Beyond obvious cosmetic concerns, spider and varicose veins can create health issues. In the more severe forms, varicose veins result in decreased nutrition to the skin leading to eczema, inflammation or skin ulceration. Spider and varicose veins appear when valve function breaks down and blood pools, rather than flows freely through the vein.

Fortunately, there are a host of procedures available to treat the problem. There are four major types from which to choose, sclerotherapy, endovenous techniques, laser/light therapy and surgical intervention. The severity of vein issues determines which procedure is best. All non-surgical procedures involve sealing the interior of a problem vein, causing blood flow to re-route to healthy veins. For some treatments, compression stockings are worn afterwards, and walking or biking recommended to decrease blood pooling or pressure in the area.

Sclerotherapy

• solution is injected into a vein irritating the lining, causing it to seal
• no incisions are necessary • minimal to no discomfort
• full effects of treatment occur after 15-20 minutes
• commonly used to treat spider veins and small varicose veins
• Highest patient satisfaction and least invasive
Before and after pictures.

Endovenous Techniques

• ultrasound guided sclerotherapy - sclerotherapy performed while underlying vein is observed via ultrasound
o takes 15-30 minutes o done with no or local anesthesia
• endovenous laser treatment - after anesthesia is delivered within the vein, a thin laser fiber is inserted, heating it upon withdrawal. o FDA approved procedure shown to be very safe
o possible side effects include skin numbness, blood clots and phlebitis o not recommended for extremely twisted veins
• radiofrequency occlusion - after anesthesia is delivered within the vein, a radiofrequency catheter is inserted, heating it upon withdrawal
o requires single puncture rather than multiple incisions
o yields less bruising and pain then surgical alternatives
o not recommended for extremely twisted veins

Light/Laser Therapy

• an alternative to sclerotherapy for smaller veins
• a light beam is pulsated onto the vein heating its interior, and sealing it
• cooling gel, cool air, or other methods may be applied to protect the top layer of skin
• several treatments are usually required
• patients experience a heating sensation as the light source pulsates over the vein
• can be more uncomfortable than sclerotherapy

Spider & Varicose Vein Treatments

Surgical Techniques
• vein stripping : the upper end of a vein is tied off, and the remainder removed o performed in an operating room
• ambulatory phlebectomy : tiny punctures are made under local anesthesia through which the problematic vein is removed
o no sutures required
o performed in an office
• ligation : incisions are made over the problem areas, and the vein tied off
o blood flow is reduced so vein swelling goes down
o often not recommended due to high rate of reoccurrence
o used to treat bulging varicose veins

While spider and varicose veins may be a common problem, a host of treatments are currently available. Many options are performed in your doctor's office, causing a minimal amount of scarring, if any. Discuss symptoms and concerns with your practitioner to decide which best suits your needs.