The Body: Sclerotherapy/Laser Photothermolysis or Spider Vein Treatment

Small, dilated, superficial veins may appear on the body representing tiny blood vessels in the skin that have enlarged to the point that they have become visible. Their treatment is usually best classified by their location --whether on the face or on the extremities, especially the legs.

Dilated veins on the face, which may be called telangiectasias or spider angiomas, are best treated with yellow-light laser therapy. This therapy is very rapid and safe with minimal discomfort, consisting of a brief burning pain when the laser is fired and slight itching afterwards.

The treated areas usually become quite dark and bruised for a period of seven to 10 days following the procedure. During this time, the small blood vessels, which have been clotted by the heat from the laser, begin to slowly disappear over the ensuing months. Risk of scarring is low. However, complete resolution of the problem may require two to three treatments.

The preferable treatment for dilated veins, or spider veins, of the leg is sclerotherapy or vein injection. These small dilated superficial veins on the legs are a common problem, particularly in women after pregnancy and in people with varicose veins. While large varicose veins are most often treated surgically, small superficial veins are best treated with sclerotherapy, which involves injecting a solution into the vein to cause inflammation and subsequent disappearance of the vein.

Sclerotherapy is performed as an outpatient procedure and requires 15 to 30 minutes depending on the number of areas being treated. No sedation or anesthesia is required. The patient experiences a temporary cramping sensation during injection as the solution enters the vessel. This sensation resolves within minutes. Injection sites are then covered with gauze and tape, and the legs are may be wrapped with an elastic wrap. No wound care is required. The treated vessels gradually disappear over the following month.

Sclerotherapy is a safe procedure with few significant risks. The most common complication is the development of brownish pigment in the treated area, which usually disappears within two to six months. Rare patients may develop matte-like telangiectasias, which are small sunburst-like blood vessels at the injection site. Patients may occasionally develop a small scab at the injection site if any of the solution escapes from the blood vessels. This is treated with an antibiotic ointment until the scab clears. There is little risk of infection or bleeding from sclerotherapy.

Sclerotherapy may be performed in conjunction with patients having treatment for large varicose veins, but is preferably performed after treatment of large veins.