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Spider Vein Treatment

We treat spider veins by two methods. Laser is used for the tiniest of veins. The laser picks up the red color and the energy causes the vessel to close. Sclerotherapy is the gold standard for most spider veins and small varicose veins. We use Asclera solution which I feel has the lowest risk. The veins do look clotted and take 4-6 weeks to resorb so it is best to do before summer. Patients will also need to wear compressive hose during the recovery and refrain from exercise for a week. It is an office procedure with no down time from work.

Spider veins are the small cluster of red, blue or purple veins that appear on the thighs, calves and ankles. It is estimated that half of all female adults have spider veins. If you want to reduce your spider veins Iowa Plastic Surgery can help. There are various effective and safe for reducing unwanted veins – the best method for you can be determined in consultation with Genesis Plastic Surgery. Various options are outlined below.

The legs may be treated with sclerotherapy, a procedure in which the veins are injected with a solution causing them to collapse and fade. This is considered the gold standard for treatment of spider veins. Genesis Plastic Surgery primarily uses two sclerosing solutions:

Sodium Tetradecyl Sulfate
Commonly used agent causing destruction of the internal lining and eventual sclerosis of the vein. Occasionally it does not work, or could “leak” into the surrounding tissue and cause scabs and later scars.

Asclera® (polidocanol)
Commonly used for the smaller spider veins, it works in the same manner, by injection and injuring the vein wall. It is felt to have less pigmentation and less injury to surrounding tissue.

Another option for remedy of the tiniest of spider veins is laser treatments:

Diolite is a laser that generates an intense beam of light. This beam brings energy to a specific site, through a small handpiece. It then breaks up the pigmentation color. It can only treat the tiniest veins , that a needle cannot inject. Side effects include white spots, or failure to be successful.

Surgical Excision or ‘Stab’ excision is yet another option for treatment of small varicose veins. It involves making small surgical incisions to remove the varicose veins. The incisions are very small and thus the scars related to these are minimal.

Large Varicose Veins may be referred to a vascular surgeon to do a minor surgery where the vein is treated from inside by a laser or radiofrequency treatment to clot it. This has replaced stripping of larger veins.


  1. The treatment of spider veins of the lower extremities may require more than one series of injections as will be determined in your initial consultation.
  2. The injections are performed with you lying down. You will feel some slight discomfort from the fine needle sticks; the number will be determined by the number of veins requiring treatment. The medicine may cause mild discomfort upon injection.
  3. There have been reported rare cases of allergic reactions to the medication. Do not hesitate to tell us if you feel faint or have any discomfort during your treatment.
  4. Compression stockings are to be worn after your treatment. You should wear the compressed stockings for 3 days to 3 weeks (except for showering) for best results.
  5. You may feel some cramping in your legs for the first day or two after the injections.
  6. The veins will look worse before they look better. By this we mean that there will be firm dark blue veins, which will decrease over approximately one month’s time. In many cases, there may be some residual brownish pigmentation, which gradually fades over a period of approximately one year. The injected veins may be hard or firm and take six weeks to soften.
  7. In some cases, the skin overlying the vein can be injured resulting in a wound, which upon healing will leave a scar. Tiny scars are common. Larger scars (> than a dime) are uncommon.
  8. The injected veins may get a little reddened around them. A small opening is not uncommon. Please call the office if it becomes a dime size opening for an appointment.
  9. There may be an additional session required for excessive or recurrent veins, or ones that do not “take” or sclerose.
  10. Normal walking is allowed after the injections. You may shower. Exercise should be avoided for one week. This dilates the veins and prevents them from clotting.
  11. Avoid prolonged sitting, standing and pounding-type of exercises after the injections.

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