Sometimes patients ask me if a cosmetic med spa is a good place to go to treat their spider veins and varicose veins. Is a medical spa as safe and effective as going to a boring doctor’s office? Personally, I think this is a good question. Med spas are very popular these days, and many of my patients visit them regularly for other treatments. They are luxurious and fancy and make us all feel pampered. I go to them myself.

Many med spas have a doctor on staff because only a licensed medical professional is allowed to perform sclerotherapy and other medically based procedures. However, having a medical doctor who is not a vascular surgeon treat your spider veins or varicose veins is not an assurance of quality treatment. There are a few things that differentiate a vascular surgeon’s office from a typical med spa:


A medical spa typically will treat telangectasias (spider veins). These veins are connected to bigger veins (reticular veins) and those are connected to even bigger veins (including greater and lesser saphenous veins). The relationship between these systems is not always obvious. Sometimes treating the spider veins alone may make them disappear. However, sometimes is is necessary to treat the deeper veins as well to prevent more serious disease. Not doing so can make spider veins more likely to re-appear. It’s hard to know what to do if you don’t know the venous system in detail nor know how to obtain and interpret a quality vascular ultrasound.


Sclerotherapy is still one of those rare procedures in surgery which are a combination of science and art. In order to get the best results, it really does pay to go to someone who has seen thousands of patients and injected thousands of veins. It’s even better if that person really cares not just about clinical outcomes, but also aesthetics. Because of the training culture of vascular surgeons, it is often difficult to find a surgeon who has the expertise and knowledge about veins who ALSO cares about cosmetics. So while some patients might lean toward a med spa for ascetics, I am a vascular surgeon who balances the cosmetic results with the health of your leg veins.


They say ,“if all you have is a hammer, everything looks like a nail.” In other words, if you go to a cosmetic med spa that only offers sclerotherapy, you may get sclerotherapy even if it’s not the right answer for you. At the San Francisco Vein Center, I offer all vascular treatments from surgery for difficult or unique cases, to sclerotherapy for simple or complex telangectasias, to radiofrequency ablation for people who need varicose vein treatment and relief from venous insufficiency. Every patient is different, and should be treated accordingly.

So the answer to the question of med spa vs. vein center is this: Go to the med spa for pampering and skin treatments and come to us for your spider veins or varicose veins! You deserve the best, and so do your veins!