Microsclerotherapy is used for treatment of spider veins.
Spider Veins are common on the outside of the thighs and inside of the knees but can also involve any part of the legs and are sometimes seen on other parts of the body such as under the breasts, abdomen and face.
In some cases microsclerotherapy may be supplemented with other treatments such as laser or Elos IPL. Elos IPL is the treatment of choice for facial veins but lasers have proven to be very unreliable for leg veins because the veins are too deep in the skin for the laser to be consistently effective. Microsclerotherapy remains the treatment of choice for leg spider veins.
Spider veins are also called telangiectases and these are typically fed by reticular veins which in turn can be under pressure because of chronic venous incompetence. For this reason at Palm Clinic we prefer to perform a diagnostic ultrasound of all legs before treatment to spider veins in case there are deeper veins which need to be treated first. If there are deeper veins needing to be treated we typically wait three months after the deeper treatment before treating the actual spider veins.
Risks of Microsclerotherapy treatment include telangiectatic matting (development of new, very fine spider veins) and haemosiderin staining (a bruised appearance which can take several months to resolve).
Frequently Asked Questions
How does Microsclerotherapy work?
Microsclerotherapy involves the injection of a sclerosant (a solution of polidocanol, sodium tetradecyl sulphate or hypertonic saline) into the tiny spider veins through a very fine 30g needle. Polidocanol is the sclerosant most commonly used at Palm Clinic.
The sclerosant irritates and inflames the inside lining of the spider vein which stimulates your body's natural healing to close off the vein. There is no problem closing these veins as they are abnormal veins and the blood will be redirected through normal veins. Generally the spider veins are fed by deeper and slightly larger blue/green reticular veins.
These "feeding" veins need to be treated first by microsclerotherapy. Occasionally spider veins can be as a result of incompetence in the larger saphenous veins. Generally these veins cause varicosities if they are incompetent but sometimes the varicosities are not obvious on the skin and just show up as spider veins caused by the high pressure in the underlying incompetent saphenous vein. This can be determined, if suspected, by ultrasound mapping.