•Most effective treatment for spider veins is sclerotherapy
•To be effective the sclerosant must destroy the endothelial cells and cause intimal disruption
•Detergents may also produce hyalinization of the smooth muscle layer but frank perforation is to be avoided
•The detergent Sotradecol and Polidocanol cause permeability of the basement membrane with resultant vessel wall alterations
•Sotradecol is anionic and method of dilution makes a difference
•Polidocanol is nonionic and its strength is independent of the diluents water or saline
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