Hratch Karamanoukian, MD answers: Treating Spider Veins

Often the underlying cause of reflux disease or feeder veins to the spider veins cause recurrence of lack of adequate treatment. These have to be obliterated and therefore, you must see a specialist who can treat them. This may require foam sclerotherapy, or surgial ligation of the perforator veins, or radiofrequency, or laser ablation of perforator venous reflux disease. Typical areas of failure, as you describe, is in the lateral (outside thighs) and the inner legs near the ankles.