What are spider veins?
Spider veins are small, web-like surface veins, usually red, purple, or blue. They most commonly appear on the legs and face. They are often cosmetic, but in some cases they are associated with underlying venous reflux that should be evaluated.
Common causes
- Heredity and family history
- Hormonal changes (pregnancy, menopause)
- Prolonged standing or sitting
- Sun exposure on the face
- Prior leg injury
- Increasing age
Cosmetic vs. medical considerations
For many patients, spider veins are purely cosmetic and sclerotherapy is an appropriate option. For others — especially when symptoms or larger varicose veins are present — spider veins may be a sign of underlying venous insufficiency. We always start with an honest evaluation so you understand which category applies to you.
When ultrasound may be recommended
If your spider veins are widespread, recurring after previous treatment, or come with leg symptoms such as aching, heaviness, or swelling, your physician may recommend a duplex ultrasound to look for venous reflux before sclerotherapy. Treating the source first leads to better, longer-lasting results.
How sclerotherapy works
Using a very fine needle, your physician injects a medical solution directly into each spider vein. The solution gently irritates the inner lining, causing the vein to close. Over the following weeks the closed vein is reabsorbed by the body and gradually fades.
How many sessions and what to expect
Sessions
Most patients need 2–4 sessions, spaced 4–6 weeks apart, depending on the extent of the veins.
After each visit
Compression stockings are recommended for a short period. Mild bruising or darkening at injection sites is normal and fades over time.
Results
Improvement is gradual. Final results are usually visible several weeks after the last session. Individual results vary.
Compression and aftercare
Compression stockings help your veins heal evenly and reduce the risk of pigmentation changes. Walking regularly, avoiding hot baths and direct sun on the treated areas, and skipping strenuous exercise for a short period after each session are typical recommendations.
Who may not be a candidate
Sclerotherapy is generally not performed during pregnancy or breastfeeding. Patients with certain blood clotting disorders, recent blood clots, or known allergies to sclerosing agents may need an alternative approach. Your physician will review your medical history at your consultation.
Insurance expectations
Cosmetic sclerotherapy for spider veins is generally not covered by insurance. If an ultrasound identifies underlying venous reflux that meets medical necessity criteria, treatment of the underlying disease may be covered. Our team can help clarify what is and is not eligible — see our insurance page.