Spider Vein Treatments

Spider veins are the name given to a collection of dark red or purple veins that appear near the surface of the skin, vaguely resembling spiders. Spider veins, or telangiectasias, usually occur on the legs but can occur on almost any skin surface, including the face. While they are not dangerous in and of themselves, many people find them undesirable from an aesthetic point of view. Spider veins are considered by many to be a sign of aging, often premature aging. In people of lighter skin tones, spider veins can be particularly difficult because the dark, thin veins appear so vivid in contrast to the color of the skin. Fortunately there are a few ways that plastic surgeons can remove spider veins in patients that desire it.

 

 

The most widely performed method for treating spider veins, especially in the legs, is called sclerotherapy. The prefix sclero- means “hardness” and sclerotherapy is a means of spider vein treatment that essentially results in a hardening of the spider vein. A chemical is injected directly into the vein causing it to harden which causes then the surrounding tissue to break down the hardened vein reabsorb it into the body.

 

There are several agents that have been used for sclerotherapy over the years. They usually fall into one of a three categories: Detergents, osmotic agents, or chemical irritants. The most commonly used agents are hypertonic saline, an osmotic agent, and sodium tetradecyl sulfate or polidocanol, which are detergents. While effective, the problem with hypertonic saline (a highly concentrated salt water solution) and sodium tetradecyl sulfate is that they can cause pain and burning upon injection, even into small, thin veins. This has led many plastic surgeons and dermatologists to use polidocanol, also known as Aethoxysclerol. Polidocanol does not cause pain and burning like other sclerotherapy agents and is less likely than the other chemicals to cause destruction of tissues surrounding the vein.

 

Troublesome veins can also be treated by laser ablation therapy. While larger varicose veins can be treated with endovenous laser therapy in which a probe is guided to a place within the vein, spider veins are much too thin to pass a probe along their length. Therefore transcutaneous laser and intense-pulsed light therapy are used to destroy some spider veins. Transcutaneous simply means across (trans) the skin (cutaneous). This approach is useful for very small veins that are very near the skin’s surface. If the spider veins are too deep or too large, the trancutaneous laser approach cannot deliver enough energy to destroy the vein. Transcutaneous laser therapy has been widely used to treat spider veins on the face, which are quite fine and superficial (close to the skin’s surface). Unfortunately, even though light energy is used, many patients report pain associated with this form of spider vein treatment.

 

Regardless of the technique used, the patient must bear in mind that spider vein treatment may require multiple visits to achieve the desired result. Also, in people who are genetically predisposed, spider veins may recur in different locations throughout life. In patients who are unhappy with the cosmetic appearance of their spider veins serial visits may be necessary to treat new spider veins as they arise.