Treating Varicose and Spider Veins with Sclerotherapy

Varicose and spider veins are related conditions, and both are commonly found in the legs. When the superficial veins, or those nearest to the surface, become damaged, they tend to grow larger, collecting blood and leading to a raised, darkened appearance.

Typically, spider veins are considered to be a mild version of varicose veins. They are smaller, less swollen, cause fewer symptoms and generally appear as a “web” of blue or red across the skin.

Varicose veins vary in size, but are often characterized by a twisted, bulging or “rope-like” appearance. These enlarged veins can cause itching, aching, burning or throbbing in the legs. In addition to being a cosmetic concern, they are more likely to lead to complications.

Our cardiovascular system is complex, but its job is relatively simple: to keep blood moving to and from the heart. The veins in our legs have a “one-way” valve system. When these “doors” become damaged, blood can flow backwards and collect in the veins just beneath skin, leading to the enlarged and discolored appearance.

The damage to these veins can be caused by the natural strain we place on our legs on a day-to-day basis, but the following may make varicose and spider veins more likely:

• Age – As we get older, our bodies – and our veins – experience more wear-and-tear. The aging process can naturally lead to weaker or poorly functioning valves.
• Sex – Women are more likely to experience varicose veins than men. This may be linked to the hormonal changes associated with pregnancy, menopause and the use of hormonal birth control.
• Weight – Being overweight can lead to increased pressure on the legs, making it more difficult for our veins to pump blood back to the heart. This increased workload can contribute to failing or leaky valves.
• Pregnancy – The increased volume of blood needed to support a growing fetus, coupled with the hormonal changes and natural weight gain associated with pregnancy, can make varicose and spider veins more likely during pregnancy.
• Standing or sitting for long periods of time – When we stay in the same position for long periods of time, our circulation decreases. Varicose and spider veins may be particularly likely if you spend all day on your feet.

Speak to your healthcare provider about possible at-home management of varicose veins. Losing weight, exercising more, improving circulation, wearing compression stockings and elevating your legs may help reduce symptoms, but they are unlikely to make the condition disappear.

If these self-care solutions do not relieve your discomfort, or if you are seeking treatment for cosmetic reasons, there are a variety of ways to treat varicose and spider veins. One of the most common techniques is a minimally invasive procedure called sclerotherapy.

Note: larger varicose veins may require more advanced treatment, such as endovenous laser ablation (ELA) or surgical stripping. If this is the case, our providers will discuss these treatment options in detail and prepare you for your procedure accordingly.

Sclerotherapy is a simple, in-office procedure. Anesthesia is not needed, and you can typically resume normal activities in 24-48 hours.

During the procedure, which takes approximately 20-30 minutes, medication is injected into the enlarged and visible veins. This medication clears away the blood that has collected within the vein and causes the vessel to collapse, getting rid of both the swollen and discolored appearance.

The treatment is not painful, but you may experience a slight burning sensation at the time of the injection.

After your sclerotherapy treatment, your legs will be wrapped in a compression bandage or support stocking. This helps keep the recently-collapsed vessel closed, preventing it from refilling with blood. Eventually, your body will simply absorb this unused vein.

You may experience some bruising at the injection sites, and your legs may temporarily itch or cramp. Any bruising or discoloration you experience should fade in the weeks following treatment, and you should see significant improvement in the appearance of your legs approximately a month following treatment.

Sometimes, you may notice a light brown discoloration in the treatment area. This is caused by a pigment released as the vein is absorbed, and the time it takes to disappear can vary depending on the size of the affected vein, your skin type and your body’s healing process.

The number of treatments needed varies from patient to patient. Some need just one session while others need a few. Regardless of how many treatments you receive, varicose and spider veins shouldn’t grow back after effective treatment.

However, we can’t change our genetics and we certainly can’t stop aging: this means you may develop new varicose or spider veins following treatment. If this is the case, you may opt to repeat sclerotherapy or discuss alternative treatment options with your provider.

You should avoid any activities that put increased pressure on the treatment area (like heavy lifting or jogging) for a few days. After this initial resting period, exercise is encouraged. Your provider may suggest a walking program to increase circulation and promote healing.

The simplest, most effective exercise for good vein function is walking.

The cost for sclerotherapy may vary depending on how many areas are being treated, as well as how many sessions you need. In most cases, sclerotherapy is considered a cosmetic procedure, making it less likely to be covered by insurance. Sometimes, however, symptomatic veins (those that cause pain, itching or discomfort) may qualify for insurance coverage.

Check with your health insurance provider for plan details, or call our office for more information.