Spider Veins

spider veinsSpider veins (telangectasias) are small damaged veins typically on the face or legs. They are often the earliest manifestation of venous disease. They are more common in women and can increase with age. Spider veins form when small veins under the skin become dilated and then visible through the skin’s surface. Fortunately, spider veins can be removed. Spider vein removal is performed with injections during a procedure called sclerotherapy.


Spider veins can be blue, purple, or red. They form extensive patterns of linear, starburst, or tree-like distributions. Spider veins can form all over the legs including the inner thighs, ankles, and calves. This may be a sign that a condition exists called venous insufficiency. Typically, they are not painful. However, it is very common to remove spider veins for cosmetic reasons.


Multiple factors cause spider veins and the risk factors are similar to those for varicose veins:

  • Genetics
  • Age
  • Gender
  • Pregnancy
  • Lifestyle
  • Obesity
  • Injury


Typically, diagnosis is not necessary as most patients already know they have spider veins. However, in some cases, it can be important to first further diagnose using ultrasound. This is especially true if there are varicose veins, the veins are tender, or if the legs feel heavy. With ultrasound, Dr. Aquino can determine the best treatment plan for spider veins removal.

Sclerotherapy for spider vein removal

sclerotherapy for the removal of spider veinsSclerotherapy is a safe and minimally invasive treatment for spider vein removal. The small spider veins are injected with an FDA-approved substance called sodium sotradecol to remove them. Sclerotherapy can take up to three sessions. Patients often experience considerable improvement after the first session. Each sclerotherapy session lasts approximately 30 minutes. To perform sclerotherapy, a very small needle is placed in the spider veins to inject tiny amounts of solution. The solution causes the spider vein to scar and then permanently close. This forces blood to reroute through the healthier veins. Tissue absorbs the closed vein and it eventually fades.

Is sclerotherapy painful?

The procedure can sometimes produce a small amount of stinging but this usually goes away after a few minutes. Laser treatment of spider veins is considered to be more painful than sclerotherapy. If you have heard that sclerotherapy is painful, that is because in the past, vein specialists used a solution called hypertonic saline. This solution is painful which is why Dr. Aquino chooses to use sodium sotradecol which is much less painful but just as effective for spider veins removal.

Can spider veins be removed permanently?

Patients often ask if spider veins can recur. They can, but usually they come back in a less prominent way. The tendency to get spider veins is somewhat genetic like the tendency to get freckles or age spots. For some patients, keeping spider veins at bay means occasional “maintenance” appointments for sclerotherapy.

Other treatment options to remove spider veins

Other methods to remove spider veins include laser treatment. This treatment works by using a laser to heat the spider vein which causes it to scar and eventually close. Similar to sclerotherapy, the laser light causes the vein to lose its source of blood and eventually to fade. Both laser treatment and sclerotherapy can be effective to remove spider veins when used properly. However, laser treatment is less effective on larger veins in the legs. Laser for spider veins is more appropriate for smaller veins on the face and chest. Laser treatment is associated with more pain than sclerotherapy. Because of the tendency for laser vein treatment on legs to produce more side effects with less effectiveness, Dr. Aquino exclusively uses sclerotherapy for spider vein removal.