Spider Vein Treatment 

The treatment of choice is with sclerotherapy. This involves manual injection of a chemical into the lumen of the spider vein, destroying the lining of the blood vessel.

This does not harm the circulation – it improves it by eliminating the abnormal, unnecessary vessel. Sclerotherapy works much better than lasers for lower limb spider veins.

Facial veins are treated with vascular lasers. We employ state of the art lasers including the very latest VBeam Prima & Derma V lasers.

Superficial veins are treated with 532 nm or 595 nm lasers.

Deep veins are treated with 1064 nm lasers.

Learn more (link to vascular lasers in the vascular laser section)

They can, however simple sclerotherapy is often better. Though we have the most advanced laser systems, we find that sclerotherapy provides better, more consistent & longer lasting results compared to laser.

The exception to this rule is with larger diameter veins. These vessels respond well to endovenous laser ablation conducted by a vascular surgeon in an operating room.

Varicose veins are larger. Think of them as major rivers, whilst spider veins are small creeks. Varicosities are green in colour & often protrude from the skin. They are often symptomatic & may be associated with pain when standing for long periods.

Spider veins are red-pink to purple in colour & measure between 0.5 to 2.5 mm in diameter. They don’t (usually) cause symptoms but may appear unsightly.

At Cutis Dermatology Brisbane, we only treat spider veins. Deeper feeding varicose veins require treatment by a vascular surgeon. If you have larger varicose veins associated with spider veins, you should ideally have these treated before spider vein treatment. The rule of thumb is to treat the ‘rivers’ before the ‘creeks’, namely big to small.

For varicosities, ask your GP to refer you to Dr Andrew Cartmill, vascular surgeon in Brisbane.

Ultrasound guidance is useful for the management of larger varicose veins. This imaging procedure is employed to visualise the vessels during injection as it helps the clinician visualise where the solution is going during the procedure.

For treatment of superficial spider veins, most patients do not require ultrasound, unless we suspect a deeper ‘feeding’ vessel.  

The number of treatment sessions depends on the size, depth, area & extent of vessels. For thread veins & small spider veins, only one session is required. For more extensive veins, you may require up to 3-5 sessions for optimal outcomes.

Treatments are spaced 6-8 weeks apart to minimise irritation of previously treated sites.

Depending on the sclerosant we employ, results can be immediate or delayed for several weeks.

If you are prone to spider veins, chances are you will get more. For most, you should get remission of 3- 6 years. Treatments cannot prevent you from getting more spider veins in time. Higher recurrence is seen in-

• Patients who have larger feeding vessels & varicose veins (hence treat big to small)
• Those with radiating mat like vessels
• A family history of varicose veins
• Patients who stand up for long periods of time
• Those who have a higher BMI 
• Patients who don’t complete their post-operative compression stocking application times

Treatments are well tolerated. For leg veins there may be some mild stinging during the procedure itself. For laser spider vein removal, we use lasers with cryogen spray, making the procedure extremely comfortable.

Medicare partially covers spider vein laser removal on the face, however there is no rebate for small spider veins on the lower limbs. As a guide:

Spider vein removal on the lower limbs/legs: $440 per 20 minutes session. $795 for a 40-minute session.

Spider vein removal on the face: $260 – $550 out of pocket (depending on the consultant)

Sclerotherapy – small area ($200-$250)

Sclerotherapy – medium/large area ($350-$400)

*If you are after budget treatments, please make an appointment with our dermatology nurses. Their fees are typically half that of our senior dermatologists. For large varicose veins that are symptomatic, a Medicare rebate may apply.

Our senior nurses have over 25 years of experience (that’s not a typo) of experience in sclerotherapy, having treated thousands of patients in that time.

Our dermatologists have two decades of laser experience in the management of facial veins & redness.

A real time appointment will allow us to assess the extent of your veins, in addition to performing a clinical examination. Book a free consultation with our nurses.

*T+C applies. Consult fee deducted from procedural fee.

**Consultant dermatologist fee applies.

Though we are skilful with sclerotherapy, there are associated adverse outcomes. Most will settle down with time & include:

• Discolouration & post inflammatory hyperpigmentation is not uncommon. This occurs in up to 25% of cases & occurs along the course of the vein. It resolves within 8 months, pico lasers can speed up resolution.
• Pain & muscle spasm: are rare side effects. They can occur if your vessel walls are super thin. Settles within 15 to 30 minutes.
• Telangiectatic matting: or new vessel formation can develop in 5-10% of cases. These will persist for 4-8 months; the vast majority will resolve with time.
• Ulceration: less than 0.1% of cases. This is due to extravasation of sclerosant into the surrounding tissues. This is usually seen around the ankles in mature patients. Scaring may result. If you experience ulceration, ensure that we promptly review your case.
• Injection site swelling may be prolonged in some. The use of compression stockings will reduce this.
• Superficial vein irritation occurs in 0.1% of cases. Best treated with compression stockings & anti-inflammatory medications.
• Allergies to sclerosants other than hypertonic saline are rare, but reported.

On our part we ensure that we carefully inject the sclerosant of choice into the vessel wall, that’s given.

From your part, the use of compression stockings will markedly reduce the risk of unwanted side effects. Our nurses will guide you as to the application frequency & duration.

Your clinician will provide you with a list of dos & don’ts. It goes something like this-

• Wear your compression stockings as directed
• Avoid super strenuous activity for 72 hours post procedure.
• Normal paced walks are encouraged, 30 minutes daily.
• Avoid hot baths for 10 days.
• Avoid standing for long periods- move!