Have you noticed twisted, bulging veins snaking across your skin? Perhaps they are just a cosmetic nuisance that makes you think twice about wearing shorts in summer, or they cause discomfort and throbbing that impacts your daily activities.

These are spider and varicose veins, a common condition that affects up to 35% of adults in the United States.

Spider and varicose veins don’t have to be permanent. Breakthroughs in medical research and technology have led to the development of treatments that can efficiently mitigate and even eliminate both.

Varicose veins can be treated by a Board-certified Vascular Specialist, while spider veins can be treated with sclerotherapy at your dermatologist’s office.

Today, we’re focusing on the treatment of spider veins: sclerotherapy.

What Are Varicose Veins?

Spider veins are swollen, damaged blood vessels that often appear darker blue or purple just beneath the surface. They’re most common in the legs and feet, as our upright posture exerts extra pressure on the veins in our lower body, causing them to swell and twist.

One significant factor is age. With increasing age, the efficiency of the vein valves, which are responsible for maintaining unidirectional blood flow, decreases, leading to poor circulation and blood accumulation in the veins and resulting in their dilation and varicosity.

If there’s a family history of spider veins, the probability of developing the condition also rises. In fact, nearly 50% of those who develop spider veins have other family members with the condition, often due to an inherited genetic weakness in the blood vessels’ walls and valves. 

External factors, like lifestyle and occupation, also come into play. Pregnancy increases blood volume but decreases blood flow from the legs to the pelvis, which can form spider veins. Obesity puts additional pressure on the veins, and occupations requiring extended periods of standing or sitting can exacerbate vein pressure, all of which can contribute to the development of spider veins.

While many people might be concerned about their cosmetic implications, the discomfort caused by spider veins is a more pressing concern. 

Symptoms can range from a mild aching or heavy sensation in the legs to more serious issues such as muscle cramps, leg swelling, skin discoloration around the vein, and itching.

How Sclerotherapy Can Help

Sclerotherapy is an increasingly popular treatment method for spider veins, providing a minimally invasive yet effective solution that involves injecting a solution known as a sclerosant directly into the affected vein.

This sclerosant irritates the lining of the treated blood vessel, causing it to swell, block off blood flow, and eventually collapse. Over time, the body naturally reabsorbs the treated vein, resulting in an improved cosmetic appearance and relief from symptoms.

What to Expect From Sclerotherapy

Before you decide whether or not sclerotherapy is the right treatment option for your spider veins, you should speak with your dermatologist about the process, side effects, and what to expect from this therapy. While we’ll discuss these topics below, everyone is different and may require special considerations that your doctor can explain in more detail.

Sclerotherapy Process

The process of sclerotherapy is relatively straightforward. A board-certified dermatologist uses a fine needle to inject the sclerosant into the spider vein in an outpatient setting without requiring anesthesia.

A single sclerotherapy session often takes no longer than 30 to 60 minutes, making it a convenient option to fit into your busy schedule.

The number of treatment sessions required depends on the severity and number of spider veins present. For smaller veins, you might see significant improvement within 3-6 weeks, while larger, more severely-impacted veins can take up to 4 months to fully collapse and reabsorb.

Each session will typically only address a portion of the veins, and we space sessions out over several weeks to allow proper healing and recovery.

After each session, you can usually resume normal activities almost immediately, avoiding heavy lifting, running and strenuous activity. Staying active by walking daily, can also help prevent blood clots from developing in the veins. You should also wear compression stockings for two weeks to apply consistent pressure to the treated area.

Sclerotherapy Side Effects

As with any medical treatment, sclerotherapy does come with potential side effects. However,  the majority of these are minor and temporary.

Immediately after treatment, you may notice some slight swelling, redness, or bruising at the injection site. You may also notice small red areas or skin sores or experience a burning sensation during or shortly after the procedure. These symptoms generally subside within a few days.

More uncommonly, patients may develop tiny blood vessels around the treated area around 4-6 weeks later, a condition known as telangiectatic matting. This condition typically resolves on its own within three to twelve months.

Serious side effects are rare but can include allergic reactions to the sclerosant, formation of blood clots in the treated vein, or inflammation caused by blood trapped in the treated vein, known medically as thrombophlebitis.