Together, spider veins and varicose veins affect approximately 80 million people in the United States each year. Spider veins are most commonly located on the face and legs. In contrast, varicose veins tend to be localized on the backside of the calf or along the inside of the leg. Although physicians do not fully understand the cause of spider and varicose veins, they do attribute factors such as genetics, weight gain, and hormonal fluctuations associated with pregnancy, birth control pills, and hormone replacement therapy, as well as sitting or standing for extended periods of time.

In addition to being unsightly, some types of spider and varicose veins can be associated with varying degrees of pain and discomfort, and in some instances, more serious medical conditions. As the most common treatment option available, sclerotherapy is a safe, effective, nearly painless procedure used to treat spider veins and varicose veins on the body.

Sclerotherapy Introduction

Blood Flow in the Legs

Before you learn how spider veins and varicose veins can be treated using sclerotherapy, you need to understand what causes spider veins and varicose veins. Your circulatory system is composed of arteries and veins. Arteries transport oxygenated blood from the heart and lungs to the rest of your body. In contrast, veins transport blood back to your heart and lungs. Spider veins and varicose veins most commonly occur in the leg, in what are known as the superficial veins. This is because the veins in your legs are subject to large amounts of pressure and must work harder than other types of veins to transport blood upward to the heart, against the force of gravity.

What Causes Spider & Varicose Veins?

Blood typically flows from superficial veins into deep veins, which are often connected by perforating veins. Normally functioning veins have uni-directional valves which prevent blood from flowing backwards in the vein, as it travels upwards toward the heart and lungs. If valves in the perforating veins or superficial veins do not work properly, some blood will be allowed to flow backwards, and collect in a pool below. As blood accumulates, it exerts increasing pressure on the walls of the vein, which causes them to weaken and become dilated, or stretched. As a result, spider veins or varicose veins form in the region.

Differences between Spider & Varicose Veins

Although they have similar causes, spider veins and varicose veins are not the same. Spider veins are generally small thread-like veins with a blue or reddish color that appear beneath the skin’s surface. These veins can have a characteristic circular pattern similar to a spider’s web, or can be independent of other veins. Unlike spider veins, varicose veins are generally swollen, twisted cord-like veins that rise off the skin's surface. Usually deeper than spider veins, varicose veins are flesh-colored or blue in appearance and can cause pain, cramps, swelling, and fatigue in the legs. While sclerotherapy is used to treat a variety of spider and varicose veins, surgical treatment may be more appropriate for the treatment of medium and large varicose veins.

How Sclerotherapy Works

During sclerotherapy, a chemical solution known as a sclerosing agent is injected at several points along spider and varicose veins. Sclerotherapy is commonly performed with a concentrated saline solution, although other chemical solutions or special foam may be used as well. The agent irritates the lining of the veins, which in combination with compression after treatment causes the vein walls to collapse. Over time, the veins will be absorbed by the body, restoring a smoother, more youthful appearance. Like other vein removal therapy, multiple treatments are usually required to achieve the desired results, but sclerotherapy can reduce the appearance of most spider veins and some small varicose veins significantly.

Procedure Preparation

Sclerotherapy treatments are simple, quick outpatient procedures, with most lasting between fifteen and forty five minutes. As the procedure is almost painless, anesthesia is not typically required. Prior to the start of your procedure, the treatment area will be thoroughly cleansed, usually with an alcohol based cleanser.

Sclerotherapy Procedure–Part I

During the procedure, a very thin needle will be used to inject the sclerosing agent at one inch intervals along the spider or varicose vein. The sclerosing agent causes the inside of the treated vein to turn white beneath the surface of the skin.

Sclerotherapy Procedure–Part II

Once injected, the sclerosing agent works by irritating the lining of the vein, which causes the vein to become inflamed. In combination with compression therapy following the procedure, this inflammation, or swelling, causes the walls of the vein to collapse inward and stick together, closing the vein off completely. Eventually, the vein will transform into scar tissue and be absorbed by the body in the weeks following treatment. The collapsed veins will not affect the circulatory system, as the blood flow will be routed through other normally functioning veins.

Sclerotherapy Post-Procedure

Following the injections, it is important that the veins stay in a collapsed state. Therefore, cotton balls and a compression wrap may be applied to the treatment areas and you may have to wear compression stockings to promote proper healing. In addition to preventing the treated veins from re-opening following treatment, compression stockings will help to prevent blood from clotting within the collapsed veins.

Sclerotherapy Recovery

Following the procedure, you may experience some bruising and brown pigmentation around the treatment areas, although this discoloration usually fades with time. The treated veins will begin to fade in a few weeks, as the veins transform into scar tissue. In order to treat the veins completely, you will most likely undergo multiple treatments spaced approximately four to six weeks apart. Although the number of treatments varies by individual, most individuals receive approximately two to four treatments.

Sclerotherapy Results

The results from a sclerotherapy procedure may vary depending on the thickness and the extent of veins that require treatment. It is important to realize that sclerotherapy may not remove spider or varicose veins completely, nor will it prevent new enlarged veins from developing in the future. It is likely that you may experience a significant improvement in at least half of the treated veins, while the remaining veins may show partial improvement. However, sclerotherapy can safely and effectively reduce their overall appearance significantly, giving your skin the smooth appearance that you desire.

This content is for informational purposes only. It is not intended to represent actual surgical technique or results. The information is not intended to be a substitute for professional medical advice, diagnosis, treatment or care. Always seek the advice of a medical professional when you have a medical condition. Do not disregard professional medical advice or delay in seeking advice if you have read something in this printout.
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