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Microsclerotherapy for Spider Veins

1. About the Treatment

Injection (sclerosant) therapy is suitable for dermal flare veins (thread veins, spider veins, broken veins) that are unsightly but cause no symptoms. It works by making the vein wall stick to itself, thus obliterating it. An extremely fine needle is used to perform the injections, hence the term "microinjection".  Very small veins which cannot be injected (Telangiectasias) or veins in sensitive areas such as the face, may be treated using Intense Pulse Light (IPL) or Laser.


2.  At the clinic

A small amount of sclerosant fluid is injected into the flare veins at multiple sites using a tiny needle. A compression stocking is then put onto the leg. Minor discomfort may be experienced during injections but it is rarely painful.


Usually several veins on one or both legs are treated per visit and repeat injections will be required if both legs are affected or if you have extensive flare veins. Initially, further injections will be undertaken at weekly intervals. Subsequently, appointments may be spaced out depending on progress, but the timing of repeat injections is not essential. The treatment is continued until you are happy with the cosmetic results. The average number of sessions of treatment required is typically about 4. We will give you an indication of the likely number of sessions required before we commence the course of treatment depending on the severity and extent of your leg veins.


3.  Afterwards

The compression stocking must be kept dry. After 24-48 hours you should remove the stocking. Short walks are fine, but try to avoid vigorous exercise for a few days e.g. running. Try and avoid very hot baths for a few days.


4.  What to expect after the injections

After injection of flare veins an initial inflammatory reaction is common with the overlying skin becoming red and raised. The veins may initially appear more prominent and darker in colour. Often, discolouration rather like a bruise surrounding the injected flares develops. These changes resolve over a period of weeks as the flare veins disperse and fade away. It is important to appreciate that the full benefits of treatment may not be appreciated for around 6-8 weeks after treatment.


While most patients experience no problems after injection of flare veins, a small number may experience one or more of the following:


  • Discomfort, hardness or tenderness at the injection site(s);

  • A persistent hard "cord" in the line of the vein;

  • Brown staining of the skin in the line of the vein or surrounding it; 

  • Rarely, ulceration of the skin or severe allergic reaction at the injection site;

  • Failure of the injection to obliterate the vein;

  • New or recurrent flare veins or telangiectasis (matting) developing in the treated areas.


6. The Future

As you are clearly predisposed to formation of thread veins it is likely that new or recurrent veins may develop in the future. In order to discourage the occurrence of further veins you should exercise as much as possible, maintain normal weight and consider wearing light support stockings or tights particularly when standing for long periods. Even if more flares develop, the treatment can always be repeated in the future.

Simon Ashley


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