Spider veins (those little red and purple veins on your legs) are best treated by injection sclerotherapy. Injections of a special solution into each vein close them down. For a small percentage of people, laser or intense pulsed light (IPL) can work, but only for really fine red veins on the feet and ankles. Injections work best for most people.

Winter is the best time to treat spider and varicose veins because you need to wear compression hosiery for a week or two after treatment. The hosiery is nice and cosy in winter, and looks like black opaque stockings, so they fit easily with winter outfits. It’s also good to hide your legs away until they’re all healed up as it can take weeks for the bruising and marks to fade away completely after treatment.

Spider veins are sometimes caused by varicose veins that aren’t visible on the skin as bulging varicose veins. A warning sign you might have underlying varicose veins is spider veins on the inside of the ankle or thigh. A special vein ultrasound scan will show any invisible varicose veins. These have to be treated before the spider veins can be taken care of.

Like spider veins, varicose veins can be injected with a special solution to close them down, but because the veins lie deeper under the skin, it’s best done with an ultrasound to guide the needle. This is called Ultrasound Guided Sclerotherapy (UGS). Alternatively a laser can be threaded into the vein through a tiny nick in the skin and used to seal the vein off. This is Endovenous Laser Ablation (EVLA). UGS and EVLA don’t need a general aneasthetic or time off work (unless you have a job involving lots of heavy lifting). Surgery is also an option, but is used less often these days as it hurts more afterwards and you need a general anaesthetic. 

Does it hurt?
Well needles are usually involved, so yes you do feel it! But people tell me it isn’t bad at all, and even needle phobic people cope really well with the injections. Of course the needles are TINY, so that helps. Chewing gum while you’re lying there having your veins treated, or squeezing a stress ball, takes your mind off it. One lady fell fast asleep while I was doing endovenous laser on her varicose vein (when I put the laser up inside the vein in the thigh) so I guess that’s not too bad either. Your legs can get an achy restless feeling at the end of the injection session (from the irritation process required to close the veins) but this passes quickly once you start walking immediately after treatment. When larger veins are treated they can be tender while they’re healing. Paracetamol or a NSAID like Voltaren helps this. 

Are there any side effects?
There are three main side effects with vein treatments: brown pigment, ‘matting’ and DVT. Brown pigment is a stain on the skin over where the vein used to be; it can take 18 months to go away. Matting occurs when the body makes tiny new red veins on the skin as a reaction to treatment. It happens in 10% of people and usually fades away, but there is a small chance it won’t disappear which is very annoying. At Palm Clinic the way we treat veins minimises the chance of matting. DVT or deep vein thrombosis is a clot in the deep veins of the leg. If a piece broke off the clot and travelled to the lungs, it could be fatal. To prevent this happening we ask patients to wear compression hose and walk an hour a day after treatment. If you are at higher risk for a DVT we give special anti-clotting injections to protect you.        

Who should I go and see?
Palm Clinic of course! But seriously, there are many vein treatment centres around where you can get your veins taken care of. Before having treatment you should have your veins checked by the doctor and discuss all the possible side effects and requirements of treatment. Ideally, check the doctor treating your veins is qualified with the Australian College of Phlebology.