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- Before & After
It's been 2 weeks since my first sclerotherapy treatment, and the area that was injected has new spider veins?
Occasionally, smaller veins can recur after injections. These may be a sign of valve problems in the veins below, occasionally as well.
They can be treated if they occur sometimes with reinjection or even possibly the veinwave device.
See your provider for your options.
Michael D. Ingegno, MD
Have the treating physician evaluate them.
Were your reticular (feeder veins), if any, treated this first time? That is, did your Sclerotherapist use a light in a darkened room to inject deeper veins not visible on the surface?
It is important to go to the cause of the spider veins to prevent them pushing back into the area and re-opening treated veins.
We usually recommend evaluating veins at a minimum of 4 weeks after treatment. Also it does take an average area of veins 3 - 4 treatments.
Some people are unusually prone to to developing new veins but it is rare.
Don't be despondent at this stage. You should see more improvement after the second treatment if treated thoroughly.
Give it at least six weeks from the time of treatment. It takes at least 6 weeks to see resolution of spider veins. Then, you have to compare your legs to pre-sclerotherapy pictures of your legs to truly assess what is new and what was pre-existing.
In general 2 weeks is a very short time and takes longer for veins to resolve after sclerotherapy. On the other hand some spider veins can be "stubborn" and need more than one injection. Be patient.
The treatment of spider veins is a process. It is impossible to eradicate all spider veins with one treatment and sometimes new veins can form after injecting. This is called neovascularization. Usually these new veins will resolve spontaneously over time. If new veins continue to develop then a reflux utrasound would be important to obtain. You should follow up with your vein care specialist.
You should go back to the doctor who injected you. You may have matting. You may just need more injections.
It may just be inflammatory and temporary but an ultrasound evaluation can show if you have underlying venus reflux, or leaking veins which may contribute to this. These deeper leaking veins need to be treated prior to treating the spider veins. I also recommend using compression stockings for two weeks after sclerotherapy to reduce complications such as this.
Ronald Lev, MD