Almost everybody knows someone with spider veins or small varicose veins. Patients who have noticed the appearance of small vessels on their legs, ankle, or face might have many questions about treatment options at a vein clinic. Sclerotherapy is the most commonly used treatment for these small vessels.
Most patients with spider veins seek treatment because of cosmetic concerns. After an initial consultation, a vein doctor will indicate whether the individual is an acceptable candidate for this so-called gold standard of spider vein treatment. Physicians also use the outpatient procedure for small varicose veins. Many patients need to undergo ultrasound imaging prior to the procedure, especially if the vein doctor plans to treat veins in the legs. The Mayo Clinic suggests arriving for the appointment wearing shorts or other loose clothing and using no body lotion for the preceding 24 hours. During the procedure, patients are on a table on their backs. Their legs are elevated. After cleansing the area to be treated, a vein doctor injects a special liquid or foam called a sclerosant into each targeted vein using a fine needle. Some sclerosants are manufactured with lidocaine, which is a type of local anesthetic. The injected substance irritates the lining of the vein, which eventually swells shut and disappears from view. Other veins nearby take over the duties of the destroyed vessel. Doctors consider this procedure noninvasive. Each session usually takes less than one hour. The number of treatments a patient needs depends on the number and the size of targeted vessels. At most, patients cite minor stinging or cramping when the physician inserts the needle. After withdrawing it, the vein doctor applies pressure and gently massages the treated area to help the sclerosant disperse. Walking or generally moving around after treatment is essential to help prevent any blood clots. Discharge orders specify how long patients should wear compression stockings after a session. Although they must avoid strenuous exercise until the physician allows it, most get back to their regular schedule the same day as the procedure. Physicians also advise patients to stay out of the sun after treatment to avoid the formation of dark spots on their skin. According to UCLA Health, some patients experience cramping that requires no medication for one or two days. Bruising usually lessens in a month or less.
Use of sclerosants is a highly successful way to treat spider veins. The Cleveland Clinic reports that more than 90 percent of patients respond to this type of treatment. Doctors estimate that each session destroys 50 to 80 percent of vessels targeted for treatment. Results for most spider veins are obvious within six weeks after treatment. It can take larger vessels three to four months to respond.
