How we get rid of spider veins

Spider veins are ugly, troublesome but generally fully harmless dilatations of the blood vessels, which are mainly (although not exclusively) seen to occur in women. Even very young and slender women are frequently seen to suffer from this unsightly variant of varicose vein illness.

Conventional therapy

When such spider veins are present, one should first clarify what the precise cause is for this illness, and whether or not one of the larger truncal veins has already fallen ill: Occasionally, a varicose vein exists in a hidden area of the truncal vein, which is not yet visible superficially. If this is the case, the treatment must begin there - for example, with the aid of radiofrequency therapy (see there) - and only then is a treatment of the superficial varicose veins ("spider veins") advised.

Previously, the therapy of choice was primarily conventional phlebosclerosation; here, a liquid, alcoholic sclerosing agent is injected into the afflicted vein (or into the spider vein). In this way, the inner wall of the vein is intentionally damaged and, mostly by way of an intermediate stage of a local, minimal thrombosis, it results in a closure of the vein or the spider vein.

For some years now, "microfoam" or sclerosant foam has also been used for phlebosclerosation of the veins. Hereby, the same alcoholic sclerosing agent is whipped to a very fine and stable foam and this foam is then injected into the vein or the spider vein (please also see the section on "Foam sclerotherapy"!).

The method is indeed very effective, but all kinds of sclerosing agent can easily result in the development of long-lasting brown spots on the skin, a symptom which is sometimes even more disturbing than the spider veins which were present beforehand.
At our institute, we consequently no longer make use of microfoam sclerotherapy for the treatment of spider veins, but instead use an ultra-modern, powerful laser system.

Spider Vein Treatment at the Private Institut für Chirurgie München

Laser treatment for spider veins is the most effective method and surely results in the best aesthetic outcome. Unfortunately, most physicians avoid the very high acquisition and overhead costs of the new laser systems so that treatment frequently continues to be carried out using obsolete methods such as "high-frequency electrotherapy" or with old, often unfit laser devices.

Dr. Netzer performing laser spider vein removal using the Nd:YAG laser system

To perform laser treatment for spider veins, we use a Nd:YAG system:

• The spider veins are briefly irradiated (for about 50 milliseconds) using energy-rich light impulses of a particular wavelength so that the laser light passes through the skin and its pigment layer without any effect and is able to unfold its full effect on the thin vessels of the skin and the subcutis (the so-called spider veins).
• Through the light impulses, the blood in the spider veins is heated and causes the small vessels to burst. A small, local haematoma of a few millimetres in diameter develops, which the body then degrades, along with the remainder of the spider veins, within 10 - 14 days.
• In contrast to sclerotherapy - and foam or microfoam sclerosation – pigment changes practically never occur, that is to say, neither brown nor lighter spots are seen to develop.
• Laser spider vein removal is naturally performed on an ambulatory basis and, as a rule, lasts about 10 - 15 minutes per leg.
• After the treatment - in contrast to foam or microfoam sclerosation - no compression stockings have to be worn and patients can return to work on the same day or participate in sports.
• In cases where we perform surgery on a patient\'s varicose veins, we in principle also treat spider veins during the same procedure.
• To completely eliminate all of the spider veins, it is often necessary to undergo a number of these short visits, usually two to three.

In cases where we perform endoscopic surgery, radiofrequency therapy or the steam vein sclerosis method (SVS) on our patients with varicose veins, we also treat their spider veins during the same sitting.

A lifelong elimination of spider veins, however, is not possible: as a rule, the unsightly, tiny vessels appear again after some years (sometimes even sooner) and must then be treated once again.