Vascular Associates of Northern Virginia

Timely and considerate care of the arterial and venous systems.

Spider Veins?

Millions of people are bothered by spider veins — those small yet unsightly clusters of red, blue or purple veins that most commonly appear on the thighs, calves and ankles.  It is estimated that at least half of the adult population is plagued with this common cosmetic problem.
Spider veins are treated with sclerotherapy.  In this rather simple procedure, veins are injected with a sclerosing solution, which causes them to collapse and fade from view.  This procedure may also remedy the bothersome symptoms associated with spider veins, including aching, swelling, and burning.

What are spider veins?

Spider veins — known in the medical world as telangiectasias or sunburst varicosities — are small, thin veins that lie close to the surface of the skin.  Although these super-fine veins are connected with the larger venous system, they are not an essential part of it.
Factors contributing to the development of spider veins include: heredity, pregnancy and other events that cause hormonal shifts, weight gain, occupations or activities that require prolonged sitting and standing, and the use of certain medications.
Spider veins usually have one of three basic patterns.  They may appear in a true spider shape with a group of veins radiating outward from a dark central point; they may be arborizing and will resemble tiny branch-like shapes; or they may be simple linear and appear as thin separate lines.  Linear spider veins are commonly seen on the inner knee, whereas the arborizing pattern often appears on the outer thigh in a sunburst or cartwheel distribution.
Varicose veins differ from spider veins in a number of ways.  Varicose veins are larger and usually more than a quarter-inch in diameter, darker in color and tend to bulge.  Varicose veins are also more likely to cause pain and be related to more serious vein disorders.  For some patients, sclerotherapy can be used to treat varicose veins; however, often surgical treatment is necessary for this condition.

Who are the best candidates for sclerotherapy?

People of any age may be good candidates for sclerotherapy, but most fall in the 30-60 age range.  In some people spider veins may become noticeable very early on in the teen years.  Others may not become obvious until you reach your 40s.
Spider veins in men are not nearly as common as they are in women.  Men who do have spider veins often don’t consider them to be a cosmetic problem because the veins are usually concealed by hair growth on the leg.  However, sclerotherapy is just as effective for men who seek treatment.

What to expect from sclerotherapy?

Sclerotherapy can enhance your appearance and your self-confidence, but it’s unrealistic to believe that every affected vein will appear lighter.  Two or more sessions may be required to achieve optimal results.  Think carefully about your expectations and discuss them with the doctor before you have sclerotherapy done.

Risks related to treatment

Serious medical complications from sclerotherapy are extremely rare when the procedure is performed by a qualified practitioner.  However, they may occur.  Risks include the formation of blood clots in the veins, severe inflammation, adverse allergic reaction to the sclerosing solution and skin injury that could leave a small but permanent scar.
A common cosmetic complication is pigmentation of the treated area.  These brownish splotches on the affected skin may take months to fade, sometimes up to a year.  Another problem that can occur is “telangiectatic matting” in which fine reddish blood vessels appear around the treated area, requiring further injections.
Although no one can offer a guarantee on the outcome of sclerotherapy, choosing a qualified doctor who is well versed in the types of sclerosants available and has adequate training in sclerotherapy can reduce your risk of an undesired outcome.

Planning your treatment

During your initial consultation, your legs will be examined.  During the examination you will be checked for signs of more serious “Deep vein” problems, often indicated by swelling, sores, or skin changes at the ankle.  If such problems are identified, your vascular surgeon may request that you have further evaluation.  Problems with the larger veins must be treated first, or sclerotherapy of the surface veins will be unsuccessful.
You will be asked about any other problems you may have with your legs, such as pain, aching, itching or tenderness.  You will also be asked about your medical history, medications you take, or conditions that would preclude you from having treatment. Individuals with hepatitis, AIDS or other blood-borne diseases may not be candidates for sclerotherapy.  Patients with circulatory problems, heart conditions, or diabetes may also be advised against treatment.
The procedure will be explained in detail, along with its risks and benefits, the recovery period and the costs.  (Medical insurance usually doesn’t cover cosmetic procedures.)  It’s important to be open in discussing your history and treatment goals with your doctor.  Don’t hesitate to ask any questions or express any concerns you may have.


Vascular Associates of Northern Virginia, P.C.

Vascular surgeons:
Robert S. Podolsky, M.D.
Avisesh Sahgal, M.D.


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