Spider veins are also known as telangectasias. They are often the earliest manifestation of venous disease. They are formed by small veins under the skin that become dilated making them visible through the skin's surface. They can be blue, purple, or red and are frequently extensive, forming various patterns of linear, starburst, or tree-like distribution.
Sometimes spider veins appear all over the legs, especially in the inner thighs, ankles, and calves. This may be a sign that one of the larger veins is not working well (venous insufficiency). To learn more about an individual patient's spider veins, we recommend an ultrasound - especially if the veins are tender or if the legs feel heavy or full. With ultrasound, Dr. Aquino can determine the best treatment plan.
In other cases, spider veins can form networks on the outer thighs or the outer calves. These veins tend to form a starburst pattern along the outer thigh. Most of the time, these veins are treated with injections (sclerotherapy).
Sclerotherapy is a safe and minimally invasive spider vein treatment. The small veins are injected with an FDA-approved substance (sodium sotradecol) to eliminate them. Sclerotherapy can take up to three sessions, but often considerable improvement is seen after the first session. Each sclerotherapy session lasts approximately 30 minutes. To perform sclerotherapy, a tiny needle is placed in the spider vein to inject tiny amounts of liquid (sodium sotradecol). The solution causes the vein to scar and then permanently close, forcing blood to reroute through the healthier veins. Tissue absorbs the closed vein and it eventually fades.
Is sclerotherapy painful?
The procedure can sometimes produce a small amount of stinging, but this usually goes away after a few minutes. Laser treatment of spider veins is considered to be more painful than sclerotherapy. If you have heard that sclerotherapy is painful, that’s because in the past, vein specialists used a solution of hypertonic saline for this procedure. The hypertonic saline was painful, which is why Dr. Aquino chooses to use the effective, but nearly painless, sodium sotradecol solution.
Is spider veins treatment permanent?
We are often asked, "Can spider veins come back?" They can, but usually they come back in a less prominent way. The tendency to get spider veins is somewhat genetic, like the tendency to get freckles or age spots. For some patients, keeping spider veins at bay means occasional “maintenance” appointments for sclerotherapy.
Other spider vein treatment options
Other spider vein treatments include laser treatment which works by using a laser to heat the vein which causes it to scar and eventually close. Similar to sclerotherapy, the laser light causes the vein to lose its source of blood and eventually to fade. Both laser treatment and sclerotherapy can be effective when used properly. However, laser treatment is less effective on larger veins, particularly in the legs. It is more appropriate for smaller veins on the face and chest. Laser treatment can also be associated with more pain than sclerotherapy. Because of the tendency for laser vein treatment on legs to produce more side effects with less effectiveness, Dr. Aquino exclusively uses sclerotherapy.