Procedures

Spider Vein Therapy (Sclerotherapy)

We All Want Great Skin (without unsightly spider veins)

We all want smooth, uniform skin coloration—whether milky white or, perhaps more often, bronze and tan—the uniformity of our skin is both desirable and, unfortunately, harder to achieve as we gain advanced maturity! So many of our patients at Minneapolis Plastic Surgery, LTD., are pleased to know that some of those more annoying imperfections, such as so-called spider veins, are actually quite easy to treat. These include not only spider veins of the lower extremities, but also small dilated vessels (telangiectasias) of the face, nose, decollete, and other areas of the body.

Spider veins of the lower extremities are still most successfully treated with sclerotherapy, the injection of tiny volumes of irritant that cause the unwanted vessels to spasm and seal off. Sclerotherapy can also be used on some facial vessels, such as veins along the side of the nose, or around the eyes (yes, it’s safe–we have treated these areas for nearly 30 years). Other even tinier facial vessels can still be visible and bothersome, and these might be better treated with either IPL (Intense Pulsed Light) or KTP laser, both available at MPS or Carillon Clinic across the hall.

Unsightly and Uncomfortable

Spider veins are clusters of small red, blue, or purple veins that can develop on women’s thighs, calves, or ankles. Men can have spider veins as well, but they are more common in women, particularly after childbirth, weight gain, or leg injury. Larger dilated veins with damaged valves are called varicose veins, and these are treated with surgery (vein stripping, endovenous laser, or other techniques) rather than sclerotherapy, which is the injection treatment of (smaller) spider veins.

Though spider veins are harmless, many of our Minnesota Spider Vein Treatment patients find them cosmetically bothersome. Varicose veins and sometimes spider veins can be uncomfortable, as the dilated vessels can cause aching, burning, swelling, itching, and night cramps. Some women feel self-conscious about revealing their legs in shorts, skirts, or dresses because of spider veins, altering their lifestyle, social interactions, and clothing choices.

Eliminate Unwanted Veins

A simple procedure called sclerotherapy can eliminate many of these veins. In this technique, the tiny veins are injected with an FDA-approved sclerosing solution, which irritates the inner walls of the unwanted vessels, causing them to spasm shut, seal, and fade. Accuracy of the injector is critical for success in treating the tiniest vessels, as both the right amount of sclerosant solution must be injected, and it must be injected within the vessel, not around it, or “close” to it. Because this is a critical experience-based requirement for successful sclerotherapy, very few injectors have the patience or accuracy to become an experienced sclerotherapy practitioner. (This is also why many doctors have defaulted to much easier, but much less successful, laser treatments.)

At the height of public and media interest in medical laser treatments in the late 1980’s to mid 1990’s, Dr. Tholen did an unpublished study comparing sclerotherapy (which he has performed since 1980) and laser treatment for spider veins (with undergraduate degrees in Math and Physics, Dr. Tholen taught laser surgery of all types since 1988 through the next 2 decades). He found that skillfully-performed and accurate laser treatment for small spider veins was nearly as successful as sclerotherapy, but that laser treatments had a greater incidence of side effects (blistering, healing difficulties, and scarring), as well as being more costly, compared to precisely-performed sclerotherapy. Thus, we have concluded that laser treatment for spider veins is less effective, more expensive, and with more side effects than sclerotherapy. Those doctors or centers that offer only laser treatment for spider veins apparently do so because of the need to use, promote, (and pay off) their expensive lasers, or because of their lack of sclerotherapy skills. In equally-skilled, experienced hands, sclerotherapy remains the “gold-standard” for spider vein treatment.

One or two sclerotherapy sessions are usually necessary to treat most patients, as not all injected vessels will respond on the first injection. Elastic wraps and elevation are usually necessary for a day or two after treatment to maximize results and minimize bruising. Most patients return to full activity after 48 hours, but avoidance of sun exposure or tanning is recommended until any bruising has faded (usually 2-4 weeks, but occasionally lasting several months).

Side effects of sclerotherapy are uncommon, but the most common one, bruising, is seen with all patients for a few weeks as the blood within the sclerosed spider veins is absorbed. Prolonged discoloration can occur in about 10% of patients, as the hemosiderin (breakdown product of hemoglobin) within the tissues can take longer to dissipate. This hemosiderin staining can last for several months, and its reabsorption is enhanced by avoiding sun or ultraviolet (tanning beds) and minimizing extra iron intake in your diet or vitamin supplements. In all but about 1% of patients the discoloration gradually fades. Other side effects of sclerotherapy are blistering and scarring, which occurs very infrequently (about 1 in every 350 veins injected). Permanent scarring usually decreases in visibility over many months.

As noted above, although laser techniques are available for (smaller) spider vein treatment of the legs, sclerotherapy remains the “gold-standard” for best results with the fewest side effects.

The elimination of these veins allows our patients to comfortably expand their wardrobe and behaviors, leaving behind feelings of self-consciousness in favor of the rediscovered freedom that comes from being confident in your own skin.

Costs for sclerotherapy (spider vein treatment)

Complimentary consultations are available at both Minneapolis Plastic Surgery, LTD. and Carillon Clinic, LTD. so that you can learn more about this treatment and have your spider veins evaluated. Our sclerotherapy experts can advise you about which veins can be removed by this technique and explain other options when necessary. Costs for sclerotherapy range from several hundred dollars for one or two localized areas of concern; entire leg treatment can cost up to $1900 for both legs. No anesthesia is required, as the sclerosing solution is itself a local anesthetic, so the only discomfort is that of tiny (diabetic-size) needle pricks into the upper layers of the skin to treat the dilated vessels just below the skin’s surface. Please contact us for a complimentary, no-obligation consultation with our ABPS-certified plastic surgeons.

Because of the high demand for free consultations with our plastic surgeons, our staff will ask for a credit card number in order to schedule a consultation; there is no charge whatsoever for appointments that are kept–you will be charged $100 only if you fail to keep a scheduled appointment, or fail to cancel at least 48 hours in advance of your appointment time–for Monday appointments, you must cancel no later than noon on the previous Thursday.

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