Q: What are spider veins, and how can I get rid of them?
A: Medically called telangiectasias, spider veins appear as flat or slightly raised purple, blue or red cord-like structures, often in patterns that may resemble spider webs. In contrast to larger, bulging varicose veins, which can be painful, spider veins are usually just a cosmetic issue.
Spider veins are more common in women and increase with age—it’s estimated that half of all people develop them. There’s a large genetic component, but trauma to the area, pregnancy, hormone therapy and obesity all contribute. Though they are typically found on legs, ankles and feet, they sometimes appear on the face.
There are two main ways to get rid of spider veins, best done by a skilled dermatologist or vascular surgeon:
Sclerotherapy, the gold standard for spider veins on legs, involves injecting a chemical into the vein that causes fibrous tissue to form and cut off the blood supply. The veins will disappear as the body reabsorbs them, but it usually takes several treatments to get good results. There is often some bruising at the site, and you have to wear compression stockings for up to several weeks. Other risks include scarring, discoloration, skin ulceration and allergic reactions. Sclerotherapy is not for pregnant women, people with peripheral artery disease or deep vein thrombosis, or those with diabetes, heart disease or some other systemic diseases.
Laser therapy can be used in almost anyone, though it may not be as effective on leg spider veins as sclerotherapy. It’s best when the spider veins are isolated, superficial and small in diameter. There are different laser devices; your doctor should tailor the treatment to your skin type and the color, size and depth of the veins. Initially, there may be redness and swelling; bruising can last for weeks or months. Other risks include ulceration (if the surrounding tissue is damaged) and hyperpigmentation (wearing sunscreen when in the sun can reduce this risk). Several treatments may be needed.