Spider Veins: Frequently Asked Questions

Updated on: February 13, 2017

What are spider veins?

Spider veins, also known as telangiectasias, are small superficial thread-like veins close to the skin surface. They are more prominent on the back and sides of the thigh and just below the knee. These veins are more distinct in fair skinned people, and more common in females. The spider veins may appear spontaneously and they have no symptoms. They appear as numerous fine bluish/red circles on the legs.

Can spider veins cause leg swelling or pain?

Spider veins are minute veins and thread-like. They are only of a cosmetic nuisance. They do not cause pain, leg swelling or fatigue. In any individual who has these symptoms, the spider veins are not the cause of the problem.

What causes spider veins?

The real cause of spider veins is not known, but they are more prominent in obese individuals, females, individuals who are on their feet for prolonged periods, minor trauma, pregnancy and perhaps use of contraceptives. There may be a familial component to these veins, too. In general, any condition that will increase pressure in the veins, can lead to spider veins.

How are spider veins treated?

The most important thing to know is that these veins are entirely of a cosmetic concern. There are several options in treating spider veins. The most common is sclerotherapy, laser and camouflage. Surgery is never used to treat spider veins.

How do lasers treat spider veins?

Laser treatment is a safe, effective option for spider veins. It does not involve any injection and takes a few minutes. Repeat sessions may be required in some cases. The laser causes the blood in the vein to disappear.

How is sclerotherapy done?

Sclerotherapy involves injection of a sterile solution (called a sclerosing solution) into the small veins using a very fine, thin needle. This solution irritates the vein lining causing it to undergo fibrosis and eventually disappear. Multiple veins can be injected at each session. The sclerosing solution used may be either hypertonic saline or sodium tetradecylsulfate.

Is there any harm in removing spider veins?

Spider veins have no function and removing does no harm. The only reason they are removed is because of their unsightly cosmetic.

Which is the best treatment for spider veins: laser treatment or sclerotherapy?

Sclerotherapy has been round for 20 years and is a safe procedure. The procedure involves the use of multiple injections to destroy the vein. Lasers on the other hand do not require needles and are currently in vogue. Laser therapy is also slightly more expensive than sclerotherapy. Laser therapy is fast becoming the procedure of choice.

Can anyone undergo sclerotherapy?

Almost anyone with unwanted spider veins can be treated, except women who are pregnant or nursing. Other relative contraindications include those with skin infections, uncontrolled diabetes, fever, history of deep vein thrombosis, anticoagulant therapy those patients taking corticosteroids.

Is there any preparation required before sclerotherapy?

No extensive preparation is required before the procedure. It is recommended that one stop smoking and stop taking aspirin a few day before the procedure. Any patient on a blood thinner is not a candidate for sclerotherapy.

What happens after sclerotherapy treatment?

There is some mild pain which can easily be overcome with Tylenol. The injected site will appear bruised and swollen for a few days. Continual wearing of the ace bandaged will relieved the swelling and pain. The bruising usually disappears in 2-3 weeks. One will have no problem with walking. After the first 2 days, most patients can resume their normal activities.

How long is each sclerotherapy session?

Generally, most individuals have multiple spider veins and only up to 15-20 injections can be done at seating. Each treatment session lasts up to 30 minutes. After the treatment, sterile dressings are placed over the injection site and the entire leg is covered with an ace bandage. The ace bandage is left on for 2-3 days until the patient returns to see the doctor. Most individual require 2-3 sessions the sessions are best done at weekly intervals. The interval between sessions does not affect the treated veins.

When is the best time to have the spider veins treated?

Spider veins have no symptoms and the major problem is cosmetic. Therefore, the surgery is strictly elective and can be done any time. Spider veins do tend to become more prominent during pregnancy, and so it is best to wait until the pregnancy is over.

Can spider veins recur?

Although spider veins can develop during subsequent pregnancies, previously treated veins should not reoccur. Spider veins can be removed but new ones can always occur. Most people who have spider veins have a predisposition and despite treatment, new veins will appear in the coming years. There is no cure for spider veins.

What are side effects of sclerotherapy?

Besides some stinging pain, sclerotherapy can rarely cause a few side effects. Allergic reactions are rare. A few individual may develop intense itching at the site of injection. If the chemical is injected outside the vein, profound discoloration and pain can occur.

Does insurance cover spider care treatments?

Unfortunately, spider veins are considered cosmetic in nature and the cost of treatment is not covered by any insurance companies.

Reviewed February 8, 2017

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