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What causes spider veins?

Spider veins (known medically as telangiectasias) are dilated blood vessels which

develop in most individuals as an inherited tendency. Pregnancy, hormones (such as birth control pills and Premarin), mechanical trauma, and long periods of standing or sitting contribute to this problem. While they may be red or blue, most people have both types on their legs.

How are spider veins treated?

Sclerotherapy is the microinjection technique of instilling a concentrated saline or other solution into the dilated vessels. Saline is a natural solution and is therefore usually safe to use. The solution irritates the lining of the vessels so they cease to carry blood. The body slowly replaces the vessels with invisible, harmless scar tissue. Several injections may be needed for a specific area of telangiectasias.

Blood Vessels Leg

How soon will the vessels disappear?

Usually the vessels disappear over 1 to 2 months, but occasionally fading is gradual over many months. Recurrence can occur over 1 to 5 years. Oftentimes, it may seem that a previously treated vessel recurs, when instead a new spider vein has formed.

How many treatments are required?

Optimal results usually require 2 to 5 treatment sessions. The number varies with the extent of involvement as well as the response to each treatment.

What type of results should I expect?

The goal is to produce a 70-80% improvement with multiple treatments. Although some people achieve almost complete resolution, 100% clearing does not occur in just one treatment, and may not occur even after several treatments. About 10% of patients may not respond at all. There is no guarantee that your spider veins will improve or disappear.

What are the side effects?

While side effects are uncommon, the following are possible:

Itching, Stinging or Pain: These side effects vary with the type of sclerosing agent injected and are temporary.

Muscle Cramps: Cramping usually resolves within 10-15 minutes.

Hives: Hives at the injection site usually disappear within a day.

Bruises: Slight bruising may occur at the injection site. It may last for a few weeks but is not permanent.

Pigment changes: In a few people, iron from the blood is deposited in the skin where vessels disappear. Brown stains result and may take months to resolve. Rarely, a small amount may be permanent.

Blisters or Ulcers: Blistering or ulceration of the skin is a rare but worrisome complication. If you notice any breakdown of skin at the injection site, notify our office immediately, as delaying treatment will promote scarring.

Scars: Scarring may develop after a blister or ulcer heals.

Matting: An uncommon occurrence after treatment is the development of tiny vessels that appears as a fine blush. People who are on hormones such as the birth control pill are more likely to see this side effect.

Clots: A blood clot may develop and can generally be removed with a small incision. Its removal speed the healing process. Because the treated veins are superficial and not in the deep leg muscles, internal problems (such as a blood clot forming deep in the leg and traveling to the lungs or brain) are unlikely. Clotting is minimized by using compressive wraps and hose after the treatment.

Swelling: Ankle or leg swelling is more common in people whose jobs involve standing for long periods of time, or whose ankles or lowest parts of the legs have been treated.

Superficial Thrombophlebitis: An inflamed clot can form in a vessel. If so, it must be treated with anti-inflammatories and bed rest.

Are some vessels not suitable for sclerotherapy?

Extremely small vessels and large, bulging, blue varicose veins cannot be treated with these techniques.

Are other treatments available?

Laser is usually reserved for facial vessels, for vessels that do not respond to sclerotherapy, for people who do not want needle injections, or for people whose vessels are too small to be treated by sclerotherapy.

Electrodessication and radiofrequency treatments can be useful for facial vessels. In general, those on the legs do not respond as well.

Are spider veins preventable?

Wearing support hose daily, not becoming over-weight, exercising regularly, eating a high-fiber diet, and wearing low-heeled shoes can minimize spider veins.


Appointments are made in advance after a consultation, and a deposit is required at the time the appointment is scheduled.

How should I dress for the procedure?

Wear shorts under a loose skirt. Also wear comfortable shoes.


Charges are related to the amount of time spent with the doctor and the amount of solution required. The initial treatment does not include the cost of any touch-up or follow-up sessions. A deposit is required when you make your appointment. You may use a credit card for the deposit. Each session is to be paid in full on the day of your procedure.

Will my insurance cover the treatment?

No. Sclerotherapy of spider veins is considered a cosmetic procedure and it is not covered by insurance.

How do I get started with treatment for my spider veins?

Frequently, only a few sessions are needed to see results. If you have any questions or wish to set up an appointment, please contact our office via this website or call our office today at (212) 557-2600.

Be sure to bring a pair of shorts to the office to wear during your procedure!