“I won’t wear shorts in the summer” is often a statement patients with unsightly spider veins make about their legs. Between 30% and 60% of American adults have spider veins and many of them feel uncomfortable wearing shorts or dresses as a result.
What can be done to improve the appearance of spider veins?
Sclerotherapy is a great and effective treatment to help minimize and in some cases, eliminate spider veins. This office-based procedure typically takes less than an hour and involves injecting an FDA approved solution called Asclera directly into the vein. This causes the vein to close, forcing blood to reroute through healthier veins. The collapsed vein is then reabsorbed into tissue and eventually fades. While laser treatment options exist, injectable treatments remain the gold standard for the correction of most spider veins. This is because the laser treatments are typically limited to a specific depth. Injectables allow for more customized treatment of unsightly veins.
Bulging varicose veins can be painful and are usually too large to be treated with injectable medication. This type of issue should be evaluated by a vein specialist, and in many cases, is coverable by insurance. We can refer our patients to a vein specialist in our area if we believe sclerotherapy will not be successful due to size and severity of varicose veins.
Our practice specializes in the cosmetic treatment option only, that is, spider veins that remain after treatment by a vein specialist, or spider veins in those who do not have large, bulging veins. This type of treatment is considered cosmetic, and therefore is typically not covered by insurance.
When is the best time for treatment?
Fall and Winter bring cooler weather and are typically the best time for a sclerotherapy treatment. We do not perform Sclerotherapy in the summer as the heat will make the post treatment stockings very uncomfortable to wear and patients have a greater chance of darkening of the skin (hyperpigmentation) in the treatment sites due to sun exposure. Patient evaluation is also important in determining timing of treatment. While pregnancy can cause the occurrence of visible spider veins, treatment is avoided while pregnant or breast feeding. People with severe allergies may also not be a candidate for sclerotherapy.
What to expect during and after treatment
The treatment is performed by a medical provider using a tiny needle and is mildly uncomfortable. After the treatment, it is strongly recommended that patients wear compression hosiery for the first 24 hours and then while awake for three weeks. This helps maintain compression on the treated veins in the legs. 15-20 mm HG is the strength of compression hose we recommend based on scientific research studies on optimal outcomes. These can be purchased online. They should be brought to the appointment and applied immediately after the treatment. We also recommend bringing walking shoes to take a 20 minute walk following the treatment. Walking and moving your legs helps to prevent the formation of blood clots. If weather does not permit a walk outside, you can make a shopping trip to Target or the grocery store and get some laps in!
You should be able to return to your normal activities the day of your procedure. However, your provider will likely suggest that you avoid strenuous exercise for two weeks after the procedure. During that time, you should also avoid sun exposure to the treated areas. The injections cause inflammation, and when combined with sun exposure, can produce dark spots on your skin, especially if you have a darker skin tone.
Depending on the amount of veins present, more than one treatment may be required, but once the desired outcome is achieved, it may be many years before more veins may become visible. Your legs can be beautiful again!