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Sclerotherapy
Your physician will develop a treatment plan for your individual case. Spider veins can be successfully
treated with injection sclerotherapy. Sclerotherapy is the most popular method of eliminating spider veins.
This is the “gold standard” and is more effective and less expensive than lasers. An FDA-approved medication called
sotradecol is injected into the veins using very tiny needles.
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This solution causes an irritation to the inner lining of the vein resulting in closure of the vein. The
vein stops carrying blood and therefore disappears with time. The majority of people who have
sclerotherapy performed have satisfying results and little discomfort.
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Treatment differs from patient to patient, depending on the extent of the varicosities (size and number).
An average of three to four treatments is required in most cases to achieve a 70%-80% clearing; 100% is not
a realistic goal. The treatment sessions last approximately 15 minutes and are done at four to six week
intervals to achieve optimal results.
Sclerotherapeutic Progress
After completion of the initial series of recommended treatments, successfully treated veins are either gone
or are much less noticeable. However, patients with a history of spider veins tend to develop new ones (with
or without treatment) and a yearly touch up may become necessary. If you have leaking valves in your deep veins,
you will likely continue to develop spider veins if the underlying cause is not treated.
Sclerotherapy is a treatment for spider veins, not a cure.
Laser / Closure Procedure
(Endovenous Saphenous Vein Ablation)
Your physician will develop a treatment plan for your individual case. Varicose veins caused by reflux
in the superficial saphenous vein can be successfully treated with endovenous ablation. Lasers and
radiofrequency ablation (high energy ultrasound) have been used safely for many different medical
applications throughout the body. In recent years, small fibers have been used successfully to deliver
heat energy to treat varicose veins. These methods allow your doctor to close off the diseased superficial
vein that contains leaking valves, thus preventing any further reflux (backwards flow of blood) into your
varicose veins.
The procedure is usually performed in the doctor’s office with numbing medicine and Lorazepam, thus eliminating
the need for hospitalization and general anesthesia. A laser catheter is placed into the diseased vein.
Laser energy is delivered to close off the diseased vein. Recovery is quick. Patients are encouraged to
return to normal activities the day after the procedure. The vast majority of patients have very satisfying
results and little discomfort.
Conservative
Varicose veins may not require any treatment at all if they do not bother you and they don’t cause any symptoms
of aching, swelling or skin changes. Conservative treatment includes life-style changes such as weight loss, exercise,
elevation, and compression stockings. These methods have proven successful in reducing the pressure that builds up
in your veins and can improve your symptoms.
Compression hose
Prescription strength compression stockings aid in the treatment of varicose veins by helping squeeze the blood
back out of your legs, preventing congestion. This may relieve discomfort but patient compliance is very difficult.
Ideally, compression stockings should be worn all day until you are able to elevate your legs at night. Patients
routinely complain of heat and difficulty placing the stockings. However, they certainly do reduce discomfort and
swelling associated with venous reflux and varicose veins.
Ambulatory phlebectomy
Often used after endovenous laser ablation, phlebectomy involves the actual removal of branches of varicose veins
through tiny incisions in your skin that are usually closed with only tape strips. The skin is numbed with a local
injection and special instruments are used to remove the veins through tiny incisions. In most cases, you can resume
normal activities the following day. When you leave the office after phlebectomy, those big bulging veins that have
bothered you for years will be gone!! Tiny spider veins may persist and can be treated with sclerotherapy if they do
not go away.
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