I noticed my first spider vein at Mordialloc beach last summer. More accurately, my five-year-old niece noticed it, pointed at the back of my knee and asked loudly why I had purple scribble on my leg. Kids are wonderful for your self-esteem like that.
Spider veins are one of those things you don’t notice until you do, and then you can’t stop seeing them. For most people they’re harmless. Still, I think it’s fair to say plenty of us would rather they weren’t there come shorts season.
The usual fix is sclerotherapy. What I didn’t realise until I started reading up on it is that the injections are only half the job. The other half is wearing tight compression stockings for days or weeks afterwards, and nobody seems to mention how much of a wrestle those are to get on.
What are spider veins?
Spider veins are basically the smaller, closer-to-the-surface cousins of varicose veins. According to the Better Health Channel, they’re often red or blue, can look like tree branches or a spider web and mostly turn up on the legs or face.
As for why they appear, the honest answer seems to be that nobody’s entirely sure. Better Health says the causes aren’t known, but they often run in families and women get them more often than men. It also lists hormonal changes (puberty, pregnancy, breastfeeding, menopause) and long stretches of standing or sitting as possible factors for varicose veins. I’d guess the same applies to spider veins, though the page doesn’t say so outright.
In my case, Mum has an almost identical patch behind her left knee and I spent most of my twenties standing behind a register at a shoe shop in Chadstone. I suspect I was never going to dodge them.
How sclerotherapy for spider veins works
Sclerotherapy is an injection of an irritant solution (called a sclerosant) straight into the vein. The vein spasms and collapses, the walls heal together and the sealed vein stops carrying blood. Better Health describes the needle as causing a mild pinprick, with some people feeling a brief burning sensation that passes in a few seconds. Which sounds manageable, although I say that as someone who looks away during a blood test.
It isn’t instant, either. Treated leg veins can take two to six months to fade depending on their size, and each vein may need several injections a few weeks apart. Larger varicose veins are usually dealt with surgically, while sclerotherapy suits the smaller stuff.
There are side effects to know about. Bruising is common and usually fades within a few weeks. Brown lines or spots can appear where the veins were injected, and while they mostly clear up, Better Health says fewer than five per cent of people have them hang around for a year or more. Then there’s matting, which is a network of new fine blood vessels near the treated area. One of the listed causes is not enough compression afterwards, which brings us to the stockings.
Compression stockings after sclerotherapy
Straight after the injections, you put on compression bandages and stockings (Better Health notes the bandages are meant to be tight) and then go for a walk of about half an hour. The stocking is there to reduce bruising and swelling, lower the risk of complications like inflammation and clots and help the treated veins clear faster.
How long you wear them depends on what was treated. Better Health’s guide is around three to six days for small veins and about six weeks for bigger ones. From what I’ve read, clinics don’t all agree on the exact timing, so whatever your practitioner tells you is the number that counts.
What surprised me is how much rides on actually wearing them properly. Better Health lists missing or inadequate compression as a reason inflammation and clots can happen after sclerotherapy, and as one of the causes of matting. So if you’ve paid for the treatment, skimping on the boring bit afterwards seems like a false economy.
How to put on compression stockings without the wrestle
Here’s the catch. Medical compression stockings are tight on purpose, and you’re pulling them over legs that may be bruised, tender and freshly injected. Bunching the stocking up, hooking it over your toes and dragging it past your heel is hard enough on a normal day. Doing it every morning for a week (or six) is a different story.
I’ve seen this play out at home. A couple of years ago Mum was sent home from a knee replacement with compression stockings, and putting them on became a twice-daily family event. Dad would kneel on the lounge room carpet, bunching the stocking up like he was defusing something, while Mum offered what she called helpful feedback. I think the record was about fifteen minutes for one leg, and the stocking won more rounds than he’d like to admit.
This is where a stocking applicator comes in. I came across the EzyAs applicator, which is made by a small company in Croydon South, Victoria. You turn the stocking inside out over the applicator, which holds it open and takes the strain off the fabric, then slide your foot in and ease the stocking up your leg. It works with open and closed toe stockings and comes in a few sizes based on calf measurement.
The bit I think matters most after sclerotherapy is the optional handle. It clips onto the applicator so you can put the stocking on without bending down, which is handy if your legs are sore or you’re not great at balancing on one foot first thing in the morning. The product descriptions also say it’s designed not to disturb dressings or pull on fragile skin, which seems relevant when you’re freshly bandaged.
Is it glamorous? No. But I’d probably take a slightly odd-looking plastic gadget over sitting on the bathroom floor swearing at a stocking.
Other sclerotherapy aftercare tips
Walking is a big one. Better Health calls it essential after treatment because it keeps blood moving through the deep veins, and it recommends regular exercise and support stockings between and after sessions too.
A couple of things on the Better Health list caught my eye from a beauty point of view. It suggests not taking iron supplements while you’re having sclerotherapy, because the brown lines are caused by iron from red blood cells. It also lists vitamin E supplements, anti-bruising creams and creams containing vitamin E among the possible causes of matting. I’m not sure how many of us would think to check our body lotion before a vein treatment, but it’s probably worth asking your practitioner about.
The same page recommends that women stop hormonal supplements before sclerotherapy (check with your doctor first) and notes the risk of clots is higher if treatment is done just after long-distance travel or a major operation. So maybe don’t book it for the day after you land from Bali.
I’m not a doctor, obviously. If something looks or feels wrong after treatment, talk to your practitioner or GP rather than a beauty blog.
Is sclerotherapy worth it?
I think the answer depends on how much your spider veins bother you, and whether you’re prepared to do the aftercare properly. The injections are quick. The months of waiting and the week or more of tight stockings are the real commitment, and from everything I’ve read, that’s the part that decides how good the result looks.
Would I do it? Probably, once I’ve got through my cousin’s wedding in March. I’d just want a plan for the stockings that doesn’t involve Dad on the lounge room floor again.
Have you had sclerotherapy? How did you go with the stockings? Let me know in the comments.
