Spider veins may seem like a minor cosmetic concern, but their appearance can leave you feeling self-conscious about your legs. Fortunately, sclerotherapy offers a minimally invasive way to treat these unwanted veins by injecting a specialized solution that causes them to close and gradually fade over time.
At Inovia Vein Specialty Centers, we offer personalized sclerotherapy treatments to help patients achieve clearer-looking legs. Our experienced vein specialists provide care for patients in Portland, OR, and Vancouver, WA.
Sclerotherapy for Spider Veins
Sclerotherapy can be performed in different ways depending on the size and location of the veins being treated.
Visual sclerotherapy is commonly used for small spider veins that can be easily seen at the surface of the skin. Your provider identifies the unwanted veins visually and uses a very fine needle to inject the sclerosing solution directly into them.
For larger veins beneath the skin, your provider may recommend ultrasound-guided sclerotherapy (USGST). Ultrasound imaging lets your provider see the vein below the skin, guide the needle to the right location, and monitor treatment more precisely.
The sclerosing medication may be administered as a liquid or prepared as a foam. Foam sclerotherapy can be particularly useful when treating larger veins with ultrasound guidance because the foam can effectively contact the inner walls of the targeted vein.
What Solutions Are Used for Sclerotherapy?
Modern sclerotherapy typically uses medications specifically designed to close unwanted veins. At Inovia Vein Specialty Centers, the solutions used include:
- Sodium tetradecyl sulfate (Sotradecol): A sclerosing medication that irritates the inner lining of the targeted vein, causing it to close.
- Polidocanol (Asclera): Another commonly used sclerosing agent that works similarly to close treated veins.
The appropriate medication and concentration can vary based on vein size, location, and your treatment goals.
In the past, hypertonic saline, sometimes called a salt solution, was frequently used for sclerotherapy. Although inexpensive, injections could cause considerable burning and discomfort, and ulceration at the injection site was another concern. For these reasons, Inovia Vein Specialty Centers does not use hypertonic saline.
Both Sotradecol and Asclera provide modern alternatives. Once injected, these solutions affect the endothelial cells lining the inside of the vein. The treated vein closes, and the body gradually breaks it down as blood is redirected through healthy veins.
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The Sclerotherapy Procedure
Sclerotherapy is a quick, in-office procedure that typically takes 15 to 30 minutes and does not require anesthesia. The treatment generally involves the following steps:
- Before Treatment: Your provider may take photographs of the targeted veins to document their appearance and track your progress.
- Positioning: You will lie on your back with your legs slightly elevated for the procedure.
- Preparing the Area: Your provider will cleanse the treatment area before administering the injections.
- Injecting the Solution: Your provider uses a very fine needle to inject the sclerosing solution into the affected veins. You may feel mild stinging or burning that usually fades quickly.
- Treating Multiple Veins: Depending on their size, some veins may require multiple injections, and providers can treat several veins in one session.
What Happens After Sclerotherapy?
After the injections, the provider applies compression to the treated areas. A compression stocking is then placed while you are still lying down to help support the treated veins.
You will generally be instructed to:
- Wear your compression stocking overnight following treatment.
- Continue wearing it during the day for approximately one week.
- Remove the stocking at night after the first night.
- Return to work as early as the following day.
- Resume regular activities, including exercise, the day after treatment unless instructed otherwise.
A follow-up appointment is generally scheduled within one to two weeks. At this visit, your provider can evaluate how the treated veins are responding and, when appropriate, compare your progress with photographs taken before the procedure.
Spider veins usually do not disappear immediately after sclerotherapy. Instead, the treated veins gradually become less noticeable as the body responds to treatment and the closed veins fade.