Spider veins can be a problem for many people. You are not alone in your desire to rid yourself of these unsightly veins. You may have had them for years or they may have just recently become a problem for you.
Spider veins – known in the medical world as telangiectasias or sunburst varicosities – are small, thin veins that lie close to the surface of the skin. Although these super-fine veins are connected with the larger venous system, they are not an essential part of it.
A number of factors contribute to the development of spider veins, including heredity, pregnancy and other events that cause hormonal shifts, weight gain, occupations or activities that require prolonged sitting or standing, and the use of certain medications.
Spider veins usually take on one of three basic patterns. They may appear in a true spider shape with a group of veins radiating outward from a dark central point; they may be arborizing and will resemble tiny branch-like shapes; or they may be simple linear and appear as thin separate lines. Linear spider veins are commonly seen on the inner knee, whereas the arborizing pattern often appears on the outer thigh in a sunburst or cartwheel distribution.
A very small gauge needle is used to perform the injections. Most patients relate the discomfort to that of an ant bite.
Often you will see the spider veins on the surface of your legs but may be unaware of a network of veins not so visible which may be feeding the spider veins called feeder veins.
We will first look at your legs with an illuminating light which helps us to identify any feeder veins. In some cases the feeder veins may be extensive and in other cases minimal. This will be part of what your physician bases the estimated number of treatments you may need.
If you have extensive feeders your first treatment(s) will concentrate on these veins using pain-free foam for injection. Since you could not see them you may not notice a dramatic change in the appearance of your legs initially. In most cases you will see the most impressive changes after the second and third treatment with pain-free glycerin for your smaller spider veins.
Your treatment sessions will take approximately 30 minutes. We are limited to the amount of medication we can inject because of maximum dosage limits specific to the medication we use.
We try to treat as many veins as possible during your session. If there are specific veins that bother you more than others, please make us aware of those veins so we can start with those first.
After your treatment the veins we be red and irritated as shown above. There may be welts at the site of injection which are a normal histamine reaction. The areas treated may be itchy for an hour or two after the treatment.
Post Treatment Expectations
After your treatment you will need to put on your compression hose. We ask that you wear the hose during the day for one week following your treatment, removing them to sleep.
Your legs may be uncomfortable for several days. We encourage walking for twenty minutes twice a day to promote healing. If you are involved in an exercise program you may continue as tolerated.
You may notice a significant amount of bruising, this is normal and to be expected. The bruising will fade in approximately ten days to two weeks.
Please avoid any hot tub baths for ten days as this will decrease the effectiveness of the treatment.
After your treatment you may notice that you have dark lines where your veins were. This is where the veins have closed down and there is no longer any flow through the vessel. Blood has gotten trapped inside the vein and it appears dark. This is actually a good sign that the treatment was effective. The degree of pigment changes varies greatly based on the extent and type of spider veins you have.
If you have very prominent raised spider veins the trapping of blood may be more significant as demonstrated in the picture on the left. In these cases, during your next treatment session we can “flush” the area out with an anesthetic solution. This helps to break up the trapped blood so the body can absorb it more easily.
The picture on the right demonstrates mild hyperpigmentation which can occur with any type of spider veins. This degree of hyperpigmentation requires no treatment and will fade gradually.
Ninety percent of all hyperpigmentation left untreated will fade with time, sometimes taking up to one year. It is rare that pigmentation changes are permanent.
Realistic Expectation of Results
It is important to remember that it has often taken years for these veins to develop, and they will not disappear overnight. We will give you an estimate of how many treatments you will need. It is important to keep a regular schedule of treatments every four to six weeks for the prescribed number of treatments.
It is reasonable to expect a 70%-80% clearing of your spider veins, however some people will just not respond well to the treatments and we have no way of knowing how you will respond. It is not realistic to expect 100% clearing.
Remember, once your have achieved the expected results, new veins will develop over time. We recommend a touch up session every six to twelve months as needed.
We look forward to helping you improve the appearance of your legs.