By: Dr. Corey Hartman, Skin Wellness Dermatology
Many patients look down one day and realize their legs are starting to look a lot like their mother’s. They start to notice the veins on their legs becoming more visible, and for some, this can be extremely bothersome.
While in many cases, the exact cause of spider veins is unknown, what we do know is that heredity, and even trauma, obesity, and hormone levels can play a role. Especially if you’re pregnant or over the age of 30, it’s likely that you’re starting to notice these veins more and more.
Fortunately, even though we can’t change your genes, we do have some pretty great treatment options to help you get those spider veins under control.
Sclerotherapy: The gold standard in spider vein treatment
Sclerotherapy is by far the most effective treatment for spider veins, and even reticular veins, the deeper blue veins that feed the spider veins.
(Keep in mind, once they become varicose veins, which are usually painful and palpable, you’ll need to visit a vascular surgeon, not a dermatologist, for treatment.)
With sclerotherapy, what we’re doing is injecting a sclerosing agent directly into the vein. The agent goes into the vein, closes the vessel wall from the inside and makes the vein collapse. From there, the body just absorbs that material.
Your dermatologist will use one of three sclerosis agents, which include:
Glycerin. Glycerin is a sugar that can effectively treat the majority of spider veins. It’s been harder and harder to get, but it’s the cheapest, most effective, and least painful, which is why it’s my personal favorite.
Polidocanol. Polidocanol is what I typically use if glycerin, for whatever reason, isn’t effective enough to treat certain veins.
Hypertonic saline. Hypertonic saline is a very concentrated form of salt so it burns and can also cause ulcerations, which is why I stopped using it years ago.
Teeny tiny spider veins? Bring out the laser.
While most people are happy with the improvement that we get with the sclerotherapy, I’d say maybe 25% of the time, we’ll create a more customized treatment and utilize the Excel V Laser.
Some spider veins are just so tiny that you can’t even get a 30-gauge needle into the vein, and that’s when we’ll bring out the vascular laser. It can zap those tiny veins better than anything else.
Warm or cold: When is the best time of year to do sclerotherapy?
Since we ask that you wear medical-grade compression socks for a week after the treatment, it’s best to do sclerotherapy during the winter. These types of socks are hot, and you definitely don’t want to wear them as leggings.
That means, here in Alabama, we only have a few months where I’m comfortable treating spider veins. March is a popular month, but don’t try to do it in May – it’ll be too late.
Are you a good candidate for sclerotherapy?
I’d encourage a patient to go forward with sclerotherapy any time spider veins start to bother them. It’s a cosmetic issue, and if they look down and their legs are starting to look like their aunt’s or mother’s, and they’re not happy with that, then I’d say it’s probably a good time to go ahead with the treatment.
That being said, you’re not going to be a good candidate for sclerotherapy if you have:
- Vasculopathy, or any disease affecting the blood vessels.
- Lipodermatosclerosis, which is a skin and connective tissue disease.
- Woody discoloration, pain, or constant rashes on the legs.
When to see your dermatologist for spider vein treatment
When it comes to treating spider veins, I always say, the earlier the better. When the patient comes in soon after they start noticing the veins, their experience is less traumatic, and they get a really good outcome. On the other hand, if a patient has waited a little too long, their treatment is going to be a little more painful and take longer to complete.
With just about any issue, cosmetic or medical, it’s better to prevent as much as you can and treat as early as possible. And trust me, when it comes to spider veins, if you come in early on, you’re going to be much happier with the experience AND the results.
Learn more about sclerotherapy for spider veins from Skin Wellness Dermatology in Birmingham, AL
At Skin Wellness Dermatology of Alabama, we offer cutting-edge skincare and dermatology services to our patients in the Greater Birmingham area, including Hoover and Homewood. At our offices in Birmingham & Chelsea, AL, our certified dermatologists are here to listen to your concerns and offer the individualized, high level of patient care you seek. We believe in making care accessible and affordable, and we will go out of our way to accommodate your visit. Give us a call today at 205-871-7332.