The smallest varicose veins are called spider veins or spider telangiectasias. Although these super fine veins are connected with the larger venous system, they are not an essential part of it. There is an inherited tendency to develop spider veins and the condition is aggravated by prolonged standing, injury, or pregnancy. They are usually asymptomatic, but occasionally cause a mild burning sensation.

Contributing Causes for Spider Telangiectasias / Veins A number of factors contribute to the development of spider veins, including heredity, pregnancy, and other events that cause hormonal shifts, weight gain, occupations or activities that require prolonged sitting, or standing and the use of certain medications.

• Obesity, or recent weight gain
• Pregnancy
• Prolonged sitting or standing
• Aging
• Heredity

• Small clusters or bursts of small, faint red lines on the skin surface
• Dull, mild, aching or slight burning sensation localized over the area of the spider veins

• Physical examination
• Medical and family history

• Sclerotherapy The procedure of injection sclerotherapy, is irritating to the veins and causes the tiny dilated veins to scar and disappear. This procedure treats the veins that are currently visible and does nothing to permanently alter the venous system or prevent new spider veins from developing in the future. A chemical solution is injected directly into the veins with a very small needle, irritating and collapsing the lining of the vein. The inner surface of the collapsed vein then grows together and obliterates the vein. This is done in the office, but requires the patient rest and elevate their legs for 48 hours following the procedure. Compression from support hose or elastic bandages (ACE wraps are used for at least several days following treatment.)
  • Sclerotherapy Instructions you will receive specific instructions from Dr. King and his staff, but in general you will need to plan for someone to drive you home even though anesthesia is not used. This is due to the bulky leg wraps, general temporary discomfort, and occasionally the lingering effects of pain medication. You should wear shorts or bring them to change into for the treatment. Before coming to the office, shave your legs, but do not apply any moisturizers, sunblocks or lotions. You should make arrangements to be off your feet for 48 hours. Dr. King injects veins on Fridays, and this often makes it easier to arrange to have two days off. Scheduling should be done keeping in mind not only the 48 hours off your feet, but that due to bruising and discoloration, you will likely not want to wear short skirts, bare legs, or bathing suits for several weeks after the sclerotherapy to allow your legs time to heal. Suntanning should be avoided until all the bruises have cleared to lessen the chance of long-term discoloration. Wearing support hose for the duration of the discoloration is also believed to help reduce the chance of long-term discoloration, increase the success rate of therapy and to help seal in the treatment solution.
  • Appearance Sclerotherapy can enhance the overall appearance and reduce symptoms, but it is unrealistic to believe that every vein will disappear. Often two or more sessions will be necessary to achieve the optimum results. The appearance of the legs will be worse before it improves, with bruising and discoloration common and expected for several weeks following treatment.
  • Touch-ups Most patients find that after a year or rarely, in less than a year, touch-up sessions are required for treatment of new varicose veins.
  • Recurrence Wearing support hose reduces risks, but there is no way guarantee that other, formally healthy veins will not become varicose. Following the recommendations for reducing the risk of developing varicose veins will aid in prevention.
  • Discomfort The injections are similar to insect bites. Check with Dr. King if you have a problem tolerating injections, or a low pain threshold. Ibuprofen, such as in the brand name medications Advil or Motrin are usually adequate for pain relief. Stronger pain medication is sometimes necessary. Treatment sessions last for 30minutes
  • Risks and complications Serious medical complications from sclerotherapy are extremely rare when performed by a qualified practitioner. However, complications do occur on occasion. Risks include clots in veins, severe inflammation, and adverse allergic reactions to the sclerosing solution, skin injury that could leave a permanent scar. One common complications is pigmentation irregularities or brownish splotches on the affected area of skin that may take months to fade, or less often more than a year to fade. Another problems that can occur is a "matting" appearance where fine reddish blood vessels appear around the treated area, requiring further injections.
• Reducing Risk of Development of Spider Veins It is impossible to prevent an inherited tendency toward developing spider veins, but it is possible to take measures to help in prevention. The main goal of prevention is to limit the opportunity to distend, or stretch, the veins. Spider veins are usually troublesome cosmetically rather than disabling, but occasionally may have symptoms. The following suggestions may reduce the likelihood of developing spider veins:

• Regular exercise
• Maintaining a healthy weight
• Avoid standing for prolonged periods
• Get up and move about frequently when traveling by plane or car
• Do not cross legs when sitting
• Wear support stockings regularly, but in particular when pregnant
• Avoid sitting in chairs that press against the back of the thighs
• Elevate legs and feet when possible. The elevation should be above the level of the heart, just lying on the bed flat, for example, is not sufficient