For the treatment of spider veins

Sclerotherapy eliminates smaller varicose and spider veins through the injection of an FDA-approved drug solution that causes closure of the veins. In Advanced Vein Care Center, we use a drug called Sodium Tetradecyl Sulfate (Sotradecol®). The drug is injected directly into the affected veins, where it causes the vein walls to seal together. The vein is eventually reabsorbed by the body while blood is rerouted through healthy veins nearby.

While Sclerotherapy is covered by some insurance companies for the treatment of varicose veins, it is not covered for the treatment of spider veins by most insurance companies. Therefore, most Sclerotherapy treatments performed on the spider veins are paid by the patients themselves.

Spider veins are those small and tiny, “serpentine” veins right on the skin that are 1-2 mm or less in width, and are in shades of blue, purple, or red in color.   Although there are alternative treatments for the spider veins such as topical laser treatment, Sclerotherapy is still considered the best treatment for spider veins.

No anesthetic is required prior to treatment and patients report little discomfort during and after the procedure. Most return to work and regular activities as soon as the treatment is completed.

Sclerotherapy Questions & Answers

The cost will depend entirely on the extent of your spider veins, the area of your leg covered by spider veins and the density of veins in the area.  When you obtain a consultation from us, you will be given an estimate of what it will take to address your spider veins, the length of time and the number of treatment sessions. A member of our staff will work with you to develop a finance plan that works for you and your budget. In addition to financing thru conventional credit cards, the Advanced Vein Care Center is part of the Care Credit program which offers payment plans for medical expenses, designed to meet your personal needs.

In the U.S., there are only two drug solutions that are FDA-approved for sclerotherapy. One is sodium tetradecyl sulfate (Sotradecol®) and the other is polidocanol (Asclera®).  Hypertonic solution used to be used widely, but no longer. We use Sotradecol®.

It is very, very, very important that you have a detailed and open discussion about the true effectiveness of Sclerotherapy, so that you may develop a realistic expectation of the cosmetic outcome from the procedure. Information presented in the following paragraphs should be reviewed in detail during your initial consultation.

Sclerotherapy is not magic. It is far from being 100% effective. Any physician who tells you that “Your spider veins will be all gone before the summer” is not telling you the whole truth. If you can imagine, we the clinicians inject a drug solution into these tiny veins, and we depend on a number of factors for a satisfactory outcome. One is your body’s reaction to these sclerosant agents, which is, after all, a chemical irritant. Another is the local micro-anatomy of these tiny veins, and how they are connected with the underlying larger veins. These are just a couple of factors that determine the outcome. As such, the effectiveness of Sclerotherapy to make the veins disappear is widely variable from patient to patient, and even from various parts of the leg.

Because of these reasons, studies have shown that Sclerotherapy’s effectiveness ranges from 50% to 80%, and up to 10% of patients do not respond. The further down the leg the spider veins are located, the more difficult it seems to eradicate them, such as around the ankle/foot area.

Because Sclerotherapy is only “partially successful” among those injected spider veins, multiple sessions of injection maybe needed in some patients. Between 1 to 3 sessions of treatments are usually needed for a given area, separated by weeks to months of interval in between sessions.

It is very important that before your commence your Sclerotherapy, that there is no underlying venous insufficiency. If you have an underlying refluxing vein that is feeding the spider veins, the veins will keep coming back. You should see a vein specialist if this occurs.

Sclerotherapy depends on the body’s natural inflammatory reaction to the chemical irritant inside your vein.  It must undergo its usual course for the inflammatory response, then the healing and re-absorption of the treated vein and tissue. All of this takes time. First, the injected veins and the area around them will become bright red, then it will become dark red/brown, followed by a period of fading light brown.  Most of the time, the area will not look completely devoid of any pigmentation, but the faded discoloration should look much more cosmetically acceptable than the original bright red, purple, blue spider veins.  All of this takes somewhere between few weeks to several months, up to a year sometimes. You will have to be very patient during this period.

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Benefits and Risks of the Procedure

The main benefit, of course, is to eliminate spider veins with sclerosing injections that will turn ugly red, purple, blue spider veins into less noticeable colors.

There are a number of potential complications with Sclerotherapy. These include skin hyperpigmentation, skin ulcer, micro-thrombus (tiny inconsequential blood clots-trapped inside the spider veins), allergic reaction, etc. During your initial consultation, the whole spectrum of risks will be discussed in detail.

A particularly disappointing outcome maybe that of skin hyperpigmentation. Sometimes a segment of spider veins can appear “black” because of a small trapped blood clot inside the vein, and other times, there can be a dark brown line in place of old veins because of deposit of hemosiderin from blood in the skin.  Although these complications are not common, it is important that you understand that Sclerotherapy will not magically make your veins disappear.  It is very important that you consult a vein specialist who is experienced and upfront about realistic expectations before you commence your treatment.

Sclerotherapy Before, During, and After Questions & Answers

Before the Procedure: Preparation

Sclerotherapy is an elective, cosmetic procedure with minimal impact on the rest of your body, thus there is very little in terms of preparation before the treatment.

If you wish, you can request—and we will provide a prescription—for EMLA cream so that the skin is “dull” to tiny needle injections.  For most patients, this is not necessary, however.

During the Procedure

Not usually. We use a very tiny needle, and most patients do not feel any pain at all.  Some may feel a tiny pinch that is of minimal discomfort.

Each Sclerotherapy session takes 30 minutes.

After Procedure Care

Immediately after the procedure, wearing your compression stocking

  • Low-impact: Immediately after the procedure wearing your compression stockings
  • Moderate-impact: The day after the procedure wearing your compression stockings
  • High-impact: 3 days after the procedure wearing your compression stockings

Contact Us

If you wish to learn more about how sclerotherapy treatments may be appropriate for you, we encourage you to give our Springfield, MA office a call. Our friendly staff can be reached at 413.732.4242 or use the form below.