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Spider Veins or telangiectasia, are small, dilated, tortuous red or blue blood vessels (capillaries) that are visible on the skin surface. They occur in areas where there is accumulation of fluid in the skin, such as the legs and ankles. Chronic fluid accumulation in these areas can result from gravitational forces on the veins, injuries, weight gain or medications. Chronic fluid accumulation can eventually damage valves within large veins leading to backflow of blood and body fluids into the skin. Spider veins arise on the skin surface as a natural accommodation to this backflow.
Injection sclerotherapy is characterized by the micro-injection of a sclerosing (scarring) solution into these tiny capillaries. The sclerosing solution irritates the inner lining of the capillaries so that they eventually scar closed and become invisible. FDA-approved sclerosants include hypertonic saline and Sodium Tetradecyl Sulfate (Sotradecol or STS).
Sclerotherapy can also be performed using a laser that targets small blood vessels. This type of laser is called a vascular laser; there are many different types of vascular laser. Laser sclerotherapy is usually not as effective for larger veins, compared to injection sclerotherapy. The combination of both injection and laser sclerotherapy techniques (Nd-Yag Vascular Laser) is often performed, depending on the specific needs of each individual.
Sclerotherapy does not harm the circulation. Brown discoloration (hyperpigmentation) may appear on the skin after injections, and it gradually fades over months, but sometimes over years. Pain during injections is reported by patients as very slight. Fading of spider veins is a slow process and maximum improvement may require many months and two or more treatments. Compression stockings should be worn after the treatment for up to 1 week; this helps to promote permanent closing, scarring and disappearance of the tiny vessels.