Introduction To Microsclerotherapy (Spider Vein Removal)
Superficial spider veins and telangiectasia are one of the most common vein problems, primarily affecting women. They can be of a significant cosmetic concern when they appear on the legs. Although spider veins themselves do not cause any long term health issues, they have a major impact on self confidence and lifestyle.
Spider veins are tiny red, blue or purple veins which are no longer functioning properly and have become distended due to a backflow of blood. They appear as unsightly webs, blotches and lines primarily on the legs. However spider veins or telangiectasia can also appear on other areas of the body such as the face.
Spider veins on the legs can also be a marker of problems with underlying, deeper veins in the legs such as early varicose veins. This can eventually result in pain, swelling, skin discolouration, heaviness, thrombosis and ulceration (if left untreated).
If problems with the deeper veins are suspected our doctors will refer for ultrasound assessment and to a vascular clinic or surgeon for management of the underlying problem prior to addressing the superficial spider veins.
Causes of superficial spider veins may include a family history of varicose veins, hormonal factors (such as puberty, pregnancy, menopause and being on the contraceptive pill), ageing, obesity, lack of mobility, previous venous thrombosis, leg injury and occupations that involve lots of standing (eg hairdressing, flight attendants).
frequently asked questions
+ WHAT DOES THE TREATMENT INVOLVE?
Microsclerotherapy is a procedure which involves the injection of a liquid into the spider veins using a very small needle. The liquid is called a sclerosant and causes the walls of the veins to collapse. It is an old treatment that has been used over many years to effectively treat small spider veins and is the gold standard for treatment of spider veins and varicose veins.
Over a period of 6 weeks following the treatment, the veins will slowly fade away and be removed. At this point further treatments may be required with optimal results evident at about 3 months. Each injection only treats a small area, so for extensive spider veins multiple injection sessions will be needed.
The benefit of the procedure is that it does not require hospital admission, no anaesthesia and normal activities can be resumed immediately.
It is important to avoid hormonal medication (such as the contraceptive pill), anti inflammatory medication, aspirin and blood thinners prior to the treatment (unless medically indicated). The legs must be clean, dry and without fake tan or moisturiser.
After a full consultation and consent for the procedure the doctor will clean the skin of the treatment area and insert a tiny needle into the veins to inject the sclerosant solution. Local anaesthetic is not needed as only very tiny amounts of the solution are injected so discomfort is minimal. Immediate pressure is applied to the area after the solution has been injected.
Procedure time varies depending on the area treated. In many cases we treat only one leg at each treatment session and often bring patients back the following day to treat the other leg.
+ HOW LONG DOES THE TREATMENT LAST?
Microsclerotherapy is a very effective treatment with high patient satisfaction. However results do vary from patient to patient. Most will experience a 50-70% improvement after their first treatment, but multiple sessions may be required In some cases incompetent veins can be very resistant to treatment and if there is an underlying incompetence with the deeper veins then the small superficial spider veins will eventually recur. Treating the underlying cause can prevent this from occurring.
Because microsclerotherapy does not treat the underlying causes and also does not treat the hormonal and genetic causes there is a small risk of recurrence in treated veins. They can easily be retreated. The success of the treatment also depends on the severity of the problem, age, medical comorbidities, how quickly the skin heals and how closely you adhere to the after care instructions.
+ WHAT HAPPENS AFTER MY TREATMENT?
Immediately following the treatment pressure will be applied and a specialised compression stocking will be fitted. This stocking must be worn for the next 72 hours and then daily for the next 2 weeks. We ask each patient to go for a 30 minute walk after they leave the clinic.
General aftercare includes strict adherence to our post treatment instructions (which will be provided to you at your appointment). We ask all patients to avoid swimming until the veins have healed and normal exercise can be commenced after 72 hours. Flying is to be avoided for a minimum of 2 weeks after treatment.
There may be some bruising and swelling to the veins initially and they will slowly start to disappear over a 6 week period. At this stage the area can be reassessed and further treatments performed as required.
+ IS MICROSCLEROTHERAPY TREATMENT SAFE?
The sclerosant used is one of the most popular sclerosants in the world and has been used safely and effectively in millions of treatments. As with any medical treatment there may be transient expected side effects and more serious side effects. This will be discussed in your consultation with the doctor.
Common side effects may include itching, mild pain for a few days after treatment, redness and swelling to areas of injection (this is usually a reaction to the sclerosant and can be treated with compression and massage), bruising, tender lumps, swelling of the lower limb or ankle, matting (development of a fine network of capillaries) and pigmentation due to iron pigment being released from the veins.