How about if I have A LOT OF LITTLE spider veins all over leg / thigh? I mean a LOT. If I go with sclerotherapy, does it mean that each and every little vein would have to be injected? I assume that would be quite painful?
How to Get Rid of a Lot of Little Spider Veins?
Doctor Answers (4)
Covering Spider Veins with Cosmetics is Only Masking a Progressive Problem
Covering spider veins with a cosmetic only covers a problem that is in need of treatment. These telangiectasias, aka spider veins have feeder veins that need to be injected in interupted surgically - in addition to sclerotherapy or laser therapy of the spider veins. Otherwise, over time you will get more spider veins and some will break down, extravasate blood, deposit hemosiderin in your skin and cause permanent bronzing of the skin. It will look bronze brown in color and may never go away. So, get them evaluated and treated early and do not mask them with expensive cosmetics that don't solve the problem.
Spider Vein Treatment
Getting rid of spider veins (even when you have LOTS of them) is a lot easier than you think. That said, I'd choose a physician who has specific experience/training in sclerotherapy (treatment of leg veins through injections) and who can also evaluate you for deeper (perforator or greater saphenous) vein incompetence.
Think of your leg veins as being similar to trees. The spider veins are the leaves of the tree and the underlying blue network of less prominant - though still subtly visible - veins (reticular veins) are the tree branches. If you simply treat the spider veins (leaves), you are not addressing the root of the problem (the tree branches/reticular veins that are supplying the spider veins). Thus, laser or injection treatment only to the spider veins can result in a temporary improvement in appearance, but, chances are the spider veins will subsequently recur. This is because the blue network of veins supplying the spider veins were not treated.
All of this can be done easily in clinic with minimal discomfort and no downtime.
Spider veins, sclerotherapy, ultrasound, endovenous ablation, vein valves
If you have a lot of spider veins you may have an underlying reason for this. One of the most common causes of both spider veins and varicose veins is malfunctioning of the valves in the saphenous vein system which is essentially the trunk feeding the superficial leg veins. If the valves don't close properly(reflux), then this can lead to back up of blood into the skin to cause both spider and varicose veins. A large number of spider veins would suggest valvular reflux. You should have a venous reflux ultrasound to evaluate the valves which will then help to determine treatment such as sclerotherapy alone or in combination with closure of the leaking valves. Often times many of the spider veins interconnect and, therefore, you may not need as many injections as you may think. Also we now have better sclerotherapy solutions and small needles which make the treatment much more tolerable.
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Getting rid of a lot of spider veins
When we see patients with lots of spider veins in the legs, it's often part of a bigger circulatory problem. When these small veins are very numerous and very close together it can indicate that the main vein structure is not working as well as it should be.
Before performing laser treatments in this situation (we treat only spider veins using only lasers at our facility) we recommend visiting a vascular surgeon for an ultrasound to determine how the main vein structure looks. We suggest you do the same.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.