In some women, spider veins – those small clusters of red, blue, or purple veins that appear on the thighs, calves, and ankles – become noticeable at a young age. For others, the veins may not become obvious until much later.

A number of factors may contribute to the development of spider veins in the legs, including:

• Heredity
• Hormonal shifts
• Occupations or activities that require prolonged sitting or standing
• Pregnancy
• Weight fluctuation

There are effective, safe and relatively painless methods available for reducing spider veins.

Candidates for spider vein treatment

Spider vein treatment is a good option if you:

• Are bothered by spider veins anywhere on your body
• Are committed to following your plastic surgeon’s prescribed course of treatment
• Have a positive outlook and realistic goals for your spider vein treatment

Consultation

During your spider vein treatment consultation be prepared to discuss:

• Any problems you may have had in the area to be treated, such as pain or previous injuries
• Any surgical procedures that have been performed near the area to be treated, including any previous vein treatments
• Current medications, vitamins, herbal supplements, alcohol, tobacco, and drug use
• Medical conditions, family history, drug allergies, and medical treatments
• Your goals

Your plastic surgeon will also:

• Evaluate your general health status and any pre-existing health conditions or risk factors
• Examine your veins in detail
• Discuss likely outcomes of spider vein treatment and any risks or potential complications
• Discuss your options
• Recommend a course of treatment

If leg veins are the problem, your surgeon may examine you for signs of more serious “deep vein” problems, as well as for larger, varicose veins. These conditions are often identified by swelling, sores, or skin changes at the ankle.

If more serious vascular problems are identified, your surgeon may refer you to a different specialist for further evaluation and possible treatment.

Preparing for spider vein treatment

In preparing for spider vein treatment, you may be asked to:

• Avoid taking aspirin, anti-inflammatory drugs, and herbal supplements as they can increase bleeding
• Stop smoking
• Take certain medications or adjust your current medications

Spider vein treatment procedure

Your spider vein treatment procedure may include the following steps:

Injection

• The common method of treating spider veins in the legs and ankles is called sclerotherapy.
• During treatment, a sclerosing solution is injected into the affected veins. The injection irritates the inside of the vein, and over time the vein will collapse and fade from view.
• If you have multiple spider veins, the treatment will require multiple injections to collapse all the veins.
• Bright light and magnification may be used to ensure maximum precision while injecting the sclerosing solution.

Post-injection

• After treatment, the area may be dressed in compressive tape or stockings, or an elastic Ace wrap for a period of time.
• The veined area often looks a bit bruised initially, and the color slowly fades over the course of a few weeks.
• Some people can have a bit of brownish discoloration (hyperpigmentation) occur to the area during the healing process. This hyperpigmentation fades as well but may take months.

Laser treatment option

• Spider veins may also be treated with a laser.
• In this method, an intense beam of light is directed at the spider vein, which obliterates it through the skin.
• More than one laser session may be needed to obtain the desired results. Sometimes, laser therapy is used in combination with sclerotherapy.

Spider vein treatment recovery

During your recovery from spider vein treatment, you may be instructed to wear support hose to help your legs heal.

The treated sites will appear bruised and you may feel some cramping in your legs for the first day or two after treatment. This discomfort is temporary and usually doesn’t require prescription medication.

Although every patient heals at a different rate, most are back to normal activities quickly.

You will be given specific instructions that may include how to care for your legs following treatment, medications to apply or take orally to aid healing and reduce the risk of infection, and when to follow-up with your plastic surgeon.

You can expect that your spider vein treatment recovery will follow this general time line:
Within the first week

• You may be instructed to wear support stockings for three to six weeks
• You should avoid squatting, heavy lifting and running
• The tape, cotton balls or any other dressings (if used) will be removed from the treated areas when recommended by the plastic surgeon
• The treated sites will appear bruised
• You will be discouraged from sitting or standing in one place for more than an hour or two
• You will be encouraged to walk

Within one month

• The bruises at the treated sites will diminish
• You will begin to feel more comfortable wearing leg-baring fashions
• You can resume most exercise
• One month after the first treatment, spider veins are distinctly lighter, yet still somewhat visible
• You will be discouraged from sitting or standing in one place for more than an hour or two

After two months, your veins treatment should have completed its healing. At this point, you and your plastic surgeon will decide if any additional treatment is necessary.

Spider vein treatment results

After each spider vein treatment, you will notice improvement of your skin’s appearance. However, it is important to realize that new spider veins may surface in the future.

As time passes, you may want to consider further treatment to take care of any new veins that may emerge.

The practice of medicine and surgery is not an exact science. Although good results are expected, there is no guarantee. Be sure to discuss with your surgeon the results expected in your case, as well as the cost involved.

Spider vein treatment risks and safety information

The decision to have spider vein treatment is extremely personal. You will have to decide if the benefits will achieve your goals and if the risks and potential complications of spider vein treatment are acceptable.

You will be asked to sign consent forms to ensure that you fully understand the procedure and any risks.

The risks include:

• Swelling and bruising
• Change in skin sensation
• Infection
• Hyperpigmentation
• Ulceration
• Scarring
• Persistent pain

These risks and others will be fully discussed prior to your consent. It’s important that you address all your questions directly with your plastic surgeon.

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