Patients often present with painful legs and these are almost never due to Sclerotherapy, which has been around for many years but sadly many patients who have had this procedure in the past were unhappy with their initial result or with how quickly the veins came back again. Both these problems are usually due to the same cause – the feeder veins (reticular veins) were not treated prior to the treatment of the spider veins (telangiectasia). This is due to the treating doctor no being properly trained and hence not appreciating the importance of treating reticular veins first.
Reticular veins are usually not of great cosmetic concern (unless they are particularly large and prominent) but they are the key to understanding why treatment fails. If these reticular veins are not treated before the telangiectasia (spider veins), there will be at best a short term successful result but it is more likely that all the treated veins will not disappear and some areas may even look worse. This worsening of the situation (venous “matting”) is a common result if patients are not treated by practitioners who are specialists in this area. You should always see a Phlebologist to treat your leg veins. Most patients describe these matting areas as “bruises that never went away”. On closer inspection, these areas consist of a myriad of tiny vessels. These areas can be treated, often with great results, but the spider vein treatment is more challenging and may require more treatment sessions.