Treatment of Spider Veins on the Legs: Sclerotherapy
At NoviSkin, we concentrate on the treatment of telangiectasia and small reticular veins (veins smaller that 3mm in diameter). We mainly use Sclerotherapy, which is the treatment of choice for smaller asymptomatic veins. A sclerosing agent, called polidoconal is injected in small quantities into each vein. A vascular surgeon will treat the larger varicose veins first, thereafter, will we continue with the treatment of the smaller spider veins.
This is a cosmetic procedure and will not be covered by your medical aid.
Sclerotherapy is an art, not a science and results are unpredictable and vary from person to person. There is no cure for spider veins. The majority of patients who undergo Sclerotherapy will be cleared of their superficial veins or at least see a good improvement. Unfortunately, there is no guarantee that Sclerotherapy will be effective in every case.
The number of treatments needed to clear or improve the spider veins differs from patient to patient depending on the extent of the veins present. The average amount of treatments is:
3 to 4 at 4 weekly intervals.
One leg is treated during a ½hour treatment session with a maximal amount of 10ml of sclerosing solution injected at one sitting.
Before your treatment:
No specific treatment necessary.
Come to your appointment with a pair of shorts (or a skirt) for easy access to veins and no creams applied to legs.
Please arrive 30 minutes before the scheduled time of treatment to complete the necessary forms and preparations.
During the treatment:
Sclerosing agent is injected through a very fine needle directly into the vein.
You may experience mild discomfort and cramping for one to two minutes, especially when larger veins are injected.
Compression bandage is applied which should be kept on for 2 days.
The procedure itself takes approximately 15 to 30 minutes.
There are no real alternative treatment options that successfully treat spider veins in the legs. Some possible alternative treatments can include:
- Pulse Dye laser
- Radiofrequency Vein Ablation
- Ligation (Vein stripping)
It is advised that you do not undergo Sclerotherapy for spider veins in your legs should you be affected by any of these contra-indications:
- A history of deep venous thrombosis (DVT - clots in the veins).
- Pregnancy – especially 1st and 2nd trimester.
- Patients that are not mobile due to conditions like rheumatoid-arthritis, osteo-arthritis or paralysis.
- Previous hypersensitivity / allergic reaction(s) to the sclerosing agent(s).
- Patients on anti-coagulation therapy such as Warfarin, Ecotrin, Disprin, etc.
- Patients with severe systemic life-threatening diseases.
- Recurrent bacterial infections of the skin (e.g. cellulitis).
- Patients that have a fear of needles, who have a very low pain threshold or who are not compliant to the treatment or after care treatment schedule.
- Acute fever with flu-like symptoms.
Mechanism of action
Sclerotherapy involves an injection of a solution directly into the vein. The solution irritates the lining of the blood vessel, causing it to swell and stick together, and the blood to clot. Over time, the vessel turns into scar tissue that fades from view.
Risks / Side Effects
Please find below a list of common side effects and risks, for a more comprehensive list and explanation, please refer to the consent form and discuss this with your NoviSkin Physician.
The first 9 listed here are the most common side effects:
- Bruising at the site of injection, which may remain for a month.
- Post treatment hyper-pigmentation (which is darkening of the skin) usually fades over a 3 to 4 month period.
- Temporary swelling of the area.
- Residual veins (veins that do not respond to initial treatment) will have to undergo further treatment.
- Spider vein matting – in a few cases the concentration of spider veins may increase, however, they appear much finer after treatment. This usually clears up after 2 to 3 months with further treatment or laser treatment.
- Pain – there may be initial pain at the injection site and later tenderness to touch may occur, but there should be no constant pain. If present contact the NoviSkin immediately on 012 460 4646/50.
- An allergic reaction to the tape used to compress the areas after treatment may occur as redness, itchiness or blistering.
- Superficial clotting of veins may occur 10 days after treatment. This occurs very seldom; but if it does, please contact NoviSkin immediately on 012 460 4646/50. Vein recurrence – when injecting some veins, some new ones may develop.
Seldom occurring side effects include:
- A vaso-vagal attack-fainting during the treatment.
- Sensitivity reactions to the sclerosing agent.
- A small ulcer may form at the injection site, but occurs rarely.
- Extremely rare: Deep venous thrombosis (DVT) and/or pulmonary embolism.
Post Care Instructions
After the veins have been injected small pressure bandages will be placed on each bleeding injection site or a tight compression bandage will be applied to the entire leg and should be left on for 48 hours.
The compression bandage should apply slight pressure, but at no point should cause pain or loss of feeling in legs, if this occurs the bandage should be slightly loosened.
After treatment it is very important to walk around immediately for at least 10 minutes.
The patient should walk around for 20 minutes a day for 2 weeks post treatment.
No strenuous exercise should be done for 2 weeks.
Follow-up consultation in 2 weeks for injection of the other leg and removal of any blood clots that formed at the injection sites.