How to Treat Spider Veins: Learn from a Vein Doctor

Medically reviewed by Aditya Gupta, MD, RPVI, DABVLM, on April 22, 2023

Center for Vein Restoration Vein Restoration (CVR) physician Aditya Gupta, MD, RPVI, DABVLM, answers one of the most asked questions in any vein practice. Dr. Gupta is the lead physician in CVR’s Austin SW, Texas, and Austin NW, Texas, vein clinic locations.

Spider veins, also known as telangiectasias, are clusters of small visible, damaged blood vessels under the skin’s surface. Pregnancy, obesity, and advanced age are among the known causes.

How do you treat spider veins?

I use a microinjection visual sclerotherapy to treat spider veins. This outpatient procedure involves injecting medication directly into the spider veins using a very fine gauge needle. The medication works on the inner wall of the vein, causing it to scar, close, and ultimately disappear.

Besides sclerotherapy, are there other ways to treat spider veins?

While laser therapy is sometimes used to close spider veins, laser therapy is only effective for very fine spider veins. It is not effective for medium or larger spider veins.

That said, there are some indications for laser therapy, such as spider veins on the face and upper chest. Using the right specialized equipment is vital when using a laser to treat spider veins. Only the Nd:Yag laser is effective and gives satisfying results.

How long is each sclerotherapy session?

Each spider vein treatment session takes about 20-30 minutes. We use a 32-gauge needle (one of the smallest available needles). The patient usually tolerates the procedure well. At worst, some patients describe it as “a little annoying.” Almost no one requires local anesthesia or numbing agent for the procedure.

Why are my spider veins still present after a session?

This is a common question. After a treatment session, it is normal for spider veins to bruise for about two weeks. After that time, the veins will slowly start to fade away. The treated veins can take four to five months to go away completely.

Do I have to limit any activity after the treatment?

Yes, there are precautions patients should take. Immediately after the treatment, I recommend avoiding working out for at least one week, with no heavy lifting (no more than 20 lbs.), no vigorous hiking, and no strenuous exercise. Normal day-to-day activities, such as a slow-paced 15-minute walk a couple of times daily, are harmless.

Also, I urge my patients to wear compression stockings during the day regularly for one week after spider vein treatment.

Can my spider veins return after treatment?

Yes, spider veins can return. The results of spider vein treatment are good, and the difference between before and after sclerotherapy is impressive. However, sclerotherapy does not prevent new spider veins from returning. Fortunately, returned spider veins usually do not happen quickly, and the veins can take a couple of years to return.

How will I feel after sclerotherapy?

There can be some itching, the most common symptom after the procedure. There can also be some tenderness and bruising at the injection sites, lasting three to four days. Bruising can persist for about two weeks.

Can I return to work after sclerotherapy?

Yes, you can return to work. I recommend taking it easy when moving about. Patients must avoid lifting more than 20 lbs. for seven days and avoid standing or sitting at a stretch for longer than two hours.

What are the most common side effects of vein treatment?

Itching, tenderness, and bruising are the common side effects. Uncommon side effects can include hyperpigmentation (staining), developing delicate spider veins after injections (matting), and small ulcers. They are exceedingly rare but can be problematic if they develop.

Who should avoid sclerotherapy?

Women who are pregnant and nursing must avoid sclerotherapy.

Thank you, Dr. Gupta, for sharing your vast vein health knowledge!

Dr. Gupta, board-certified In Internal Medicine, was fellowship trained in Venous and Lymphatic Medicine through the Center for Vein Restoration Fellowship Program.

Where do I get my spider veins treated?

Center for Vein Restoration is the nation’s clinical leader in spider vein treatment, impacting the lives of more than 200,000 patients annually. In fact, CVR physicians conduct more vein procedures than any other vein clinic or hospital. That means that our patients benefit from the wealth of knowledge shared among 70+ board-certified vein physicians in an environment of research and clinical excellence.

Find a CVR vein specialist near you HERE or call our Patient Services Representatives at 240-965-3915 with any questions or help you find a vein clinic near you.