Spider Veins

Spider Veins vs. Varicose Veins

On this page, Dr. Loftus will explain the difference between spider veins and varicose veins, and she will explain the best treatments for each.
Spider veins, also called telangiectasias, are tiny visible vessels just underneath the skin. They develop most commonly on the face and legs. Varicose veins are entirely different. They are distended veins beneath the skin. They may appear as bluish bumps and often cause discomfort. Those with unsightly varicose veins and aching pain often choose to have surgery to remove their varicose veins. Varicose veins are veins that are no longer functional, and their presence is not missed by the body. Ask your general surgeon about varicose vein treatment. If you have both varicose and spider veins, your varicose veins must be treated first. Treating spider veins first is generally futile because, in the presence of varicose veins, they are bound to return soon.

Treatment Choices for Spider Veins of the Legs

The two options for spider vein treatment are sclerotherapy and laser. They can be employed independently or in combination. Sclerotherapy (spider vein injection) Sclerotherapy involves injecting a liquid agent through a tiny needle directly into your spider veins, causing them to contract and collapse. This procedure is best suited for medium to large spider veins because it relies upon fitting a tiny needle into a tiny vein. The procedure is performed in the office by a plastic surgeon or nurse and is relatively painless. Depending on the number of spider veins, the procedure may require five minutes to one hour. Afterward, you will wear ace bandages or compression hose for three to ten days as recommended by your plastic surgeon. You may resume sedentary activities immediately but should avoid exercise, hot baths and alcohol for two to three days. You should anticipate 50% improvement in spider veins following each sclerotherapy session. Expect that two to six sclerotherapy sessions at one to two month intervals may be necessary to achieve your desired results. Understand that some spider veins may never be successfully treated through sclerotherapy. Laser treatment of spider veins During laser treatment, a laser is applied to the skin over your spider veins. Laser energy causes your spider veins to coagulate and shrink. Laser therapy is most effective for small and medium size spider veins. Large spider veins respond poorly and are best treated with sclerotherapy. You are likely to experience mild discomfort similar to having a small rubber band snapping against skin. Treatments usually do not require sedatives, pain medications, or injections of local anesthetic. Immediately following treatment, spider veins will be darker and more visible. Over two to six weeks, your spider veins usually fade. After each treatment, you will see a 70% to 80% improvement in the appearance of face spider veins and 30-40% improvement in leg spider veins. An average of three treatments will be required at three-month intervals to produce desired results. Combination therapy can be considered and beneficial if you have small, medium and large spider veins. You may wish to start with sclerotherapy, because sometimes all veins will be improved after injecting the larger ones. This may reduce the number of veins that need to be treated by laser and minimize your overall cost.

Spider Veins of the Face

A patient with spider veins in the face will usually choose to have laser therapy rather than sclerotherapy. Laser treatment may cause minor bruising that usually improves within a week, but often, recovery is immediate. One to three treatments may be required to achieve your desired result. Immediately following treatment, you may apply makeup for a presentable appearance.

• Ask Your Plastic Surgeon about these Potential Complications:
• Matting
• Discoloration
• Swelling

Cost

Sclerotherapy costs between $100 and $400 per session. Laser treatment costs $300-450 per session. Expect to pay more if your spider veins are extensive or if a physician rather than a supervised technician performs the treatments.

Expected Duration of Results

Regardless of treatment, you should anticipate the development of new spider veins over time, just as you would if your spider veins had not been treated. Spider vein therapy treats current spider veins but does not prevent new ones.