Spider Veins

What are Spider Veins?

spider veins

Known in the medical world as telangiectases, spider veins are small, thin veins that lie close to the surface of the skin. Although these super-fine veins are connected to the larger venous system, spider veins are not necessary for normal circulation.   

A number of factors contribute to the development of spider veins, including heredity,pregnancy and other events that cause hormonal shifts, weight gain, occupations or activities that require prolonged sitting or standing, and the use of certain medications.  Spider veins are more common in women than men. Men and women of any age may be good candidates for Sclerotherapy and Laser Treatments, but most fall in the 30-60 age range. Spider veins may become noticeable very early on – in the teen years. For others, the veins may not become obvious until they reach their 40s.

What are my treatment options?

During your consultation visit, Dr. Mann will examine your legs to determine the best treatment regimen for your veins.  The majority of spider veins will respond best to Sclerotherapy.  If you have significant symptoms (pain, tenderness, swelling) and/ or large bulging varicose veins, Dr. Mann may recommend an ultrasound to evaluate your veins.

Sclerotherapy is the most common method for eliminating superficial telangiectasias (spider veins) and has been used since the 1930’s.   A solution is injected into small and medium sized veins, which irritates the inner lining of the vein and causes it to close off.  A very fine needle is used to perform the injections and most patients relate the discomfort to a barely noticeable pinprick feel.  The majority of patients will have significant clearing of their veins.

Sclerosing agents:  There are several solutions that are commonly used in sclerotherapy.  However, none are perfect and all have certain drawbacks.  Sotradecol and Asclera (polidocanol) are the sclerosing agents most often used by Dr. Mann in our Sclerotherapy procedures. Both Sotradecol and Asclera have been approved by the FDA for Sclerotherapy.  We chose to use these agents in our procedures because it is believed by many vein specialists, including Dr. Mann, to be safe, effective, and with the least amount of side effects.  These agents produce better results and do not have the cramping or pain commonly associated with hypertonic saline (salt water).

Laser treatment for Spider Veins.  Laser therapy involves directing the laser over the specific vein to be treated, resulting in destruction of the vein walls.  Because Sclerotherapy is much more effective than Laser Treatments for spider veins on the legs, we usually reserve Laser Treatments on patients who have resistant veins or very tiny veins that cannot be treated with Sclerotherapy.


How many treatments will I need?

The majority of persons who have Sclerotherapy performed have satisfying results. Unfortunately, no medical technique is perfect and there can be no guarantee that Sclerotherapy will be effective in every case. Approximately 10% of patients who undergo sclerotherapy have fair to poor results.  In rare cases, a patient may see new veins (matting) develop in the areas of treatment.  This temporary phenomenon occurs 2 to 4 weeks after treatment and usually resolves within 4 to 6 months.

The number of treatments needed differs from patient to patient, depending on the extent of the problem.  A treatment session lasts 15-30 minutes, which may or may not allow for treatment of all vessels depending on disease severity.  A single blood vessel may have to be injected more than once, usually 1-2 months apart, depending on its size.  The need for 1 to 5 treatments is typical; the average is 2-3 treatments.  Most patients can expect about 80-90% improvement after a series of treatments.  Fading of the vessels occurs gradually, over a period of months.

Is this covered by insurance?

While some patients may develop symptoms from their spider veins, please note that Sclerotherapy and Laser Treatments are considered cosmetic and are not covered by insurance companies. 

Will I get more spider veins after treatment?

It is very important to realize that Sclerotherapy and Laser do not prevent the development of new spider veins and varicosities later in life. Many people require treatments from time to time to keep their legs clear.

Spider Veins and Pregnancy

If you are pregnant or breastfeeding, you will be advised to postpone Sclerotherapy and Laser Treatment. Also, because it’s not known how sclerosing solutions may affect breast milk, nursing mothers are usually advised to wait until after they have stopped breastfeeding.  Compression stocking worn during pregnancy may help to reduce the development of spider veins.

What are the Risks associated with Sclerotherapy?

As the vessels close up, they go through the inflammation process.  They may feel lumpy and tender under the skin. This takes several weeks to resolve, and it is common for the veins to look worse immediately after the procedure.  Temporary bruising and swelling is common and should be expected.  It is also common to get red, raised areas at the sites of injections.  These should disappear within a day or so.   Some patients complain of an itchy sensation after treatment for 1-2 days, which is also very normal.

It is important for you to wear compression stocking for 1-3 weeks after treatment to reduce the risk of bruising and swelling or other complications. This will help seal the treated vessels, keep the blood from collecting under the skin, and reduce the development of dark spots. It may also reduce the number of treatments necessary, and the possibility of recurrence.


Be Patient with Your Body

Spider veins take an average of 2-3 treatments spaced at least 4 weeks apart. The number of treatments may vary depending on your situation.

You must wear stocking for 2-3 weeks after treatment to ensure best results.

Your veins will look worse before they look better.

Discoloration varies from patient to patient, and may take weeks to months to fade completely





Dermatologic Surgery and Aesthetic Dermatology

615-266-3376(DERM) | Office in Hendersonville, TN

Dermatologic Surgeon Dr. Margaret Mann M.D., and Dermatologist Dr. Daniel Popkin, serving Hendersonville, Nashville, Rivergate, Gallatin, Goodlettsville, and the surrounding Sumner County, Tennessee area at Innova Dermatology