What is the Best Treatment for Spider Veins? How Long Will the Results Last?

Doctor Answers 5

What is the 'best treatment' for spider veins in the legs ? Buffalo Niagara, NY

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Long pulsed lasers and sclerotherapy are commonly used to treat spider veins.

In the literature, > 95% of these veins have been shown to be treated successfully with sclerotherapy alone. 

I recommend use of FDA approved chemicals and DO NOT recommend the hypertonic saline to my patients.

The advantage of sclerotherapy is the the same technique can be used to treat the underlying feeder veins, otherwise you are just addressing the 'tips of the iceberg' when you use lasers alone. 

Watch video clips of sclerotherapy on the link below. 

Depends on size of veins and location of veins.

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Spider veins are best treated by sclerotherapy as long as the vein is large enough to accommodate the needle. Very small veins are best treated by either laser, ohmic thermolysis as with VeinWave or VeinGogh or micro needle radio frequency as with the Ellman surgitron.  Also, very small spider veins on the leg do not do as well with these ancillary treatments as do spider veins on the face.

John Landi, MD
Naples General Surgeon

Best Treatment for Spider Veins

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Thank you for your question. If the vein is large enough to fit a needle in, then sclerotherapy.  If the vein is too small for a needle, then a laser is appropriate.  For a very large vein that is bulging, called varicose veins, then surgery may be an option to consider.  Be certain to be under the supervision of a board certified dermatologist, vascular surgeon, or plastic surgeon with expertise in vein and laser procedures for the most effective and safe treatments. I hope this helps.

Optimal treatment for spider veins

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The most common treatment for removing spider veins is called sclerotherapy. Sclerotherapy is the injection of a special solution directly into the small spider veins which causes them to eventually disappear. The main solutions used are sodium tetradecyl sulfate (Sotradecol), polidocanol (Asclera / Aethoxysclerol), and hypertonic saline. Sclerotherapy is a minor procedure and is performed in the office with minimal pain - depending on the solution used. Sclerotherapy uses very tiny needles, and therefore, feel like a tiny prick, rather than a painful injection. Usually, dramatic results will be evident after only one session, but more often, 2-3 sessions are needed (spaced out over several weeks) to remove spider veins successfully.

It is important to know that even spider veins may be caused by an underlying condition called venous insufficiency.  In this case if spider veins are injected without treatment of the underlying disorder, they often will recur. Therefore, treatment of the underlying venous problem is sometimes necessary prior to performing spider vein treatment with sclerotherapy.

Melinda L. Aquino, MD
San Francisco General Surgeon

Sclerotherapy is the best treatment for spider veins

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Sclerotherapy remains the best and most popular treatment for spider veins. The procedure involves placing a solution into the veins to close them down. Results are reliable, although it may take more than one treatment. Blood vessel specific lasers can also target spider veins, but lasers are usually reserved for patients with a fear of needles or veins that are too small to be adequately treated with sclerotherapy. It is common for people to develop more spider veins with time, which is the most common reason for another round of treatment over time.

Ramona Behshad, MD
Saint Louis Dermatologic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.