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Spider Vein Removal

Spider veins, which often appear on the face or legs, develop when a group of blood vessels expands near the surface of the skin. While they are usually innocuous, they may be painful and can be a symptom of a more serious underlying venous disease. If the physician suspects underlying larger vein disease, ultrasound often is performed as part of a complete evaluation

One way to remove spider veins is sclerotherapy. In this procedure, a solution is injected into the vein to injure the vein wall and encourage reabsorption. In most cases, several treatment sessions, spaced 4 to 6 weeks apart, are necessary before the veins completely disappear. Newer sclerosants, such as foam sclerotherapy, have improved results and increased patient safety.

After treatment, patients usually wear bandages or support hose for 1 week or longer, and are encouraged to walk and exercise to promote healing. Side effects of sclerotherapy usually are mild and risks include swelling, bruising, redness, soreness, and temporary changes in coloring in the treatment area (called hemosiderin staining).

Other treatments include laser surgery, which uses heat to dissolve spider veins. Laser treatments are preferred for facial veins and leg veins that are too small for sclerotherapy. Electrodessication, which uses electrical current, can be used on facial veins when laser surgery is not an available option. Electrodessication may produce scarring and this method is performed less often since the development of effective vascular lasers.

Ambulatory phlebectomy involves making small stab incisions along a varicose vein to remove it surgically. To remove larger veins, radiofrequency and laser endovenous laser treatment may be used instead of vein stripping procedures. Foam sclerotherapy of larger veins also may be effective.

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