Sclerotherapy remains the gold standard for treating spider veins and varicose veins. Sclerotherapy involves injecting a sclerosing agent directly into spider veins and varicose veins, causing them to collapse, get reabsorbed, and fade away. The combination of sclerotherapy treatment and V-Beam laser treatment are the best non-invasive methods to remove these unsightly veins and blood vessels without any discomfort or down time. Dr. Michele Green is an expert in sclerotherapy and non-invasive cosmetic dermatology, and has been treating and removing these unwanted spider veins for over 25 years in her boutique, private, NYC office. Dr. Green is an expert in treating these spider veins with both injections and lasers, to give you the best cosmetic results.
Spider veins, also known as telangiectasia, and varicose veins are conditions that commonly affect both women and men and increase in prevalence as we age. The condition is more common in women than men, and it is believed to be both genetically and hormonally mediated in women. One of the causes of varicose veins is due to the weakening or damaged valves in the veins themselves. When blood collects in the veins, the blood expands the size of the veins, making them appear varicose. Both spider veins and varicose veins are generally not linked with serious health conditions, but they are unsightly and can be uncomfortable. For these reasons many individuals seek treatment, as they are self-conscious about these spider veins and shy away from wearing shorts or dresses, which expose their legs.
Thanks to sclerotherapy and the laser treatment of spider veins and varicose veins, there is no need to cover up your leg veins during the summer months. Approximately twenty percent of adults suffer from varicose veins. With so many patients having spider veins and varicose veins, it is no wonder that more than 300,000 sclerotherapy treatments are performed in the United States each year. Dr. Michele Green has treated thousands of patients for unwanted veins in her NYC office. She will review with you all of the best treatment options to remove your unsightly leg veins, and have you return to beautiful clear legs.
What is sclerotherapy?
Sclerotherapy involves directly injecting a sclerosant, or liquid medicine, directly into damaged leg veins, forcing the veins to scar, shrink, disappear and rerouting the blood to healthier veins. FDA-approved sclerosants available in the United States include sodium tetradecyl sulfate (a detergent) and polidocanol (Asclera). In the past, hypertonic saline was used as a sclerosant, but it had the disadvantage of causing increased matting or neo-vascularization, pain, and skin discoloration.
How does sclerotherapy remove spider veins?
Spider veins are smaller than varicose veins and the affected veins can be treated with a sclerosing agent, which destroys these small veins painlessly, with minimal recovery time. Some physicians utilize foam sclerotherapy to treat larger varicose veins.
Who is a candidate for sclerotherapy?
A good candidate for sclerotherapy is someone in good health and wants to eliminate varicose or spider veins either for cosmetic reasons or medical ones. If you are concerned that you might have underlying venous disease, it is best to consult with a vascular surgeon or other qualified healthcare professional. It is important to determine if there is underlying arterial or venous insufficiency. Venous insufficiency predisposes one to increased blood clots, leg swelling, and skin ulcerations. Many patients benefit from having sclerotherapy who are suffering from aching, swollen, burning, or night cramps.
If you are pregnant, you may not be a candidate for sclerotherapy. If you are taking oral contraceptive you may not be a good candidate. A history of blood clots would also be a contraindication for sclerotherapy treatment. If you are actively smoking, you are not a good candidate since this can also cause an increased risk of blood clots.
How to prepare for your sclerotherapy treatment?
It is best to avoid blood thinners, such as aspirin, Aleve, Motrin (ibuprofen) and other anti-inflammatory medications, vitamins, and herbal supplements for at least one week before your sclerotherapy treatment. Some patients require pre-treatment with an oral antibiotic, and this should be discussed during your consultation with Dr. Green. It is best no to apply any lotions or creams to the treatment area immediately before your sclerotherapy injections. Avoid waxing or shaving the treated areas within 24 hours before your procedure.
Spider vein and varicose vein treatment with sclerotherapy
If you are a good candidate for sclerotherapy, a topical numbing cream will be applied before the procedure to the injection site, to minimize any localized discomfort from the injection of the treated veins. The treatment areas are cleaned and multiple injections with a very fine needle are performed directly into the veins. The sclerosant is injected into the spider veins or varicose veins, causing them to scar and collapse internally. The treatment itself can take 30 minutes or more, depending on the extent of the veins needing treatment.
After your sclerotherapy, the treated areas are wrapped with a long-stretch bandage to add extra pressure and support hose are recommended after treatment for both spider veins and reticular veins. You can return to most normal activities directly after your sclerotherapy treatment. Dr. Green will schedule a follow-up visit for you approximately one month after your procedure to check your progress and your next treatment session.
Instructions after sclerotherapy treatment
After sclerotherapy treatment, you will be instructed to wear compression stockings for one week. These stockings help to “compress” the treated vessels, and make the treatment results more effective. It is important to avoid the following for the next 48 hours
- Airplane travel
- Hot baths
- Direct exposure to sunlight or sunbathing to the treated areas
- Avoid heavy exercise
What are the side effects of sclerotherapy
There are mild localized side effects and more serious potential allergic reactions associated with sclerotherapy. Localized side effects include:
- Red areas or raised bumps at the injection site which should disappear within a few days
- Allergic reaction at the treatment area
- Bruising near the injected vein can last for days or weeks
- Larger veins can develop hard lumps which may take months to dissipate
- Discoloration or hyperpigmentation can develop as a result of the injections
- Neo-vascularization can occur with the development of new minute blood vessels, which are called telangiectatic matting
More serious side effects, which require immediate medical intervention include:
- Development of small ulcers at the injection site
- A sudden swollen leg
- Signs of inflammation or infection
- Deep vein thrombosis (DVT) and pulmonary embolism
- Risk of blood clots
- Necrosis due to inadvertent injection of sclerosant into an artery.
What is the Process of Sclerotherapy Treatment for Spider Veins?
The good news is that both spider veins and varicose veins can be treated effectively. If you have painful and unsightly spider or varicose veins, sclerotherapy may be the solution for you. Dr. Green uses the FDA -approved sclerosant Asclera® (polidocanol), which irritates the lining of the blood vessel, causing it to seal up and become invisible. After the vein collapses, the body slowly absorbs the remaining tissue over time until the skin becomes smooth and blemish-free. Sclerotherapy has even been used to treat patients with venous malformations.
Patients can expect a sclerotherapy session to last anywhere between fifteen and forty-five minutes in length, depending on the amount of veins needing injection. Asclera® is is injected directly into each vein, with a fine needle, and multiple injections are carried out in a single treatment session. It should be noted that most patients will require more than one treatment session, and these are typically spaced one month apart to allow the sclerotherapy treatment to heal and the spider veins to disappear. The average number of sclerotherapy sessions are four treatments, although that number can vary based on the amount of spider veins present.
VBeam laser treatment for spider veins
VBeam laser treatment is the gold standard to treat small red veins or capillaries on the skin, including the face, chest, back, arms, and legs. The VBeam is a pulsed dye, non-ablative laser, which is designed to remove vascular lesions, rosacea, redness, and pigmentation. Dr. Green utilizes the new VBeam Perfecta, which is the gold standard laser therapy to treat redness. The laser delivers a burst of energy that is intense enough to treat the targeted blood vessels, but gentle enough to preserve the surrounding tissue and ensure patient comfort.
Which is better for spider veins: sclerotherapy or laser treatment?
If a vein is large enough to have a needle injected, sclerotherapy is the treatment of choice for spider veins. However, small veins, or matted veins respond much better to laser therapy with the VBeam laser, and have no recovery time after treatment.
How much does sclerotherapy cost?
The cost for sclerotherapy depends on the size of the treatment area the the modality of the treatment, whether it be injections or laser treatment. In addition, a board certified dermatologist, who is highly experienced in treating leg veins may be more expensive than a general practitioner.
Does sclerotherapy hurt?
Sclerotherapy with Asclera is slightly uncomfortable, but not painful. In the past, dermatologists used hypertonic saline which was much more uncomfortable. To minimize any discomfort, Dr. Green will prescribe a topical numbing cream that you can apply to your legs one hour before to the treatment area.
How long does sclerotherapy last?
The results for sclerotherapy can last for several years. However, if you are prone to having spider veins, new ones can appear sooner and there is no way to prevent their formation.
Is sclerotherapy permanent for spider veins?
Sclerotherapy will treat unwanted varicose and spider veins and remove them. However, due to age, genetics, or hormones, new leg veins can appear which will require treatment.
How many sessions of sclerotherapy are needed for spider vein treatment?
The number of sclerotherapy sessions depends on the number of veins and extent of the treatment area of your spider veins. Typically four treatment sessions are needed. Treatment sessions should be scheduled approximately one month apart and it is best to have your leg veins injected during the winter months, since the main side effect is temporary bruising. By having sclerotherapy of varicose veins performed over the winter, the bruising from the injections will not interfere with your plans, and your legs will be clear by summer.
What other treatment options are available for varicose veins?
Other treatment options for varicose veins include compression stockings, endogenous laser ablation, radiofrequency ablation, and conventional vascular surgery.
Is sclerotherapy covered by insurance?
Sclerotherapy is a cosmetic procedure and most insurances do not consider it a medically necessary procedure. It is always best to consult your individual insurance company to verify your benefits and eligibility.
How do I get started with treating my spider veins?
Dr. Michele Green is a board-certified dermatologist based in NYC and an expert in a wide variety of cosmetic injections, including sclerotherapy and laser treatments to treat spider veins. With over 25 years of experience in dermatology with treatments such as Botox, chemical peels, Juvederm injections, microneedling, skin tightening, and CoolSculpting, Dr. Green will give you the best cosmetic results. When seeking treatment, it is important to consult with a dermatologist who is experienced and highly trained in treating leg veins. Find out more about the latest cosmetic procedures by calling 212 535 3088 or contact us online to arrange an appointment.