Spider veins and smaller abnormally appearing veins close to the surface of the skin are a very common form of problem vein. They tend to be more cosmetic in nature and rarely pose any health concerns. These veins can be treated by an injection technique called sclerotherapy.
Sclerotherapy of spider veins and smaller cosmetic veins is not covered under the Ontario Health Insurance Plan (OHIP) or the Régie de l’assurance maladie Québec (RAMQ). Spider vein treatment costs can be submitted to personal health insurance but are rarely reimbursed.
What is Sclerotherapy?
Sclerotherapy is a treatment where a solution is injected into a vein. It is a procedure that can treat a wide range of veins, from small spider veins to larger varicose veins. The injection is performed directly into the vein causing irritation to the inner lining which results in collapse and closure of the vein.
Spider veins and smaller superficial veins can be treated with weaker solutions which can minimize the risk of complications while still giving great results. Depending on the size of the spider vein or small superficial vein, it can no longer be visible from hours to days after the treatment. If the vein is larger, it can occasionally take weeks to months for it to disappear.
How should I prepare for the treatment?
Patients should wear clothing that is either short or loose enough to allow the treatment area to be exposed. Compression stockings are an important part of your post-treatment care. Please do not forget to bring your compression stockings to your appointment so they can be put on right after the treatment. You should avoid applying any type of lotion, cream, or gel to the treatment area on the day of your appointment. Although we do clean the area on your skin during your treatment, we strongly recommend that you wash the area at home.
How many treatments will I need?
The number of treatments required varies with each individual. The initial assessment will help give an estimate number of appointments so patients can have an idea. It is always difficult to know the exact number due to the wide range in the type, size and number of concerning veins as well as the variability in response to treatment.
Appointments are typically 30 minutes long with a fair number of veins injected during that time. Number of appointments can vary from as little as 2 or 3 for fewer spider veins and up to 7-8 appointments or even more for a large quantity and/or size of veins.
It is very important for patients to known that the treatments are not a cure. You can eliminate your presently concerning veins, however you will continue to produce additional spider veins as time goes on. Therefore, treatments are often viewed as maintenance in order to not accumulate more and more spider veins as you age.
Are the treatments painful?
Sclerotherapy for spider veins and smaller cosmetic veins is typically done using a very small needle similar to ones used to inject insulin or botox. Most patients say the sensation is similar to a mosquito bite. The needle is small enough that there are times where the poke is not felt by the patient. Most times, patients are unable to feel the solution being injected. This is a great improvement from past solutions, as patients would often feel a burning sensation when these were injected.
What can I expect after treatment?
Following sclerotherapy, bandages will be applied to the treatment area and need to be kept on for anywhere from hours to the following day. Compression stockings will be applied shortly after the completion of the treatment. Patients are recommended to wear compression stockings post-treatment to help give the best possible cosmetic results as well as reduce the risk of complications. It is encouraged to wear them till at least the end of the treatment day, but you may benefit from wearing them longer post-treatment. Patients are advised to walk regularly on a daily basis. It is best if you avoid more strenuous physical activity for next day or two following your treatments.
Small bruises at the injection site are fairly common. A larger bruise can occasionally form. Mild tenderness, either at the injection site or along the vein, can be experienced. It is typically short lived and is not usually severe enough to require any form of pain medication.