Spider Veins

Today, many plastic surgeons are treating spider veins with sclerotherapy. This is a rather simple procedure, in which veins are injected with a sclerosing solution. This solution causes the veins to collapse and fade from view.

The procedure may also remedy the bothersome symptomes associated with spider veins, including aching, burning, swelling and night cramps. Nowadays, sclerosing agents are mild enough to be used in small veins, which made sclerotherapy predictable and relatively painless.

Spider veins are small, thin veins close to the surface of the skin. They are connected with the larger venous system, but are not an essential part of it. Heredity, pregnancy, hormonal shifts, weight gain, occupations or activities that require prolonged sitting or standing, and certain medications are factors that contribute to the development of spider veins.

Spider veins may appear in a true spider shape with a group of veins radiating outward from a dark central point. They may be arborizing and will resemble tiny branch-link shapes or they may be simple linear and appear as thin seperate lines.


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Pregnant or breastfeeding women may be advised to postpone sclerotherapy treatment. Most spider veins that appear during pregnancy will disappear on their own within three months after giving birth. Furthermore, sclerosing solutions might affect breast milk. Therefore nursing mothers are also advised to wait until after they have stopped breastfeeding.

Spider veins in men are less common. Men who do have them often do not consider them a cosmetic problem as the veins are usually covered by hair growth. However, sclerotherapy is just as effective for men.

People, considering this surgery, should be aware that it's unrealistic to think that every affected vein will disappear completely. Two or more sessions are usually required to achieve the best results. Intended patients should also understand that the procedure only treats the veins that are visable at the time; it cannot alter the venous system or prevent new spider veins from surfacing in the future.

Individuals with hepatitis, AIDS or other blood-borne diseases may not be candidates for sclerotherapy. Patients with circulatory problems, heart conditions, or diabetes may also be advised against treatment.


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The surgeon will provide specific instructions on how to prepare for the surgery. Sclerotherapy is a relatively simple procedure that requires no anesthesia and will be performed in an outpatient setting.

The treatment itself is quick, lasting only about 15 to 45 minutes. The skin over the spider veins will be cleaned with an antiseptic solution. Using one hand to stretch the skin taut, the doctor or nurse will begin injecting the sclerosing agent into the affected veins. Bright, indirect light and magnification help ensure that the process is completed with maximum precision. Approximately one injection is administered for every inch of spider vein, anywhere from five to 40 injections per treatment session. A cotton ball and compression tape is applied to each area of the leg as it is finished.

During the procedure the patient can listen to music, read, or just talk to the practitioner. As the procedure continues, the patient will feel small needle sticks and possibly a mild burning sensation. However, the needle used is so thin and the sclerosing solution is so mild that pain is usually minimal.

Following the treatment, pressure may be applied to the injected area for 24 to 36 hours. Tight-fitting support hose may be prescribed to guard against blood clots and to promote healing. It's not uncommon to experience cramping in the legs for the first day or two after the procedure.

Rest is not generally necessary, in fact, daily walking for at least 20 minutes after the treatment is strongly encouraged and normal activity may be resumed.

The patient should understand that the treated veins will look worse before they begin to look better. At first bruising and reddish areas can be noticed at the injection sites. These bruises will fade within one month.


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Pigmentation irregularity is a common cosmetic complication, leaving brownish splotches on the skin that may take months, sometimes a year, to fade. Another complication that can occur is "telangiectatic matting", in which fine reddish blood vessels appear around the treated area. This will require further injections.

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