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Spider Vein Injection Sclerotherapy

By Dr Ken Seifert – Follow me on +

My name is Ken Seifert, M.D. I work at Optima Vein Care and I will be publishing in this blog weekly to help inform the public about the work we do and the help we can provide you with your varicose and spider veins.

I have been writing about the treatment of incompetence of the superficial vein system and about treatment of the larger varicose veins that results from the incompetent valves in the superficial vein system.

But many people have tiny but very visible dark veins that are called “spider veins”. Often they are numerous and very unsightly. Many people who have them are very self-conscious of them and avoid wearing shorts or bathing suits because of the presence of these spider veins.

They can be painful, or at least tender. They can be inflamed. They can itch. In the absence of an underlying problem with the valves of the superficial vein system, they are not a sign of a serious problem, but without getting an ultrasound examination, no one who has these, and no one who looks at them, can know if there is or is not an underlying problem.

Because of this, insurance companies often do not cover the cost of treatment of spider veins. However, if the ultrasound examination shows an underlying valve problem in the superficial system, then the spider veins often can be treated as part of the treatment of the incompetent valves and in that sense, they are covered by insurance.

The best treatment of the spider veins is injection sclerotherapy. After the underlying valve problem is treated appropriately, I put on a pair of magnifying glasses, illuminate the area with a good light, and, using a very tiny needle, I can inject a dilute solution of polidocanol into the vein.

A nest of spider veins are often connected, so when I inject one vein, sometimes a substantial area of veins will be filled with the sclerosent. To see this is very dramatic. A bunch of red or purple veins just under the skin suddenly disappear! However, this wonderful result is short lived. In a few minutes, the spider veins refill with blood and now they look red and inflamed. This is the result I want to see but the patient may feel disappointment. But in inflammatory response is what will make the veins slowly get attacked and destroyed by the body’s immune system.

This destruction may take several months and it may not be complete. As the sclerosent spreads around in the nest of veins, it dilutes and so the edges of the nest may not disappear, and these edges may need to be treated again. Because of the inflammation, I usually cannot re-inject a vein for several weeks after I have injected it the first time. I usually don’t try to re-inject an area for about 6 weeks. I can inject other areas, but not re-inject the same area.

So these are some of the reasons that I emphasize and repeat: Patience and persistence. There are more reasons that this process sometimes takes months to complete. I’ll write more about this next time.

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