Is sclerotherapy effective for all spider veins?
About 20% of spider veins are the result of a leaking vein. Duplex scanning is indicated if this is clinically suspected upon evaluation. If a leaking vein/valve is found it would be treated first by ultrasound guided sclerotherapy and then we would directly inject the spider veins. In general, sclerotherapy alone continues to be the most effective treatment for spider veins of the legs.