St. Augustine Woman's Journal - Educational Resource to the Women of St. Johns County Since 2009

By Ryan Pereira DPM FACFAS
Anastasia Medical Group 

The Art of Spider Vein Treatment: Sclerotherapy & Laser Therapy - Restoring the youth in your legs


June 1, 2017 | View PDF

If you are one of the many who suffer from discomfort, pain, or poor self-image due to varicose veins, spider veins, or venous reflux, a wide array of minimally invasive treatment options are available at The Centre for Advanced Vein Care (CAV Care) which has been treating venous disease since 2005.

Spider veins and varicose veins, although considered a cosmetic problem are actually a sign of an underlying disorder called Venous Insufficiency. Nearly 20-25 million Americans are afflicted by this condition. By age sixty, approximately 70 percent of women and 40 percent of men will be afflicted with venous insufficiency. Left untreated, it can lead to a chronic, debilitating, and sometimes limb-threatening condition.

Spider veins present as small webs of red, purple or blue clusters or lines that disfigure the skin surface. Varicose veins appear as dark blue veins or bulging ropes beneath the skin. While these veins are not usually life threatening, they can disrupt and interfere with a person's quality of life.

There are various treatment options available depending on the size, location and characteristics of spider veins. Some of the treatment options that have been used for the treatment of spider veins are:

• Lifestyle changes

• Support stockings

• Vein stripping surgery

• Radiofrequency Occlusion

• Sclerotherapy

• Laser therapy

For the purpose of this article I will focus on sclerotherapy and laser therapy


Sclerotherapy is the most common treatment for both spider veins and varicose veins. Dr. Pereira uses a needle to inject a liquid chemical into the vein. The chemical causes injury to the vein walls thereby causing it to stick together, and seal shut. This stops the flow of blood, and the vein turns into scar tissue. In a few weeks, the vein fades away. Sclerotherapy treatment does not require anesthesia and is performed in the office setting. Patients may return to normal activity immediately after treatment. Patients normally require between 2 and 5 treatments sessions every 4-6 weeks to obtain optimal results. After sclerotherapy patients may be asked to wear compression stockings. This treatment is very effective when done correctly.

Side effects of Sclerotherapy

Common temporary side effects of sclerotherapy are stinging, redness, raised patches of skin, bruising where the injection are performed. These subside immediately after treatment.

Spots, brown lines, or groups of fine red blood vessels around the treated vein recede shortly after treatment.

Finally blood trapping in the vein may cause a mild inflammation which is usually treated either by draining the trapped blood or applying warm moist.

Laser therapy

Laser transmits laser light through the skin to the target blood vessel up to 3 mm in size. After the laser light is absorbed, the light is converted to heat and damage the target vessel. As the vessel is damaged, circualtion stops and the blood vessel disappears shortly thereafter. This procedure is quick and can be done in about 15-20 minutes depending on the area, size and number of spider veins to be treated. The laser has a built in cooling device that prevents thermal injury to the skin and assists in the reduction of pain with the laser therapy. Laser therapy may require between 2-4 treatments in 4-8 week intervals.

Side Effects of Laser Therapy

Common temporary side effects are swelling, redness, mild pain and hypo-pigmentation or hyper-pigmentation. These side effects will gradually disappear as the lesion heals, which may take from few days to several weeks depending on the severity of the spider vein.

At CAV Care, we evaluate many patients for treatment of their spider veins, who have had these previously treated where only the cosmetic appearance was addressed, only to see reappearance after 6-12 months. Those who opt only for superficial treatments of leg spider veins exchange the veins for dark blotches in the skin. The underlying problem is never considered or treated. A careful ultrasound vein mapping may show a deeper source of reflux in a larger source vein. We offer minimally invasive treatment options like VNUS Closure procedure to address the larger source veins. Once any underlying large vein insufficiency has been excluded or treated. Sclerotherapy, laser therapy and combination therapy are utilized to restore your legs to a more youthful appearance.

For more information about vein treatments, please visit: or contact the office at 904-461-0821.

Anastasia Medical Group treats all of the aspects of venous disease, the most common of which are varicose veins, spider veins, venous ulcers, and refluxing veins. We utilize the VNUS® Closure® procedure and treatments usually last approximately 45 minutes. In order to provide for total comprehensive vein care, vein stripping, ambulatory phlebectomy and sclerotherapy are also performed at the Anastasia Medical Group.

Dr. Ryan J. Pereira (pictured above) has been in practice since 2002 and has been treating venous disease since 2005. He is a Diplomat of the American Board of Podiatric Surgery and is Board Certified in both Foot Surgery and Reconstructive Rearfoot/Ankle surgery. He is also a Fellow of the American College of Foot and Ankle Surgeons. He graduated from the Ohio College of Podiatric Medicine with his Doctorate in Podiatric Medicine.

Dr. David S. Ross (pictured below) has been in practice since 1977 and has been treating venous disease since 2008. He is Board Certified in both Emergency Medicine and Family Practice and is a Fellow of the American College of Emergency Physicians. He graduated with a Doctorate in Medicine from the University of Florida.


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