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Microsclerotherapy is the best method for spider veins


Approximately half of the patients presenting with varicose veins undergo treatment because they are not happy with the cosmetic appearance. This issue is generally underestimated or ignored by the relatives, spouses and even doctors. Sometimes even the patients themselves are too shy to express their discomfort caused by the appearance of the varices. However, cosmetic appearance can negatively affect the social life of a person and sometimes it may be the only sign of an underlying venous insufficiency.

Are there incompetent veins in patients with spider veins?

In approximately 40% of patients with spider veins, superficial vein insufficiency may be detected by color Doppler ultrasound and in this case, the incompetent veins should be closed first by means of laser or radiofrequency before the spider veins are treated. In such patients, spider veins are mostly around the ankles and are blue-purple in appearance (corona phlebectica). Color Doppler findings are normal in the remaining 60% of the patients with spider veins. In such patients, these varices are mostly on the outer side the leg and around the knee, and when carefully viewed, they are accompanied by medium-sized green varices. These varices, called the lateral subdermic venous plexus (LSVP), are in fact a remnant of the veins that we use before the birth and are disabled after delivery. In some individuals (especially women), this residue may be reactivated by the hormones during puberty and form the LSVP varices.










Treatment options in spider veins

In patients with spider veins, color Doppler ultrasound should be performed first and the presence of an underlying venous insufficiency should be investigated. If there is venous insufficiency, this should be eliminated first and then spider veins should be treated. If there is no underlying venous insufficiency, spider veins can be treated directly. Sclerotherapy is the main method of treatment of such varices. With sclerotherapy, both spider veins and accompanying green "reticular" varices can be easily treated. However, sclerotherapy is a treatment that should be performed very patiently and carefully.


In spider veins, transdermal treatments are another commonly used method besides sclerotherapy. Among these, the best known and mostly used is transdermal laser. In this method, spider veins are burned by laser beam sent through the skin. In addition to laser, transdermal treatments can be performed by methods such as radiofrequency and microwave. In these methods, the spider veins are destroyed by heat with a very fine needle inserted from the skin. However, in these methods, it is necessary to stick a large number of needles into the skin. Transdermal methods are widely available and can be applied by healthcare professionals other than physicians. However, they are more painful and never as effective as a "well performed" sclerotherapy.

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