Dr. Saliveros Apostolos

Teleangiectasia is the appearance of very small vessels on the skin with diameter between 0,1 and 1mm that is caused by several factors. Factors that are believed to cause spider veins are: heredity, pregnancy, prolonged standing, trauma, corticoid topical use, prolonged expose to sun. Many times spider veins are a sign of superficial vein insufficiency.

Spider veins cannot cause serious adverse effects (for instance they cannot cause thrombosis) but they can affect the patients quality of life due to 1. Everyday little annoying symptoms like topical itch, topical burning sensation, topical ache (especially during the menstrual circle). 2. They affect the patients appearance and especially women cannot dress the way they want or if they expose their legs many times they have to listen to things like “was is wrong with your legs”, “is it dangerous” etc. Many times  this causes anxiety and a psychological burden. 3. Sometimes a spider vein can bleed and cause panic due to the vast amount of blood that comes out of it. 

For all these reasons often patients with spider veins need to be cured from this problem. There are three main techniques for making spider veins disappear.

1. Sclerotherapy : that is the injection of special drugs inside the small veins that cause the veins finally to go away. It is the “golden standard” for many many years (> 50 years) and today. It is very effective, with little discomfort, few complications, and the only real disadvantage is that it needs several visits to the doctor office and cannot be done in one application.
2. Laser: that is burning the vessel with a special laser light. It is very effective for the face but for the legs is inferior to sclerotherapy. It has more pain and more bruising and cannot erase the bigger veins while sclerotherapy (especially with foam) can erase veins > 1mm (even varicose veins).

If you suffer from spider veins the first step is to be examined by a specialist (in Greece the specialty that deals with vein problems is the Vascular Surgeon). The specialist will examine you clinically and with ultrasound (colour duplex) in order to decide what is the nature of the problem and what is the best therapy treatment for you.

Frequent questions from patients:

1. I am concerned about the safety of the drug used for sclerotherapy: Answer : the drugs we use were discovered in the 1950’s and thus they are very well studied. On top of that sclerotherapy is the most frequent medical act of a vascular surgeon, (a disease that affects > 70 % of female patients). So you can imagine everyday how many sessions of sclerotherapy are performed all over the world. It is one of the most frequent and most studied medical procedure - and it is safe.
2. Does laser application leave marks on the skin? Answer : there is a possibility of skin hyperpigmentation or skin burn during the application of laser. Thats why it should be done by experts avoiding summertime when hyperpigmentation is more frequent. The common mistake that causes burns is to try to treat bigger spider veins and use a lot of energy.
3. If a have a session treatment for spider veins when can I get back at work ? Answer : after a session of treatment (either sclerotherapy - laser - or ablation) you can go back to work immediately.
4. Can I go to the gym after sclerotherapy ? Answer : it is advised not to go to the gym and do hard exercises for 3-5 days after sclerotherapy - but you can do light exercise like walking, slow speed treadmill, swimming in inside pool, soft pilates, easy cycling etc.
5. Do I have to wear elastic stalking after sclerotherapy ? Answer : it is advised to wear elastic shocks for at least 2-3 days after the session because the compression of the vein is considered to make it more efficient.
6. I take some medication. Can I have sclerotherapy? Answer : The only drugs that are contraindicated are hormones, anticoagulants, birth control pils and anti-inflammatory drugs.