergic reactions to sclerosing solutions. Although such reactions are uncommon, they can be treated. Inform your vascular surgeon immediately if you think you have an allergy to this solution. Inflammation of treated blood vessels. This is very unusual but when it occurs, it is treated with medications such as aspirin, compression, antibiotics or heat.
  • Lumps in injected vessels. This is coagulated or “trapped” blood and is not dangerous. The surgeon may drain the blood from these areas a few weeks after injection, if needed.
  • Burning with discoloration of the skin.
Q: Will treated veins recur?

A: Large veins may recur even after surgical procedures. Spider veins may also recur. It may seem that a previously injected vessel has recurred when in fact, a new spider vein has appeared in the same area.