Spider Vein Treatment
Also known as sclerotherapy and laser vein treatment
Spider veins (not to be confused with varicose veins) are dilated or stretched blood vessels that have a branching pattern and are commonly found on the thigh, lower leg and occasionally on the face. Spider veins are progressive in nature and usually increase in number and visibility with age. Sclerotherapy and laser vein treatments are used to treat these vessels, erasing them from your skin.
When to Consider Spider Vein Treatment
- If you have visible veins on your legs or thighs that have a branching or weblike pattern
- If you have a pattern of branching veins on your face that you try to conceal
- If you feel that your spider veins are a sign of aging that you would like to eliminate
Spider veins can be treated with sclerotherapy or with lasers. The complete removal of spider veins is not expected in the first treatment and multiple treatments are required for optimal results.
- Sclerotherapy is effective for medium-sized blood vessels (greater than three millimeters in diameter)
- A sclerosing solution is injected into the vein with a micro-needle which causes the vein to shrink, turn white (blanch) and then gradually disappear
- After the procedure, compression stockings are recommended to compress the veins and maximize the chance of treatment success
- There is little if any discomfort when undergoing this procedure and there is no downtime
It is important to note that you are not a candidate for sclerotherapy if you are pregnant. Also, if you have a history of blood clots you may not be a candidate for this procedure.
Laser vein treatment
- Lasers are typically used to treat small to medium-sized blood vessels (one to three millimeters in diameter) that usually occur in the face
- During treatment, your eyes will be covered so that your corneas and retinas are protected from the laser.
- A handpiece is passed over your skin and the laser light is absorbed by the blood, causing the vessels to coagulate and be absorbed by the body.
- There may be some skin reddening, bruising, and blistering, but these side effects subside over a couple of weeks to a couple of months.
- There is little downtime; however, you will need to protect the area(s) treated from sun exposure.
Laser ablation may be able to treat smaller vessels easier than sclerotherapy, especially on sensitive areas like the ankle.
Your surgeon will provide you with preoperative instructions and answer any questions that you may have.
In advance of your procedure, your surgeon will ask you to:
- Stop smoking before undergoing treatment to promote better healing.
- Avoid taking aspirin, certain anti-inflammatory drugs, and some herbal medications that can cause increased bleeding.
- Regardless of the type of procedure to be performed, hydration is very important before and after surgery for safe recovery.
Spider vein treatment is usually performed on an outpatient basis. Be sure to arrange for someone to drive you home after treatment and to stay with you at least the first night following treatment.
What can I expect on the day of spider vein treatment?
Spider vein treatment is performed on an outpatient basis. Most spider vein treatment procedures take at least 30 minutes to one hour to complete but may take longer.
- Medications may be administered for your comfort during the procedure.
- Your surgeon will follow the plan discussed with you before treatment.
- After sclerotherapy you will wear compression stockings to maximize the chances of treatment success.
You will probably be permitted to go home after a short observation period unless you and your plastic surgeon have made other plans for your immediate postoperative recovery.
Sclerotherapy has proven to be a very safe and popular nonsurgical cosmetic procedure for treating spider veins. In some cases, if spider veins are small and located around your ankle or on your face, laser therapy may be a good nonsurgical alternative to sclerotherapy.
Varicose veins differ from spider veins in that they are often bulging and are normally darker in color and larger in size. Varicose veins are not effectively treated with sclerotherapy or with lasers. Surgery is usually required for optimal treatment.
It’s important to choose your surgeon based on:
- Education, training and certification
- Experience with spider vein treatment
- Your comfort level with him or her
Members of the American Society for Aesthetic Plastic Surgery are experienced and qualified to perform your aesthetic procedure. Learn how to select a surgeon.
After finding a board-certified plastic surgeon in your area who is experienced in performing spider vein treatment, you will need to make an office appointment to set up your consultation. Generally, because of the in-depth nature of the consultation, there is a cost associated with the initial visit.
During your initial consultation, you will have the opportunity to discuss your cosmetic goals. Your surgeon will evaluate you as a candidate for spider vein treatment and clarify what spider vein treatment can do for you. Understanding your goals and medical condition, both alternative and additional treatments may be considered. (See related procedures.)
You should come to the consultation prepared to discuss your complete medical history. This will include information about:
- Previous surgeries
- Past and present medical conditions
- Allergies and current medications
- If you are pregnant or have a history of blood clots in your legs
Based on your goals, physical characteristics, and the surgeon’s training and experience, your surgeon will share recommendations and information with you, including:
- An approach to your treatment, including the type of procedure or combination of procedures
- The outcomes that you can anticipate
- Your financial investment in the procedure
- Associated risks and complications
- Treatment location options
- What you need to prepare for your treatment
- What you can expect to experience after treatment
- Show before-and-after photos of cases similar to yours and answer any questions, so you can make the most informed and intelligent decision
For a general list of questions to ask your surgeon about his or her background, to find out about plastic surgery safety, and to plan your procedure, visit the Planning Toolkit.
We developed these questions to help you:
- Make the most informed and intelligent decisions about your procedure
- Confirm that you have the right surgeon for your procedure
- Make your initial consultation as rewarding as possible
- Understand your options, potential outcomes and risks
It is important for you to take an active role in your surgery, so please use this list of questions as a starting point for your initial consultation.
- Am I a good candidate for spider vein treatment?
- Will sclerotherapy or laser ablation be more effective for treating my spider veins?
- Are the results I am seeking reasonable and realistic?
- Do you have before-and-after photos I can look at for the procedure I am undergoing?
- Will there be scarring?
- What will be the costs associated with my treatment?
- What will you expect of me to get the best results?
- What kind of recovery period can I expect, and when can I resume normal activities?
- What are the risks and complications associated with my procedure?
- How are complications handled?
- What are my options if the cosmetic outcome of my treatment does not meet the goals we agreed on?
Usually there is no downtime after spider vein treatment. For most patients, full activity may be resumed immediately. After the procedure, you and your caregiver will receive detailed instructions about your post-treatment care, including information about:
- Skin care
- Normal symptoms you will experience
- Potential signs of complication
See options for short-term recovery locations in Aftercare and Recovery (Planning Toolkit).
Immediately after your spider vein treatment
After the procedure you will notice a reduction in your spider veins. If you undergo sclerotherapy, about fifty to seventy percent of the treated vessels will be permanently gone. With laser ablation, some veins may disappear after one treatment while others may take longer. With either treatment, multiple procedures are required for optimal results.
Spider vein treatments are performed with minimal discomfort. You may experience temporary skin discoloration, skin reddening, bruising, and occasionally blisters. These side effects subside over a couple of weeks to a couple of months. Contact your surgeon to find out if your pain, or any skin conditions, is normal or a sign of a problem.
Recovery time frame after spider vein treatment
Spider vein treatment requires little, if any, recovery. You will be able to resume work and almost all normal activities right away. You may be asked initially to wear support stockings to help keep treated veins closed and to reduce bruising. Direct sunlight should be avoided during the first few weeks following treatment.
It is vitally important that you follow all patient care instructions provided by your surgeon. This will include information about wearing compression garments and the level and type of activity that is safe.
More than one treatment is often required, since all the veins will not respond to the first treatment. Also, since spider veins are a progressive condition, you can expect new spider veins to form over time, which may require treatment every few years to maintain the improvement.
Maintain a relationship with your aesthetic plastic surgeon
For safety, as well as the most beautiful and healthy outcome, it’s important to return to your plastic surgeon's office for follow-up evaluation at prescribed times and whenever you notice any changes in your treatment areas. Do not hesitate to contact your surgeon when you have any questions or concerns.
The cost of spider vein treatment varies from doctor to doctor and from one geographic area to another. Because spider vein treatment is an elective procedure, insurance does not cover these costs. Many surgeons offer patient financing plans to make the procedure more affordable.
See the national average for physician fees per procedure.
These numbers only reflect the physician/surgeon fees last year and do not include fees for the treatment facility, anesthesia, medical tests, prescriptions, compression garments or other miscellaneous costs related to treatment.
Choose your surgeon based on quality, training, and experience—not cost.
See why ASAPS members are widely recognized for upholding the highest standards in the area of aesthetic plastic surgery by viewing their basic credentials, training, and certifications.
Fortunately, significant complications from spider vein treatment are infrequent. Your specific risks for spider vein treatment will be discussed during your consultation.
All procedures have some degree of risk. Some of the potential complications include:
- Infection and bleeding
- Allergic reactions
- Damage to underlying structures
- Unsatisfactory results that may necessitate additional procedures
Other risks specific to spider vein treatment are outlined below:
- Skin discoloration
- Skin reddening or loss
You can help minimize certain risks by following the advice and instructions of your board-certified plastic surgeon, both before and after spider vein treatment.This article was originally published for Smart Beauty Guide and was legally licensed