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. Before your next visit
Ideally you should have stopped taking the combined (those containing Oestrogen plus Progestogen) oral contraceptive pill at least one month before your appointment but the increased risk of causing a serious venous thrombosis is extremely small with spider vein treatment. There is little evidence that low dose “mini-pills” and hormone replacement therapy (HRT) need to be stopped.
3. At the clinic
A small amount of sclerosant fluid is injected into the flare veins at one or more sites and a cotton wool or rubber pad applied. A compression bandage / stocking / tubigrip is then put onto the leg. Minor discomfort may be experienced during injections but it is rarely painful.
Usually several veins on one leg 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 compression stocking must be kept dry. Try and elevate your legs as much as possible during the first 24 hours. After 24-48 hours you should remove the stocking and cotton wool pads. Short walks are fine, but try to avoid vigorous exercise for a few days. Try and avoid very hot baths for a few days.
5. 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 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.