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Spider veins are tiny, dilated blood vessels which appear to project outward from a vein like the legs of a spider. They are actually smaller versions of varicose veins lying close to the surface of the skin. Spider veins can be symptomatic, causing itching, burning, aching, bleeding or clotting. Typically they are merely a cosmetic nuisance and serve no useful function for the body.

The precise cause of these unwanted vessels is still the subject of investigation. However, we believe they develop as a result of a complex interplay of genetic, hormonal and environmental factors. There is often a strong family history responsible for their formation. You might find, for example, a mother, daughter and sister suffering the same problem. Hormonal factors including puberty, pregnancy, menopause, and the use of birth control pills increase your chances of developing spider veins. Other factors, including prolonged standing, obesity and trauma to the leg can aggravate the problem.

Alsara Vein Clinic is a specialty clinic treating most types of leg veins. We have many tools available and one of our Board Certified Providers will determine which procedure would be ideal for your individual needs. Frequently we use a combination of tools since surface veins come in different shapes and sizes and have variable sources. Typically we like to identify the source by using ultrasound, or a special light which allows us to see deeper into the skin. By nailing down the source, we can get you better, long-term relief in fewer sessions.

Injection Sclerotherapy remains the gold standard treatment and the most common method for getting rid of spider veins on the legs. Sclero literally means “scar.” Sclerotherapy works by irritating the lining of the unwanted blood vessels to such an extent that they collapse upon themselves and eventually scar over and disappear from view entirely. The success of the sclerotherapy relies upon the experience and skill of the provider. Choosing the right sclerosant, target, volume, concentration and “exposure time” make the difference between success and failure.

We first scan the affected areas using ultrasound looking for any “feeder” veins beneath the skin surface. If present, we use Ultrasound Guided Sclerotherapy to close an entire cluster of spider veins at its source beneath the skin that is otherwise not visible from the surface. Any remaining visible spider veins are then treated using injection sclerotherapy where medication (sclerosant) is injected directly into the affected surface veins. We use Ohmic Thermolysis or Surface Laser for veins that are either too small for sclerotherapy or located in areas where sclerotherapy is not recommended. Ohmic thermolysis and Laser use the spectrum of light that targets spider veins from the outside and closes them by heating the hemoglobin within the affected veins.

Larger surface veins can also be removed by microphlebectomy which is a minimally invasive procedure. Using very fine instruments, the unwanted bulging surface veins are removed through miniscule openings without the need of sutures and topically without causing any scanning.

You may experience mild itching, which can last for one or two days after the procedure. Also, you may experience raised, red areas at the treated site. These should disappear within a few days. Bruising may also occur around the injection site and can last several days or weeks.

If you had sclerotherapy, you may experience the following:

•  Larger veins that have been injected may become lumpy and hard and may require several months to dissolve and fade.
•  Brown lines or spots may appear at the vein site. In most cases, they disappear within three to six months, but they may also last longer and in rare cases, indefinitely.
•  Neovascularization or matting – the development of new, tiny blood vessels – may occur at the site of sclerotherapy treatment. These tiny veins can appear days or weeks after the procedure but typically fade within three to twelve months without further treatment.

Post-sclerotherapy bruising is frequently a result of trapped blood in treated veins and can occur due to inadequate compression, walking, or failure to identify and treat “feeder” veins which flow into the spider veins. Bruising typically resolves in 2-3 weeks. Sometimes aspiration of trapped blood may reduce bruising swiftly. You may also notice discoloration or hyperpigmentation that may last for several months depending on several factors including skin characteristics, use of antibiotics such as minocycline and intake of iron supplements.