Vein Sclerosing (Spider Veins)

Explore what vein sclerotherapy and sclerosing plastic and cosmetic surgery has to offer you by Dr. Michael Bermant, MD.

Michael Bermant, MD
Board Certified by the American Board of Plastic Surgery

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Vein Sclerosing (Spider Veins)

Spider "veins" are enlargements of tiny blood vessels which can be flat, raised, red or blue. Spider veins can occur anywhere but most frequently are found on the thighs, legs, and ankles. As in the drawing above, various patterns include unconnected lines, star bursts, and streaks of lightening. Many consider them to be ugly and will not wear a bathing suit. Women so affected hide their legs under long clothing, heavy stockings, or make-up. The defects can appear in both men and women. Fashion has not dictated as much male concern. spider veins

No one knows for certain what causes spider veins. Some families have a greater tendency for this condition. Traumatic injuries, long periods of sitting or standing, tight girdles and garter belts may contribute to their formation. Birth control pills and pregnancy may worsen spider veins. During menstrual periods and warm weather, they can become painful. Support hose may prevent spider veins. Reducing excessive weight and regular exercising may also help.

There are many methods to deal with spider veins. The simplest is to just accept them as they are. If you are able to ignore them, you will save much in aggravation and money. However, few can just ignore these blemishes.

Heavy stockings or clothing cover most spider veins. Such stockings do not go with many fashions. Both techniques are uncomfortable in warm weather.

Special make-up usually also covers these blemishes. We can show you the techniques and specific thicker material designed for this purpose. Application is time consuming. Removal requires soap and water. Various shades are necessary to conceal different colors the skin becomes during the year (i.e. a suntan).

Electrodesiccation uses electric current in a nonspecific destruction of vessels and the overlying skin. There is a greater tendency for scarring.

Laser surgery can be effective for extremely small vessels. A powerful light destroys the vessel. The laser is an expensive device and thus treatments are more costly.

vein sclerosing With sclerosing therapy, the tiny vessels are injected with a very thin needle. Sclerosing solution irritates and destroys the lining of the blood vessels making them clot off. The plugged vessels may leak blood cells into surrounding tissue causing bruising. The closed vessels and bruises are gradually dissolved by the body.

The treatment of spider veins of the legs often requires several series of injections. Dr. Bermant will discuss this with you during your initial consultation. You will be lying down for the injections. There will be a slight discomfort from the very fine needle sticks. The medicine may cause a mild discomfort on injection. The number of injections will depend on how many veins need treatment and how well each one goes.

There have been a few cases of allergic reactions described in the literature. We therefore use a limited dose the first session as a test. Do not hesitate to tell me if you feel faint or have any discomfort during your treatment.

You will have a compressive dressing over the injection sites for the first 48 hours. This tape occasionally causes blisters especially if you perform excessive activity. Walking is encouraged after the injections. After treatment avoid prolonged sitting or standing, jogging, aerobic and pounding exercises. You may feel some cramping in your legs during this time. After two days you may remove the tape carefully. Dr. Bermant will write a prescription for compressive stockings or wrap your legs with bandage if necessary.

Your legs will look worse before they look better. Some bruising decreases over the next month. Fair skinned individuals show their bruises more than darker skinned people. Brownish pigment remains from the dissolved bruises and gradually fades over about two years. Rarely the pigment is permanent. If you notice blue - black clots in the veins, please let us know. Dr. Bermant can sometimes express some of the blood to diminish the degree of bruising.

The skin over the vein can be damaged resulting in a wound. Healing may take 6 weeks or longer. Wound and scar care help minimize the eventual scar. This scar fades to some degree but is permanent.

About 5% of patients develop a network of very small red vessels that lighten with pressure. This problem is called "telangiectasia matting." They may disappear on their own. Further injection treatments may help.

Some vessels may reopen with time causing a recurrence of the spider veins. However, recurrence usually is from new vessel formation. In about five percent of patients tiny vessels reform causing a matting effect. Repeat injections sometimes treat this problem.

The goal for sclerosing is to decrease the objectionable appearance of the spider veins. Complete obliteration of every offending blood vessel is not realistic.

Do not use any creams or moisturizers to your legs the day of your procedure. Suntans can result in prolonged pigmentation in bruised skin. Sun tanning before sclerosing or during the bruised phase is not a good idea. Charges relate to the amount of time spent by Dr. Bermant. Actual injection is done only by the doctor, not a nurse or an assistant. You may also need to buy compression stockings. These stockings are washable and can last for years. Most insurance companies do not pay for sclerosing therapy if performed for cosmetic reasons. A few companies cover treatment for pain or discomfort that impedes activity. Each carrier is different. We recommend checking with your own agent to see if there is coverage. Sclerosing sessions are only scheduled after an evaluation appointment.


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This page last updated on: April 21, 2012

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