What Are Spider Veins?
Spider veins are much finer than varicose veins. This makes treating spider veins easier than treating varicose veins, in some respects, but there are also fewer treatment options. Since spider veins are so fine ( i.e., they have a small diameter compared to varicose veins), it is impossible to sneak a cannula into them, as a vein specialist might do to treat varicose veins. On the other hand, sclerotherapy is more effective at treating spider veins than it would be in treating large varicose veins. Moreover, spider veins can be treated with noninvasive surface laser procedures whereas larger varicose veins cannot.
Spider Vein Treatment: Sclerotherapy
Sclerotherapy is the preferred spider vein treatment. While multiple treatments may be necessary, a single treatment can result in 70 to 80% clearance of spider veins.1 In sclerotherapy, a solution is injected into the spider vein that eventually destroys it. The injected substance (sclerosing agent) irritates the walls of the vein, causing it to swell, close off, and block the flow of blood. Your vein specialist may or may not use a topical or local anesthetic to numb the treatment area. In some cases, a numbing agent is added to the sclerosing agent to help minimize discomfort. Sclerosing agents include liquids, foams, or glues.
The main sclerosing agents used to treat spider veins are
- Concentrated saline
- Sodium tetradecyl sulfate
- Chromated glycerin
Your doctor may compress or massage the area around the vein after the injection. In cases of larger veins, a compression pad may be applied with tape to compress the area. Many times, a doctor can treat numerous veins in a single session, which will last between 15 minutes and an hour. No hospitalization or recovery time is needed for any type of spider vein treatment. Typically, bruising and mild local pain are the only side effects. One advantage of sclerotherapy for spider vein treatment is that it can cover a rather large area of veins. On the other hand, if the sclerosing agent moves out of the vein it can cause pain and ulcers, though this occurs in less than 5% of patients. Talk with your vein specialist about the advantages and disadvantages of sclerotherapy for spider veins.
Spider Vein Treatment: Laser
The major advantage of laser spider vein treatment is that it is a non-invasive procedure. There are no incisions or injections. In laser spider vein treatment, a medical laser or intense light source is applied to the surface of the skin. The wavelength of light targets molecules within the vein, such as hemoglobin. The laser light energy excites the hemoglobin molecules heating them and essentially destroying the spider vein. Surrounding skin, muscle, or other tissues are only mildly affected, if at all.
Since laser treatment does involve heating the spider vein, your vein specialist will typically administer local or topical anesthesia. The procedure can take 20 minutes to an hour, depending on the extent of your spider veins. Once the laser has sealed the vein, your body will slowly reabsorb it. It is important to note that, multiple treatments are usually needed to achieve an optimal effect. Likewise, it may take weeks for the full effects of these laser or sclerotherapy procedures to become apparent. Many people notice an immediate decrease in the intensity of the spider vein after treatment, followed by a gradual fading.
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Medically reviewed by Dr. Susanne Woloson on 5-01-2020.
- Mujadzic M, Ritter EF, Given KS. A Novel Approach for the Treatment of Spider Veins. Aesthet Surg J. Sep 2015;35(7):NP221-229. doi:10.1093/asj/sjv004