Sclerotherapy — or injection therapy — is the most commonly used treatment for small diameter (<5mm) veins, such as spider veins. In Sclerotherapy, a liquid is injected with a tiny needle into the vein that causes inflammation of the vein walls and causes the vein walls to stick to one another, collapsing the walls together. This solution and the use of a compression stocking, effectively prevents the vein from working and it stops carrying blood. The vein therefore disappears with time.
Small veins are effectively removed by Sclerotherapy but veins will often reappear if the underlying causes, incompetent blood vessels, are not treated. Sclerotherapy is associated with brown discoloration of the vein that may take up to one year to disappear and usually requires repeated treatments. It rarely can cause skin ulcers and as with all medications, some patients may have an allergy to the solution.
Ultrasound Guided Sclerotherapy
Ultrasound guided sclerotherapy is used for the treatment of deeper veins that cannot be seen or felt and for larger superficial veins.
Using ultrasound, a solution is injected into the veins causing the vein walls to collapse. Compression stockings are then used to make sure that the vein walls stay collapsed. Ultrasound guided sclerotherapy requires expert knowledge that conventional sclerotherapy does not. Once again, as the larger veins are treated, smaller spider and reticular veins will often disappear.
The advantages are no scarring and smaller veins disappear, while the downside is brownish discolorations, allergic reactions and the rare development of skin ulcers.