Spider Veins: what are your treatment options?


Spider veins are problematic and cause significant distress when they appear on the legs. People often go to great lengths to have beautiful legs, and it is frustrating to do everything right only to have a cosmetic issue arise that negates all of the hard work that was put into your legs.

So what can be done about spider veins, and how do these different treatments compare with each other?

Spider Vein Treatment Options



Traditional sclerotherapy is the most effective treatment available and it has been used for over 100 years. It’s inexpensive, reliable, involves minimal pain and has few associated complications. Traditional sclerotherapy takes 10-20 minutes to perform.

Commonly used agents for sclerotherapy include detergents and osmotic agents.

Polidocanol is the most commonly used detergent in our practice, it also functions as a local anesthetic. Detergents work by scarring the inner wall of the spider veins which causes them to be reabsorbed by your body after a month or so. Polidocanol is a relatively mild and forgiving agent.

The detergent sclerosants like polidocanol are often mixed with air to form a foam.  This is called foam sclerotherapy.  Foam sclerotherapy accomplishes three things. It reduces the amount of agent that is required, it increases the amount of surface area where the sclerotherapy agent comes in contact with the inside of the vein, and it displaces the blood in the vein to improve chances that the vein will scar down and disappear.  Foam sclerotherapy is usually reserved for larger spider veins.

The most commonly used osmotic agent for sclerotherapy is hypertonic saline. It also works by damaging the inner wall of the spider vein. Hypertonic saline is a slightly stronger agent, and works better than polidocanol but requires greater experience to use. Hypertonic saline burns slightly when it is injected. Because the ingredients are found naturally in your body, allergic reactions are unlikely. For spider veins on the face, sclerotherapy with hypertonic saline has excellent results.

Laser sclerotherapy is used in some centers for spider veins. Its use is limited, because it has a higher cost, is more painful and is not as effective as traditional sclerotherapy. It does work well for spider veins on the face.

Compression Garments

Graduated compression garments are sometimes used to treat spider veins. They are painless and can help improve pain associated with underlying venous reflux but they can also be annoying to wear all the time

Lifestyle Changes

Lifestyle changes, like diet, exercise and leg elevation don’t make spider veins go away, but they can slow the progress of spider veins.

Other Options

There are other treatments that involve passing electrical current through a wire to induce scarring that will eliminate spider veins, but they involve an increased cost without a clear benefit. Unfortunately topical treatments and supplements that are advertised as being able to eliminate spider veins are completely useless.

Despite recent advances in technology. Traditional sclerotherapy is still the best treatment and the one that we use the most.

Want to Learn More?

For more information about looking and feeling your best, please contact NYC Surgical Associates or call 877-221-3955.

How to Tell If You Have Spider Veins

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Spider veins are fairly common in the western world, and we see them all the time in our practice, but how do you know if you have them?

They can be difficult to see, as they usually measure less than a millimeter wide, and often occur in the legs in locations that are difficult to see behind the knee or on the back of your thighs or calves. To examine these areas by yourself with a mirror is challenging as it’s a couple feet away looking at a reflection, not necessarily with optimum lighting.

Spider veins have a predilection for the ankles and feet, so you may first notice the veins in these areas. On closer inspection they range in color. They can be blue, purple or even red. Often they will form a small cluster in close proximity where they seem to be almost connected and appear web-like, which is why they have been referred to historically as spider veins.

You may have your attention first called to your spider veins by friends or family members who notice them, which can make you self-conscious and sometimes people can end up preferring pants as a result. This is unfortunate and unnecessary because these veins can be treated effectively with sclerotherapy injections.  

People with darker skin or significant freckles can have a more difficult time seeing their spider veins. Freckles in particular act as a natural camouflage. For this reason people with spider veins often spend more time in the sun or in tanning beds to hide them.

Spending a lot of time on your feet or in a seated position can lead to spider veins, so if you have a job or lifestyle that requires a lot of time standing, you are much more likely to have spider veins. The same is true for people who have spider veins that run in their families.

If there is any suspicion of spider veins, they should be evaluated fully. It doesn’t take a long time  to evaluate them, and we can treat them with sclerotherapy on the same visit, usually in less than an hour. It’s definitely preferable to being limited to pants year-round.


Want to Learn More?

For more information about looking and feeling your best, please contact NYC Surgical Associates or call 877-221-3955.