Treating Spider Veins

Patient Information About Sclerotherapy

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.

In most cases they are of a cosmetic concern only, but in some cases they may in fact be related to an underlying medical problem known as venous insufficiency or reflux. In either situation spider veins may be causing you a dull aching feeling. The next few pages will explain what differentiates veins as a cosmetic concern versus a medical problem.

The Circulatory System

Arteries carry oxygenated blood to your legs and the veins carry de-oxygenated blood away from your legs. The blood returns to the lungs to pick up more oxygen and returns to the heart to be pumped out again through the arteries.

The venous system has two components. The first is the deep venous system. It lies below the muscles and transports 90% of the blood away from your legs. It is the system that can get blood clots, which may be life threatening if not treated. It usually has nothing to do with your spider veins.

The second component is the superficial venous system. It transports approximately 10% of blood away from your legs. You can get clots in this system that causes pain and discomfort (superficial phlebitis) but they are not life threatening. The superficial system is the system that involves varicose and spider veins.

Veins have one-way valves that open up as the blood travels upward, and then close down tightly to prevent the blood from leaking back down. The deep and superficial veins both have these valves.

When the deep system has faulty valves (the valves do not close tightly, thereby allowing the blood to leak back down) you will develop profound and chronic swelling. When the superficial system has faulty valves you may develop varicose and spider veins.

Understanding Reflux

The condition that results from these leaky valves is known as reflux. When the blood is refluxing back down the legs it puts excess pressure on the vein walls which causes them to expand. This expansion causes the valves to be even more ineffective.

In the picture above, the black markings represent the deep venous system. The red marking represents the superficial system. The Saphenous Vein is the main tree of the superficial system. Varicose and spider veins are like the branches of the tree.

In the case of varicose veins (big bulging rope like veins visible on the skin), they are almost always related to leaking valves in the Saphenous Vein (the main tree of the superficial system). In rare cases you may have reflux in the saphenous vein that can contribute spider veins without having varicose veins.

Your physician as part of your initial consultation will evaluate you for this condition, it may be necessary to have an ultrasound exam to further evaluate the condition. 

Should an ultrasound confirm reflux in the saphenous system, your spider veins will not respond to treatment without first treating the underlying reflux.  In these cases your insurance company may consider the treatment of the saphenous vein as medically necessary. After the reflux is treated the spider veins will respond better to sclerotherapy.

, once the reflux is treated there is no longer a medical problem and insurance companies consider the remaining spider veins a cosmetic problem.

Dr. Dohner physician will develop a treatment plan for your individual case. Spider veins can be successfully treated with injection sclerotherapy.

Sclerotherapy is a very popular method of eliminating spider veins. A solution called a sclerosing agent is injected into the veins. This solution causes an irritation to the inner lining of the vein resulting in closure of the vein. The majority of persons who have Sclerotherapy performed have satisfying results.

The number of treatments needed differs from patient to patient, depending on the extent of the problem. An average of three to four treatments is required in most cases to achieve a 70%-80% clearing; 100% is not a realistic goal. The treatment sessions are done at four to six week intervals to achieve optimal results.

After the initial series of recommended treatments are completed successfully treated veins are gone, but patients with a history of spider veins tend to develop new ones. However, patients with a history of spider veins tend to develop new ones and a yearly touch up is recommended.

Click here to read about treatment options for spider veins.