Spider veins are small superficial blood vessels that appear red or blue in the skin. They commonly occur on the legs, but are also found on the face or other areas of the body.

Larger dilated blood vessels called varicose veins may be raised above the skin surface. They may occur with spider veins.

If spider veins are bothersome, they can be treated with laser or by injection of a special solution that can destroy them. They can disappear or become much smaller. There is about an 80 - 90 percent chance for a greatly improved appearance.

The injection method is a procedure called sclerotherapy. One of several kinds of solutions called sclerosing solution is injected into the blood vessel with a very fine needle. The solution irritates the lining of the vessel causing it to swell, stick together, and the blood to clot. Over a period of weeks, the vessel turns into scar tissue that fades, eventually becoming barely noticeable.

A single blood vessel may have to be injected more than once, some weeks or months apart, depending on its size. A number of vessels can be injected in any one-treatment session.

The injection solutions available are slightly different, and the choice of which to use depends on several factors including the size of the vessel. Your dermatologist will choose a solution that is best for your particular case.

How successful is sclerotherapy?

Before treatment	After treatment

After several treatments, most patients can expect an 80 - 90 percent improvement. Fading will gradually occur over months. Disappearance of treated spider veins is usually achieved, but similar veins may appear in the same general area.

What about lasers?

Wavelengths of light are absorbed by the hemoglobin in the blood vessels to destroy them. Your dermatologist will recommend the best type of laser for you.

Can sclerotherapy or lasers be used on all skin types?

Yes. All skin types and skin colors respond well, although some skin types require special lasers.

Are there side effects to sclerotherapy?

There are some possible side effects. They include:

• Stinging or pain at the sites of injection, swelling of the ankles or feet, or muscle cramps. This usually occurs whenhypertonic saline solution is used. Hive-like reactions usually go away within 10 to 15 minutes after injection.

• Red, raised areas at the sites of injection. These are similar to hives and the response should disappear within a day or so.

• Brown lines or spots on the skin at the sites of treated blood vessels. Darkened areas may result when blood escapes from treated veins and are probably formed from iron in the blood. These dark areas occur more often in patients who have larger veins treated or those patients that tan easily. In most cases, they disappear within a year, but they may last longer.

• Development of groups of fine red blood vessels near the sites of injection of larger vessels. About one-third of patients develop groups of vessels especially on the thighs. Most disappear by themselves, some need additional injection treatments or laser therapy, a few may last.

• Small, painful ulcers at treatment sites either immediately or within a few days of injection. These occur when some of the solution escapes into the surrounding skin or enters a small artery at the treatment site and can be successfully treated, but it is necessary to inform the dermatologist immediately.

• Temporary bruises. Bruises usually occur after laser treatments and are probably related to the thinness of blood vessel walls. They usually disappear in a few weeks. Occasionaly, bruising is seen with sclerotherapy.

• Allergic reactions to sclerosing solutions. Although such reactions are uncommon, they can be treated. Inform your dermatologist immediately.

• Inflammation of treated blood vessels. This is very unusual but when it occurs, it is treated with medications such as aspirin, compression, antibiotics, or heat.

• Lumps in injected vessels. This is coagulated blood and is not dangerous. The dermatologist may drain the blood from these areas a few weeks after injection.

Will treated veins recur?

Large veins may recur even after surgical procedures. Spider veins may also recur. It may seem that a previously injected vessel has recurred when, in fact, a new spider vein has appeared in the same area