Sclerotherapy is a simple procedure for treating spider veins that has been used in Europe for at least five decades. It has crossed the pond and started to get popular in the U.S. in the last ten years. In recent years, very mild sclerosing agents have become available. This makes the procedure safe and relatively painless.


If you are looking for a means to improve the appearance of your legs, this informational section can give you a good overview of this treatment method. It covers basics like who should consider it, what is involved and what you can expect. Do keep in mind that this is a general overview. It is not intended to cover all possible questions. For specific questions related to individual circumstances, you can ask Dr. Leonard about any of your concerns.

Diminishing Unsightly ‘Spider Veins’

Millions of people have spider veins. They are small, unsightly veins near the surface of the skin that mar one’s complexion. They most often appear on the legs, predominantly the thighs, calves and ankles and sometimes just above the knee. They can be red, blue or purple. It is likely that more than half of the adult women have them. It is primarily a cosmetic issue, though it is sometimes associated with more serious problems.

Today, it is typically treated by plastic surgeons using a technique called sclerotherapy. This involves injecting the small veins in question with a sclerosing solution. This agent causes them to collapse. Over time, the collapsed veins fade. Although the condition is primarily cosmetic, spider veins also can cause irritating symptoms, such as burning, aching, swelling and night cramps. Schlerotherapy not only improves the cosmetic appearance, it often reduces these unpleasant associated symptoms.

What Are Spider Veins?

There are two medical terms for this condition: telangiectasias or sunburst varicosities. Very small blood vessels near the surface of the skin are more visible than usual for some reason. They are connected to the cardiovascular system, but they can be safely removed without harming overall circulation.

Some people are especially prone to spider veins due to heredity. Other things that can promote their occurrence include weight gain, various medications, jobs or activities that involve long periods of standing or sitting, pregnancy and other hormonal events.

They get called “spider veins” because one of the common appearances is a dark central point with veins radiating out from it like spider legs. However, some look more like a small tree branch and others appear as individual lines. Typically, linear are found on the inner knee. More extensive patterns are often found on the outer thigh.

Spider veins are not varicose veins, which are larger, deeper and a more serious condition. Although sclerotherapy can sometimes be used to treat varicose veins, they usually require surgery instead.

The Best Candidates For Sclerotherapy

The best candidates are typically between the ages of 30 and 60. Although some people develop spider veins as early as their teens, these tend to develop later in life and some people do not see their first spider veins until after age 40. Treating them early while one is still young is generally a good idea.

The best candidates are not currently pregnant nor breastfeeding. Pregnant women should wait until the baby is at least three months old because spider veins sometimes disappear on their own after the baby is born. This can be a temporary side effect of pregnancy. It is not known what effect sclerosing solutions have on breast milk, so the conservative answer is to not have this procedure while lactating.

Men can get spider veins and can get them treated with sclerotherapy. They often don’t really consider spider veins to be a noteworthy issue, in part because men do not typically shave their legs, so leg hair usually obscures their spider veins.

What to Expect From Sclerotherapy

Sclerotherapy will generally cause spider veins to fade and be less noticeable. However, it can take two or more sessions to get the best possible results. Each session will reduce their visibility, but they may not ever be completely eradicated.

Furthermore, even if current spider veins are made invisible, this procedure does not inoculate anyone against getting new spider veins. Before making a decision, you should get clear in your mind what you are hoping for and talk with Dr. Leonard about how realistic your expectations are.

Risks Related to Treatment

When the procedure is performed by a trained professional like Dr. Leonard, serious medical complications are rare. Although rare, the procedure can cause blood clots, severe inflammation or permanent scarring. Some people also have an allergic reaction to the sclerosing solution.

Although not dangerous, a common irksome complication is pigmentation irregularity. This can result in brown patches that can take up to a year to resolve. Sometimes red blood vessels appear around the treated area. This necessitates further treatment to resolve.

The best way to mitigate your risks is to choose a talented physician like Dr. Leonard. He has proper training in sclerotherapy and is knowledgeable about the various available sclerosing agents. Dr. Leonard can help you choose the right sclerosing medication for your needs.

Planning Your Treatment

The initial consultation starts with an examination of your legs. In order to map out the presentation of spider veins in your case, Dr. Leonard may make a sketch of your legs. You will also be checked for indications of deep vein issues, such as sores or swelling. Where appropriate, a small Doppler ultrasound device may be used to detect venous back flow.

When such problems are found, Dr. Leonard may refer you to a another doctor. Deep vein problems are more serious than spider veins and must be resolved before pursuing sclerotherapy.

You will also be asked about any other leg problems you may have, such as pain, itching or tenderness. Your medical history will be reviewed, along with a list of whatever medications you are on. Blood-borne conditions, like hepatitis or AIDS, are contraindications for sclerotherapy. Heart disease, circulatory problems, and diabetes can also be contraindications

Dr. Leonard will explain the procedure, its risks and benefits, and the costs. Keep in mind that cosmetic procedures are not typically covered by medical insurance. If you have any questions or concerns, the initial consult is a good time to bring them up.

Preparing For The Procedure

You will be given written instructions. These need to be followed carefully.

You should not to apply any of the following to your legs the day of treatment: moisturizer, sunblock or oil. You bring shorts to wear for the duration of the procedure, plus physician-prescribed support hose and long pants to wear afterwards.

Your legs may be bruised or discolored for several weeks. You should plan to keep them covered until this is fully resolved.

Where Your Treatment Will Be Performed

Sclerotherapy does not require anesthesia. It is typically handled on an outpatient basis. In most cases, it will be performed in Dr. Leonard’s office.

The Procedure

Most sessions take between 15 and 45 minutes. You put on a pair of shorts and then a photographic record of your legs is made. This will go in your medical records. You then lie down on the exam table. The skin in affected gets cleaned with an antiseptic, then pulled taut so the vein can be injected.

Typically, somewhere between five to forty injections occur per session. After each injection, a cotton ball and compression tape get applied.

Some people distract themselves by listening to music or reading. You will periodically need to adjust your position. Some people report a mild burning sensation.

After Your Treatment

Many people need to wear tight-fitting medically prescribed support hose for 72 hours or longer. This helps protect against the formation of blood clots. You can remove the cotton balls and tape after 48 hours.

Leg cramps are a common side effect in the first day or two. It isn’t serious and typically resolves on its own without treatment. You will also have bruising and discoloration that can take some weeks to resolve.

Getting Back to Normal

You probably won’t want show off your legs for at least two weeks, but this treatment will not seriously limit your activities. Walking can help reduce the odds of developing blood clots. You should avoid prolonged standing or sitting, as well as jogging, heavy weight lifting and similar stressors.

You must wait one month before getting additional treatment for the same sites. With each treatment, you will see additional improvement.

Your New Look

With the spider veins drastically reduced, your legs will look younger and healthier. The long skirts and long pants used to cover them may stop being your fashion staple as you revel in showing off more leg. The improvement can be surprisingly dramatic. Some people occasionally come back for touch up treatments as new spider veins develop, but the old ones will be permanently gone.

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