Microsclerotherapy

Spider veins or thread veins are swollen, twisted veins that most often occur in the legs, but can also occur in the face and other parts of the body. They are smaller than varicose veins and often do not cause any symptoms or health problems. However, in some people a thread vein can cause an achy, heavy feeling in the leg. Other symptoms can include pain, burning, throbbing, cramping, swelling, itching, and skin discoloration. As you may know, a vein is a blood vessel that carries blood from different parts of the body back to the heart. The problem occurs when the valves in the veins stop working, permitting backflow of blood.

Spider veins and varicose veins are more common in women than men. Older age, pregnancy, and obesity are known risk factors. A minimally invasive treatment known as microsclerotherapy can help eliminate unsightly and uncomfortable thread veins. Keep reading for more information about this procedure. Also, find out the difference between sclerotherapy, foam sclerotherapy, and microsclerotherapy.

What is microsclerotherapy?

Microsclerotherapy is a common and effective treatment for thread veins. It is especially effective in treating spider veins in the legs.

The treatment involves injecting a solution called a sclerosant into the affected thread veins. The chemical that is used most often is sodium tetradecyl sulphate. Other sclerosants include polidocanol. Sclerosants are irritants that lead to scarring of the affected vein. This forces the blood to re-route through healthy veins. The collapsed and scarred vein is ultimately reabsorbed by the body into the surrounding tissue and fades over time.

While treatments like laser and IPL may are effective for thread veins in the face, they do not work as well for spider veins in the legs. Microsclerotherapy is the most effective treatment for leg spider veins.

Both sclerotherapy and microsclerotherapy use the same chemical, sodium tetradecyl sulphate, in liquid form. However, in microsclerotherapy a much more dilute solution is used. Another type of treatment called foam sclerotherapy involves mixing the chemical with air to form a foam akin to shaving foam. Foam sclerotherapy is useful in treating longer and larger varicose veins.

While it is most commonly done on the legs, a microsclerotherapy treatment can be performed on any part of the body provided it is below the level of the heart. As noted, spider veins on the face are better addressed with laser treatment or IPL.

How is microsclerotherapy for spider veins performed?

The microsclerotherapy treatment itself is quite straightforward. The doctor uses a very small needles to inject the sclerosant into a cluster of spider veins. A magnifying glass and light source are used to visualize the tiny spider veins.

It is worth noting that only a limited amount of the liquid chemical can be placed at the injection sites, so it may not be possible to inject all your thread veins during one microsclerotherapy session. The entire process takes anywhere from 15 to 60 minutes depending on the areas being treated and the injection techniques.

Following the injection, a swab is taped to the skin to provide compression. Before you go home, a compression stocking will be placed on the leg and you must wear this for up to 3 weeks.

Contrary to what you may think, thread veins, which are smaller than varicose veins, are more difficult to treat. It can take multiple treatment sessions to obtain resolution of the thread veins and relief from symptoms. Most patients require 2-4 injections, although some patients may get relief from a single microsclerotherapy treatment. The number of treatments will depend on the severity of your thread veins.

How effective is microsclerotherapy?

Thread veins can cause lifestyle-limiting symptoms such as pain, itching, swelling, and ulcerations. Without treatment, complications like rupture can occur. Microsclerotherapy is highly effective in treating thread veins. Most patients obtain relief of symptoms after the first treatment. Additional injections can often achieve complete obliteration of the offending blood vessels and complete healing or decrease in size of active ulcers.

Preparing for a leg thread veins procedure

At the time of your consultation, your doctor will examine you and obtain a complete health history. They will be especially interested in any history of heart disease or clot formation. Your doctor will also ask about your current medications, including things like aspirin and ibuprofen which can increase the risk of bruising and bleeding with needle pricks. You will receive additional information about aftercare and recovery after the treatments.

Before advising you to undergo microsclerotherapy for thread veins, your doctor will determine the underlying cause for the formation of these veins. This can be accomplished with a test called a venous duplex ultrasound scan. The scan helps to identify any varicose veins that may be feeding the spider veins on your legs. It is important to treat the underlying cause first to ensure the problem does not recur.

Before your sclerotherapy treatment, you will be fitted for a full-length compression stocking (class II). You should bring this with you on the day of your thread veins treatment. Be sure to wear loose-fitting clothing, such as track pants, to your appointment, so that it fits over the stocking.

On the morning of your injections, wash your leg with thread veins using soap and water, but avoid using any moisturizer or lotion. You should also ensure there is no fake tan on your legs as this can interfere in properly identifying the spider veins. A brisk walk before the treatments can help dilate the veins and make identifying them easier.

Description of the procedure

You will sit or lie comfortably in the treatment chair. No anesthesia is required. Your doctor will place a tourniquet on the affected leg to dilate the veins being injected with the sclerosants. The liquid will be injected using LED lighting and magnification to better visualize the small thread veins. Ultrasound may be used to guide the injections into larger veins.

Aftercare and recovery

To achieve the best results from microsclerotherapy treatments for thread veins, patients are encouraged to wear the compression garment for three weeks. Keeping the vein compressed after the treatment session helps with scar formation. Removal of the compression too early can result in blood flow returning to the spider vein, leaving a brown discolouration. In most patients, the brown stains fade over time, but they can sometimes be permanent.

What are the possible risks of microsclerotherapy?

When performed by an experienced provider, sclerotherapy treatments for thread veins are safe and effective. However, like all procedures, there can be possible issues. The most common side effect of microsclerotherapy is brown stains at the injection site. This usually occurs in patients who remove their stockings before the recommended time of 2-3 weeks. It is important to keep the pressure on the area to reduce the chances of staining.

In rare cases, an ulcer can develop where the injections were performed at the site of the thread veins. This occurs due to the sclerosant entering an artery. Other rare side effects include thrombosis (clot formation), skin necrosis (death of skin tissue), and nerve injury.

In patients in whom underlying varicose veins were not properly identified before the sclerotherapy treatment for thread veins, a side effect known as telangetic matting can occur, consisting of red staining or bruising in the treated areas.

You can reduce your risk of side effects by choosing an experienced provider and following your doctor's instructions.

How much does it cost to treat spider veins?

The average cost of the first session of microsclerotherapy for thread veins is around $475 (£350). Subsequent sessions usually cost less because the treatment takes less time, typically around $350 (£250).

Finding a provider

Microsclerotherapy is the gold standard of treatment for thread veins or spider veins in the legs. Finding practitioners who are experienced in this procedure is important to ensure safety and good outcomes. The MeTime app makes it easy to find experienced practitioners for microsclerotherapy in your area. You can chat with experts, do a video consult, upload pictures, and have suggestions sent directly to you. If you suffer from thread veins in the legs and want to see if microsclerotherapy could help, download the MeTime app now!