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Spider Veins & Sclerotherapy

Spider Veins & Sclerotherapy at VidaVascular in Oxon Hill, MD

Spider veins are those thin red, purple, or blue lines that look like little webs under the skin, usually on the legs. For many people, they are mostly a cosmetic concern. For others, they come with annoying symptoms like burning, aching, or itching, especially after a long day on your feet. They are common, and you are not “being dramatic” for wanting them checked.

At VidaVascular, a vascular and interventional care practice in Oxon Hill, Maryland, patients can be evaluated for spider veins and discuss treatment options like sclerotherapy in a patient-centered way. Many people also visit from nearby areas like National Harbor, Fort Washington, Temple Hills, and Suitland, especially when they want clear answers about what is cosmetic, what is medical, and what is worth treating.

What are spider veins, and how are they different from varicose veins?

Spider veins are tiny surface veins called telangiectasias. They can be flat or slightly raised and often look like thin lines or branching patterns. Reticular veins are a bit larger than spider veins and sit a little deeper, often appearing blue or green. (1)

Varicose veins are different. They are larger, bulging, and “rope-like.” Varicose veins are more likely to be linked with venous reflux, which means blood is slipping the wrong way because vein valves are not working well. (7)

Why do spider veins show up, and can they cause symptoms?

Spider veins often develop because of a mix of genetics and pressure in the veins over time. Sometimes they are just “a thing your body does.” Sometimes they are a clue that the vein system is under stress. (1)

Common contributors include:

- Family history

- Pregnancy and hormones

- Aging

- Long hours standing or sitting

- Higher body weight

- Past vein injury or clot history in some cases

Symptoms can happen, even though many people have no symptoms at all. In research reviews, people report things like pain, burning, or itching with spider and reticular veins. (1)

When should I see a vein specialist, and do I need an ultrasound?

If your spider veins are purely cosmetic and you have no other leg symptoms, some people do not need extensive testing. But if you have discomfort, swelling, visible larger veins, skin color changes near the ankle, or a history of clots, an evaluation can be smart.

A duplex ultrasound is a painless test that shows blood flow and checks for reflux. It is widely used when clinicians are evaluating possible venous reflux. (7) European sclerotherapy guidelines also describe ultrasound as part of standard diagnostics in chronic venous disorders, with some flexibility for smaller veins depending on the situation. (4)

Consider getting evaluated sooner if you have:

- New or worsening leg swelling

- Aching or heaviness that affects daily life

- Skin irritation or darkening near the ankle

- Bleeding from a vein

- A tender, cord-like vein (possible inflammation)

Urgent note: sudden one-leg swelling, chest pain, or shortness of breath can be signs of a blood clot emergency.

What is sclerotherapy, and how does it work for spider veins?

Sclerotherapy is a treatment where a clinician injects a medication (a sclerosant) into the targeted small veins. The medicine irritates the inside lining of the vein, which helps the vein close and fade over time as your body reabsorbs it. (4)

Two commonly discussed sclerosants in major guidelines and studies are:

- Polidocanol

- Sodium tetradecyl sulfate (STS) (4)

In a randomized, double-blind clinical trial (the EASI study), polidocanol and STS were compared with placebo for spider and reticular veins, supporting sclerotherapy as an established approach with measurable improvement. (2)

What results can I expect, and what are the risks or side effects?

Real talk: spider veins usually improve, but they do not always disappear in one session, and new ones can develop later. That is not “failure.” That is how veins behave.

What many patients can expect:

- Gradual fading over weeks

- Often more than one treatment session for best cosmetic blending (1)

Better results when underlying reflux is addressed if it exists (7)

Common temporary side effects can include:

- Bruising or tenderness

- Temporary darkening of the skin (hyperpigmentation)

- Tiny new “blush” vessels near the treated area (matting)

- Small lumps or firmness that soften over time

Hyperpigmentation is a known side effect. A systematic review focused on polidocanol reported wide ranges depending on concentration and technique, and noted that longer-lasting pigmentation can occur in a smaller subset. (5)

If you are comparing options, a network meta-analysis found that different treatments (including laser and injection approaches) vary in clearance and side effects for telangiectasias and reticular veins, which is why some patients do best with combination planning. (6)

Why Choose VidaVascular for Spider Veins & Sclerotherapy?

Spider veins might be “common,” but that does not mean you have to ignore them, especially if they are bothering you physically or mentally. VidaVascular offers evaluation and treatment options for spider veins, including sclerotherapy, in Oxon Hill, MD, with a focus on helping you understand what is going on and what a realistic plan looks like.

Located in Oxon Hill, Maryland, VidaVascular serves patients from nearby communities including National Harbor, Fort Washington, Temple Hills, Suitland, and Forest Heights. If you are searching for spider vein treatment near Oxon Hill or want to speak with a vein-focused team in Prince George’s County, a visit can help you get clear answers and options you actually feel good about.

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References:

1. Nakano, L. C. U., Cacione, D. G., Baptista-Silva, J. C. C., & Flumignan, R. L. G. (2021). Treatment for telangiectasias and reticular veins. Cochrane Database of Systematic Reviews, 2021(10), CD012723. https://doi.org/10.1002/14651858.CD012723.pub2

2. Rabe, E., Schliephake, D., Otto, J., Breu, F. X., & Pannier, F. (2010). Sclerotherapy of telangiectases and reticular veins: A double-blind, randomized, comparative clinical trial of polidocanol, sodium tetradecyl sulphate and isotonic saline (EASI study). Phlebology, 25(3), 124–131. https://doi.org/10.1258/phleb.2009.009043

3. Wong, M., Parsi, K., Myers, K., De Maeseneer, M., Caprini, J., Cavezzi, A., et al. (2023). Sclerotherapy of lower limb veins: Indications, contraindications and treatment strategies to prevent complications: A consensus document of the International Union of Phlebology 2023. Phlebology, 38(4), 205–258. https://doi.org/10.1177/02683555231151350

4. Rabe, E., Pannier, F., & Guideline Group. (2014). European guidelines for sclerotherapy in chronic venous disorders. Phlebology, 29(6), 338–354. https://doi.org/10.1177/0268355513483280

5. Bossart, S., Daneluzzi, C., Cazzaniga, S., Ramelet, A. A., Uthoff, H., Seyed Jafari, S. M., et al. (2023). Skin hyperpigmentation after sclerotherapy with polidocanol: A systematic review. Journal of the European Academy of Dermatology and Venereology, 37(2), 274–283. https://doi.org/10.1111/jdv.18639

6. Bontinis, V., Bontinis, A., Koutsoumpelis, A., Claridge, M., Chorti, A., Rafailidis, V., et al. (2023). Interventions for the treatment of lower limb telangiectasias and reticular veins: A systematic review and network meta-analysis. European Journal of Vascular and Endovascular Surgery, 66(4), 560–576. https://doi.org/10.1016/j.ejvs.2023.05.029

7. Gloviczki, P., et al. (2023). The 2022 Society for Vascular Surgery, American Venous Forum, and American Vein and Lymphatic Society clinical practice guidelines for the management of varicose veins of the lower extremities. Part I: Duplex scanning and treatment of superficial truncal reflux. Journal of Vascular Surgery: Venous and Lymphatic Disorders, 11(2), 231–261.e6. https://doi.org/10.1016/j.jvsv.2022.09.004