Spider veins are small, thin veins that lie close to the surface of the skin. These thin clusters of red, blue or purple veins are connected with the larger venous system but are not an essential part of it. Although spider veins are commonly found on the thighs, calves and ankles, they can also be found on the face. They can cover either a very small or very large area of skin.
The cause of spider veins is not completely known, but they often run in families. Spider veins appear in both men and women, but, more frequently in women. Some factors that may contribute to spider veins include:
- Other events that cause hormonal shifts
- Weight gain
- Occupations or activities that require prolonged sitting or standing
- The use of certain medications
- Spider veins on the nose and the cheeks of fair-skinned people may be related to sun exposure
Spider veins may take on 1 of 3 basic patterns:
- True spider shape with a group of veins radiating outward from a dark central point
- Tiny branch-like shapes
- Linear, appearing as thin separate lines
Spider veins can cause pain that ranges from dull and throbbing to a burning sensation. Discomfort may not be related to the size of the blood vessel.
Spider veins cannot always be prevented. Wearing support hose may minimize unwanted blood vessels from developing. Weight control and regular exercise may be helpful. Sun protection is important to limit the number of unwanted vessels on the face.
A: The injection method is called sclerotherapy. This procedure has been in use since the 1930s. A sclerosing solution, such as Asclera® or Sotradecol®, is injected directly into the blood vessel with a fine needle. The solution irritates the lining of the vessel causing it to swell, stick together and the blood to clot. Over several weeks, the vessel turns into scar tissue and eventually fades, becoming barely noticeable. A single blood vessel may have to be injected more than once, usually weeks to months apart, depending upon its size. A number of vessels may be injected at any treatment session. After several treatments, most patients can expect an 80%-90% improvement. Fading of the vessels occurs gradually, over a period of months.
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.
A: To improve the blood circulation in the deep veins, it is essential to walk after the treatment. Patients wear a compression stocking to reduce the risk of bruising and swelling or other complications. This may help seal the treated vessels, keep blood from collecting under the skin and reduce development of dark spots. It may also reduce the number of treatments necessary and the possibility of recurrence.
We recommend regular exercise, weight control and the use of support stockings (if practical) between treatments and after treatments.
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.
- Red, raised areas at the sites of injection. These are similar to hives and response should disappear within a day or so. Hive-like reactions usually go away within 10-15 minutes after injection.
- 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 who 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 1/3 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. This 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.
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.