1. Spider and Varicose Veins Slideshow Pictures
2. Skin Pictures Slideshow: Adult Skin Problems
3. Take the Skin Quiz

Medical Author:

Gary W. Cole, MD, FAAD

Gary W. Cole, MD, FAAD

Dr. Cole is board certified in dermatology. He obtained his BA degree in bacteriology, his MA degree in microbiology, and his MD at the University of California, Los Angeles. He trained in dermatology at the University of Oregon, where he completed his residency.

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Medical Author:

Siamak T. Nabili, MD, MPH

Siamak T. Nabili, MD, MPH

Dr. Nabili received his undergraduate degree from the University of California, San Diego (UCSD), majoring in chemistry and biochemistry. He then completed his graduate degree at the University of California, Los Angeles (UCLA). His graduate training included a specialized fellowship in public health where his research focused on environmental health and health-care delivery and management.

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Medical Editor:

Steven Doerr, MD

Steven Doerr, MD

Steven Doerr, MD, is a U.S. board-certified Emergency Medicine Physician. Dr. Doerr received his undergraduate degree in Spanish from the University of Colorado at Boulder. He graduated with his Medical Degree from the University Of Colorado Health Sciences Center in Denver, Colorado in 1998 and completed his residency training in Emergency Medicine from Denver Health Medical Center in Denver, Colorado in 2002, where he also served as Chief Resident.

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Medical Editor:

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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In this Article

• Varicose veins and spider veins facts
• What are veins and what is their function?
• What are varicose veins and spider veins?
• Varicose vein and spider vein pictures
• Who gets varicose and spider veins?
• What causes varicose and spider veins?
• What are varicose vein symptoms?
• How are varicose veins evaluated (diagnosed)?
• What treatments are available for varicose veins and spider veins?
• How can compression stockings help with varicose veins?
• What is sclerotherapy?
• Pictures of sclerotherapy treatment
• What are potential side effects and complications of sclerotherapy?
• What surgical procedures are available to treat varicose veins?
• Can laser be used to treat varicose and spider veins?
• What type of doctors provide treatments for varicose and spider veins?
• What are the side effects of these treatments?
• How can varicose veins be prevented?
• Spider and Varicose Veins Slideshow Pictures
• Take the Skin Quiz
• Patient Comments: Varicose Veins - Treatments
• Varicose Veins Index

In about 10% to %30% of patients treated with sclerotherapy, dark discoloration of the injected area may occur (hyperpigmentation). This usually happens because of disintegration of the red blood cells in the treated blood vessel. In the majority of cases, this discoloration will completely go away within 6 months.

Another potential problem is the formation of new spider veins near the area that was treated with sclerotherapy. This can happen in about 20% of patients, but these new vessels also typically disappear within 6 months.

Rare complications may include the formation of an ulcer around the injection site or the formation of small blood clots in the small surface veins (superficial thrombophlebitis).

Sclerotherapy is generally safe for most people for the treatment of varicose and spider veins. However, in certain groups of people, such as those individuals who are unable to walk (non-ambulatory), sclerotherapy should be avoided. Other contraindications for undergoing sclerotherapy include obesity, blood clots in the deeper veins, allergy to the sclerosing agent, pregnancy, and arterial obstruction (blocked blood flow in the artery near the varicose vein).

Varicose veins are frequently treated by surgically eliminating the "bad" veins. This forces the blood to flow through the remaining healthy veins. In vein stripping surgery, the problematic veins are "stripped" out by passing a flexible device through the vein and removing it through an incision near the groin. Smaller tributaries of these veins also are stripped with this device or removed through a series of small incisions. Those veins that connect to the deeper veins are then tied off. This stripping method has been used since the 1950's. This is now usually performed using outpatient surgical procedures and rarely requires general anesthesia.

Spider veins cannot be removed through surgery. Sometimes, they disappear when the larger varicose veins feeding the spider veins are removed. The remaining spider veins also can be treated with sclerotherapy.

For all of these procedures, the amount of pain an individual feels will vary, depending on the person's general tolerance for pain, how extensive the treatments are, which parts of the body are treated, whether complications arise, and other factors. Because surgery is performed under anesthesia, pain is not felt during the procedure. After the anesthesia wears off, there can be some pain at or near the incision(s).

For sclerotherapy, the degree of pain will also depend on the size of the needle used and which solution is injected. Most people find hypertonic saline to be the most painful solution and experience a burning and cramping sensation for several minutes when it is injected. Some doctors mix a mild local anesthetic with the saline solution to minimize the pain.