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Sclerotherapy of spider veins using the accurate depth‐gauge collagen needle

Sclerotherapy of spider veins is a cosmetic treatment that is simple and enjoyable to perform but requires time to develop expertise. Residents in dermatology training programs seldom have the luxury of learning this procedure. They generally attend workshops and seminars before graduation, but have limited experience in sclerotherapy before beginning their own practice. Traditionally, sclerotherapy of spider veins is enhanced by various techniques that are learned either by watching experts perform live procedures or through videotaped symposia that are dedicated to teaching the novice. Important and well-documented techniques that enhance the field of operation and vision of these 1to 2-mm veins include an appropriate angle of light and the use of alcohol to better visualize the vein and stretch the skin. 1 The use of a 30-gauge needle with the bevel up (sometimes bent intentionally by the operator) generally is recommended; the needle is almost parallel to the skin when approaching the vein (Fig. 1).