Vein Care

Direct vision SCLEROTHERAPY for ‘Spider’ or surface veins

Sclerotherapy is used to treat surface (spider) Veins on the legs

Sclerotherapy is the injection of specific chemicals, in either liquid or foamed form, into superficial and surface veins. These chemicals deliberately disrupt the lining of the veins being treated, instigating a response which ultimately results in the replacement of the treated vein with fibrosis, obliterating the vein itself. These injections can be done under direct vision for visible surface veins, or under the guidance of ultrasound for superficial varicose veins not visible to the naked eye.

Sclerotherapy is first-line recommended treatment for surface or “spider” veins. Spider or surface veins can occur as a primary condition (not related to any other pathology) or it can exist as a result of coexisting varicose veins.

Sclerotherapy for surface or ‘spider’ veins

Sclerotherapy under direct vision is the first line of treatment for surface or spider veins. In this setting specific chemicals are injected in very dilute concentrations in extremely small doses into visible surface veins. This is a highly precise and skilled treatment which should only be undertaken by practitioners with specific training in this delicate art. These injections can carry a small amount of discomfort at the time of the treatment. However there should be no significant discomfort after the treatment. Most patients will require more than one treatment of sclerotherapy under direct vision to clear their surface veins to their satisfaction. Each treatment session needs to be approximately a minimum of 6 weeks apart.

What will the recovery be like following direct vision Sclerotherapy?

A full length class II compression stocking is applied at the end of the procedure. You will need to wear this stocking for 1 week following direct vision sclerotherapy. It is essential that you walk at least 30 minutes a day starting as soon as practical after your sclerotherapy treatment, for at least the duration of wearing your stockings. It is advisable to avoid heavy exercise during this time however. You will be provided with written post-treatment care instructions and be followed up closely after the procedure by your doctor. 

Are there any risk involved with direct vision Sclerotherapy?

Like all our non-surgical treatment modalities, sclerotherapy under direct vision is considered a safe procedure, but has some recognised side effects. Serious side effects are very rare. Common side effects are harmless, but can include bruising, pigmentation of the skin caused by blood breakdown products, and swelling. These side effects are temporary. 

Serious side effects are very rare. Deep vein thrombosis is extremely rare after direct vision Sclerotherapy. Migraine can occur following sclerotherapy, more commonly in patients who were frequent sufferers of migraine beforehand. It is more common to experience the aura rather than the full progression to migraine. Superficial thrombophlebitis can occur following sclerotherapy, whereby the skin and soft tissue around a treated vein can become red and tender. This can usually be simply managed and brought under control with simple measures. Allergic reactions are rare, but known to occur with both the utilised sclerosing agents. Our clinic is fully equipped to manage allergic reactions including severe allergic reactions known as anaphylaxis. Ulceration of the skin after sclerotherapy has been reported, involving patches of skin tissue effectively breaking down as a result of injections.

FAQS About Spider Veins

  • Surface, or spider veins, represent abnormal veins very much smaller than varicose veins, often lying in the uppermost layers of the skin itself. They usually do not cause physical symptoms per se, but can be unsightly. They can be bright pink-red in colour, or can be blue or purple. The very smallest and most superficially-lying spider veins are called telangiectasia. They are often borne from, or are fed by, slightly larger, bluer veins lying in the dermis called reticular veins.

    Once a superficial vein demonstrates varicose change, it will not heal itself, even with time. Instead, it will gradually, over time, steadily get worse.

  • The practice of sclerotherapy is a highly skilled and precise one, and a practice Dr Melanie has undertaken the highest training available in Australia to practise.

    Dr Melanie works closely with the outstanding vascular diagnostic services at South Sydney Vascular Centre to provide her patients with world-class vascular ultrasonography; which is imperative for accurate pre-treatment assessment, appropriate treatment planning, and in the safe implementation of Ultrasound-guided sclerotherapy of varicose veins.

  • Every sclerotherapy procedure will be explained in detail, including pre- and post-treatment management, and you will have a clear understanding of the procedure recommended, including how it will be done, how it will work, and possible side effects and adverse events, or complications.

  • Sclerotherapy is not for everybody, and there are a few circumstances in which sclerotherapy is simply contra-indicated. This will be carefully evaluated by Dr Melanie.

  • Optimum outcomes in sclerotherapy of both surface veins and varicose veins, depend first on determining if sclerotherapy is the best treatment for your particular pattern of veins. It then relies on the procedures being done safely and thoroughly, which takes study and specialised training. Outcomes also rely on how you look after yourself in the post-treatment period.

    Dr Andronicus will explain all of the necessary steps you will need to take in this period to optimise safety and good outcome. These steps will include the requirement to walk daily and wear a medical grade compression garment for 1-2 weeks following the treatment.