Spider veins (known medically as telangiectasias) are dilated blood
develop in most individuals as an inherited tendency.
Pregnancy, hormones (such as birth control pills and Premarin), mechanical
trauma, and long periods of standing or sitting contribute to this problem.
While they may be red or blue, most people have both types on their legs.
Sclerotherapy is the microinjection technique of instilling a concentrated
saline or other solution into the dilated vessels. Saline is a natural
solution and is therefore usually safe to use. The solution irritates the
lining of the vessels so they cease to carry blood. The body slowly replaces
the vessels with invisible, harmless scar tissue. Several injections
may be needed for a specific area of telangiectasias.
Usually the vessels disappear over 1 to 2 months, but occasionally
fading is gradual over many months. Recurrence can occur over 1 to 5
years. Oftentimes, it may seem that a previously treated vessel recurs,
when instead a new spider vein has formed.
Optimal results usually require 2 to 5 treatment sessions. The number
varies with the extent of involvement as well as the response to each
The goal is to produce a 70-80% improvement with multiple treatments.
Although some people achieve almost complete resolution, 100% clearing
does not occur in just one treatment, and may not occur even after several
treatments. About 10% of patients may not respond at all. There is no
guarantee that your spider veins will improve or disappear.
While side effects are uncommon, the following are possible:
Itching, Stinging or Pain: These side effects vary with the
type of sclerosing agent injected and are temporary.
Muscle Cramps: Cramping usually resolves within 10-15 minutes.
Hives: Hives at the injection site usually disappear within
Bruises: Slight bruising may occur at the injection site. It
may last for a few weeks but is not permanent.
Pigment changes: In a few people, iron from the blood is deposited
in the skin where vessels disappear. Brown stains result and may take
months to resolve. Rarely, a small amount may be permanent.
Blisters or Ulcers: Blistering or ulceration of the skin
is a rare but worrisome complication. If you notice any breakdown of
skin at the injection site, notify our office immediately, as delaying
treatment will promote scarring.
Scars: Scarring may develop after a blister or ulcer heals.
Matting: An uncommon occurrence after treatment is the
development of tiny vessels that appears as a fine blush. People who
are on hormones such as the birth control pill are more likely to see
this side effect.
Clots: A blood clot may develop and can generally be
removed with a small incision. Its removal speed the healing process.
Because the treated veins are superficial and not in the deep leg muscles,
internal problems (such as a blood clot forming deep in the leg and traveling
to the lungs or brain) are unlikely. Clotting is minimized by using compressive
wraps and hose after the treatment.
Swelling: Ankle or leg swelling is more common in people
whose jobs involve standing for long periods of time, or whose ankles
or lowest parts of the legs have been treated.
Superficial Thrombophlebitis: An inflamed clot can form in a
vessel. If so, it must be treated with anti-inflammatories and bed rest.
Extremely small vessels and large, bulging, blue varicose veins cannot
be treated with these techniques.
Laser is usually reserved for facial vessels, for vessels that
do not respond to sclerotherapy, for people who do not want needle injections,
or for people whose vessels are too small to be treated by sclerotherapy.
Electrodessication and radiofrequency treatments can be useful
for facial vessels. In general, those on the legs do not respond as well.
Wearing support hose daily, not becoming over-weight, exercising regularly,
eating a high-fiber diet, and wearing low-heeled shoes can minimize spider
Appointments are made in advance after a consultation, and a deposit
is required at the time the appointment is scheduled.
Wear shorts under a loose skirt. Also wear comfortable shoes.
Charges are related to the amount of time spent with the doctor and
the amount of solution required. The initial treatment does not include
the cost of any touch-up or follow-up sessions. A deposit is required
when you make your appointment. You may use a credit card for the deposit.
Each session is to be paid in full on the day of your procedure.
No. Sclerotherapy of spider veins is considered a cosmetic procedure
and it is not covered by insurance.
Frequently, only a few sessions are needed to see results. If you have
any questions or wish to set up an appointment, please contact our office
via this website or call our office today at (212) 557-2600.