Dysfunction of the valves within veins contributes to appearance of spider veins, and several factors may play a prominent role in their development and progression.  These factors include heredity, pregnancy, hormone replacement therapy, oral contraceptives, obesity, and trauma. Although exercise, weight loss, and support hose may limit the number of new vessels, it will not fully prevent their development.

Performed on an outpatient basis, sclerotherapy involves the injection of a sclerosing solution, (such as hypertonic saline, glycerin or Sotradecol, Asclera) into the abnormal dilated vessels. This causes the lining of the vessels to swell and the lumen to close.  In many cases, the veins can be completely eliminated.

• Do not take Vitamin E or non-steroidal anti-inflammatory medications, such as Advil^®, Ibuprofen, Motrin^®, or aspirin at least one week prior to treatment. Tylenol is a good substitute if necessary.
• You may also want to consider bringing comfortable shorts to wear during treatment and/or loose-fitting pants or a skirt.

Most people experience mild discomfort for about 15 to 30 seconds, similar to a mosquito bite. The injected veins completely disappear for a few minutes as blood is pushed out by the solution, but they reappear when the blood flow returns. Since many vessels are interconnected, one injection may eradicate several dozen vessels at once by washing over the cells lining the inner wall of the vessel, causing them to shrink. The veins will slowly disappear following the injection.

Veins will fade over six to eight weeks after treatment. Smaller vessels may disappear completely and large vessels may decrease in size and/or completely disappear.

Serious side effects from this procedure are extremely rare; however, some temporary side effects may occur.

• Local swelling and bruising may occur at the injection site and along the vessel. Swelling usually lasts no more than 24 hours; bruising fades within several weeks. Brown discoloration may infrequently develop. This usually lasts approximately three months, slowly fading away.
• Tenderness may occur at the injection site and along the vessel, and may persist for a few days.
• Immediately following injection, a hive-like reaction may develop at the site, usually lasting no longer than 30 minutes.
• Following injection of the ankle or calf, cramping similar to a “charley horse” may occur.

Pressure gauze bandages may be placed over the treated vein and remain overnight after treatment. You should avoid contact sports, aerobics, and use of leg weights during this treatment. A 30-minute, moderately paced walk may be substituted for your regular workout.  Thereafter, compression support hose must be worn continuously (except to shower) for five days after treatment.  Medium-weight compression support hose are recommended for daytime wear during the one to two weeks following treatment; either Jobst sheer support pantyhose or Sigvaris Delilah pantyhose. Both are nonprescription, fitted by height and weight and available in several colors.