Spider veins on legs

Leg veins: Why they appear and how dermatologists treat them

Varicose and spider veins: Varicose veins are enlarged veins that often twist and can bulge above the surface of the skin. They may be blue, red, or flesh-colored. Spider veins often look like webs. Having spider or varicose veins can affect more than your appearance. These veins can cause serious discomfort. Some varicose veins put you at risk for a complication like a blood clot or open sores on your legs.

Minimally invasive treatment can get rid of or fade leg veins. Treatment can also diminish symptoms like pain and fatigue and prevent complications.

Why we get visible leg veins

Varicose and spider veins are damaged veins. We develop them when tiny, one-way valves inside the veins weaken. In healthy veins, these valves push blood in one direction — back to our heart. When these valves weaken, some blood flows backward and accumulates in the vein. Extra blood in the vein puts pressure on the walls of the vein.

With continual pressure, the vein walls weaken and bulge. In time, we see a varicose or spider vein.

Some people have a higher risk of developing these veins. If blood relatives have them, you have a higher risk. Many people get them because they sit or stand for long periods most days of the week. These veins also become more common with age and during pregnancy.

Spider veins can also be caused by sunlight, hormonal changes, or an injury.

How dermatologists treat leg veins

Treatment options range from self-care to minor surgery. A dermatologist may use one or more of these treatments:

Self-care: Your dermatologist can give you tips to improve your circulation. These tips include:

  • Exercise

  • Elevate your legs

  • Sit for long periods? Get up and walk around every 30 minutes

  • Stand for long periods? Take a break every 30 minutes

  • Avoid soaking in hot baths for long periods of time

Self-care tips can help prevent new varicose and spider veins but cannot get rid of existing ones.

Compression stockings: These stockings apply steady pressure to help move the blood back to your heart. The steady pressure also lessens swelling in your lower legs and reduces the risk of getting a blood clot. You’ll still have visible leg veins, though.

If you need compression stockings, a dermatologist can examine you so that you get the proper size and right amount of pressure.

Sclerotherapy: This is the most common treatment for leg veins. Over the years, dermatologists have improved sclerotherapy to make it safer and give patients better results. Today, dermatologists use it to treat spider and small varicose veins.

If you have sclerotherapy, this is what happens during treatment:

  • Your dermatologist injects a chemical into the spider or varicose vein, which irritates the wall of the vein. Different areas of the vein are injected.

  • After the injections, your dermatologist may massage the area.

  • A compression stocking is then placed on each leg.

  • You will be observed for a time and then be able to go home.

  • To help prevent possible side effects, you will need to take daily walks and wear the compression stockings as directed. Most patients wear the compression stockings for 2 to 3 weeks.

  • You can return to work and most activities the next day.

Sclerotherapy causes the walls of the vein to stick together, so the blood cannot flow through it anymore. This improves circulation in the treated leg and reduces swelling.

Spider veins usually disappear in 3 to 6 weeks. Varicose veins take 3 to 4 months.

To get the best results, you may need 2 or 3 treatments. A dermatologist can perform these treatments during an office visit. No anesthesia is needed.

Laser treatments: Dermatologists use lasers to treat spider veins and small varicose veins. During laser treatment, your dermatologist directs the laser light at the vein.

Laser light can destroy the vein without damaging your skin.

Small spider veins may disappear immediately after treatment. Larger spider veins and varicose veins will darken, and you’ll likely see them for 1 to 3 months before they disappear. To get complete clearing, you may need 3 or more treatments.

Most patients can return to work and many of their normal activities the next day.

After each treatment, some patients need to wear compression stockings for a short time.

Every patient will need to protect the treated area from the sun for 3 to 4 weeks. This helps prevent dark spots from developing. Protecting your skin from the sun year round helps to prevent new spider veins and skin cancer.

Endovenous laser therapy (EVLT) and radiofrequency ablation (RFA): EVLT and RFA are newer treatments. They often replace the need to surgically remove a vein.

Both treatments work inside the vein to destroy it. Dermatologists use EVLT to treat spider veins and small varicose veins. RFA is used to treat large varicose veins.

This is what happens during these treatments:

  • You receive local anesthesia, which numbs the area to be treated. The anesthesia also causes the area to swell.

  • Your dermatologist then makes a small incision and inserts a laser fiber (for EVLT) or catheter (for RFA) into the vein.

  • Your dermatologist activates the laser or radiofrequency device, which heats up the vein, causing it to collapse and seal shut. The heat does not harm the surrounding area.

  • After treatment, a compression stocking will be placed on each leg.

  • You are observed for a time and then able to go home.

  • To help prevent possible side effects, you will need to take daily walks and wear the compression stockings as directed. Most patients wear the compression stockings for 1 to 2 weeks.

  • You can return to work and most activities the next day.

It takes about 1 year for the treated vein to disappear with both EVLT and RFA. To get best results, you may need more than one treatment.

Physical exam essential before treatment

A physical exam helps your dermatologist decide if leg vein treatment is safe for you. During the physical exam, your dermatologist will look closely at your leg veins and ask about your medical history.

Non-invasive tests that look at the veins in your legs may also be necessary. A Doppler ultrasound will show the blood flow in your leg veins. Plethysmography (pla-thiz-muh-graph-ē) uses a blood pressure cuff to measure changes in blood volume, which can help find problems like abnormal blood flow.

After reviewing all of the information, your dermatologist can tell you if leg vein treatment is right for you and which treatment would be most effective. Sometimes, more than one type of treatment will be recommended to give you the best results and reduce side effects.

If treatment is recommended, be sure to ask whether insurance will cover it. You’ll likely have to pay if treatment is performed only to improve the look of your legs.

Skill is the key to getting best results

The results you will see depend largely on the person performing the leg vein treatment. Because dermatologists made many of the advances that have given us safer, less invasive treatments for leg veins, they have a leg up on using these treatments.

You can find a dermatologist who treats leg veins by going to, Find a dermatologist and coose the specialty of Cosmetic Dermatology.

When you call the office, ask if the dermatologist regularly treats leg veins.

Related AAD resources

  • Who should be performing your cosmetic treatment?

Images
Image 1 used with permission of Journal of the American Academy of Dermatology: J Am Acad Dermatol. 1998;38:461-75.

Images 2 and 3 from Thinkstock

American Academy of Dermatology, “Dermatologists have a leg up on newer minimally invasive treatments for leg veins.” News release issued July 31, 2013.

Moul DK, Housman L, et al. “Endovenous laser ablation of the great and short saphenous veins with a 1320-nm neodymium: yttrium-aluminum-garnet laser:” J Am Acad Dermatol. 2014;70:326-31.

Nijsten T and van den Bos RR, et al. “Minimally invasive techniques in the treatment of saphenous varicose veins.” J Am Acad Dermatol. 2009;60:110-9.

Weiss RA and Dover JS. “Leg vein management: Sclerotherapy, ambulatory phlebectomy, and laser surgery.” In: Kaminer MS, Dover JS, et al. Atlas of Cosmetic Surgery (1st edition). WB Saunders Company, Philadelphia, 2002: 407-32.

Weiss RA and Weiss MA.“Treatment for varicose and telangiectatic leg veins.” In: Wolff K, Goldsmith LA, et al. Fitzpatrick’s Dermatology in General Medicine (seventh edition). McGraw Hill Medical, New York, 2008: 2349-56.

Yiannakopoulou E. “Safety concerns for sclerotherapy of telangiectases, reticular, and varicose veins. Pharmacology. 2016;98:62–9.

What Are Varicose Veins?

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Maybe you’ve seen them before: blue or purple squiggles on grown-ups’ legs that look like lines on a roadmap. And maybe you thought, “What the heck are those?” Well, they’re veins.

But wait a second — why don’t you have them? And why do they look different from the veins on the inside of your wrist or elbow? That’s because those grown-up veins are varicose (say: VAIR-uh-kose) veins.

Blood Vessel Basics

What is a varicose vein, anyway? It’s a vein that has become stretched and swollen with blood. To understand how that happens, let’s learn a bit about what veins do.

You have veins and arteries running through your whole body. They are tiny tubes that carry blood to and from every part of your body, from your nose down to your toes. The flow of blood starts with the pumping action of your heart. When your heart beats, it pumps your blood and moves it through all those little tubes. The arteries carry the blood from your heart out to your body, and the veins carry the blood from your body back to your heart.

The blood going out to your body in the arteries is full of oxygen, which makes the blood bright red. But the blood coming back from your body in the veins is darker because your body parts have used up the oxygen in the blood. That’s why veins look purple or blue.

What Causes Varicose Veins?

It’s a lot of work to move all that blood. To do their job, veins are full of valves that help keep the blood flowing in the right direction. Valves are like tiny doors that close after the blood has passed through to keep blood moving along and to make sure it doesn’t flow backward.

As people get older, though, the valves might not work as well. When that happens, some blood can stay in a vein instead of moving forward like it should. This makes the vein swell, and that swollen vein is a varicose vein.

The veins often show up on the legs, ankles, and feet because those body parts are farthest from the heart. Gravity pulls blood down into your legs and feet when you’re standing up or sitting down. So the veins have to work extra hard to get that blood back up to the heart, and some of those veins can wear out over time.

Varicose veins look twisted and purple or blue, and they’re raised, which means they look like they’re sitting on top of the skin. They can be tender and painful, especially after sitting or standing still for a long time. People who have varicose veins might also have achy legs that feel heavy.

Who Gets Them?

Varicose veins are more common in women. People are more likely to get them as they get older. These veins can be genetic (say: juh-NEH-tik). That means that if your mom or your sister has them, you might get them. Things that put pressure on your legs and feet — like being overweight or standing for a long time every day without exercise — can also cause varicose veins. Sometimes women who are pregnant get them too.

If someone you know has varicose veins, it’s really no big deal. They’re usually pretty harmless. But people who have problems like pain with their varicose veins will sometimes see a doctor to have them removed.

To get rid of varicose veins, some of the things doctors can do is zap them with light from a special laser or use something called sclerotherapy (say: skler-OH-thair-uh-pee). In sclerotherapy, the doctor injects fluid into the vein that makes it shrivel up. Both of these treatments are pretty common.

Luckily, you can do things now so you’re less likely to have varicose veins when you’re older. First, get your blood moving with regular exercise. Keeping your body fit helps keep your veins fit too! Also, don’t put a lot of pressure on your legs and feet by standing or sitting for too long without moving around. Help keep your blood flowing and your body will love you for it!

Reviewed by: KidsHealth Medical Experts

Ten Vein Violators: The Top Ten Causes of Spider Veins

Ten Vein Violators: The Top Ten Causes of Spider Veins

A number of factors predispose us to spider veins, which are milder forms of those pesky enlarged, engorged veins called varicose veins. Why should you care? Well if you want to protect your legs, it’s helpful to now appreciate the causes. This way you can take preventative measures to avoid ensuing circulatory problems. After all, spider veins are not just a cosmetic or aesthetic issue… Read on for an understanding of spider veins causes and how you may help prevent them.

Understanding the human circulatory system offers us vital background. The heart pumps oxygen-rich blood through your body, and arteries carry it to different parts of the tissue. Veins, more specifically, carry the blood back to the heart for recirculation. In order to return that blood to the heart, the veins in your legs are forced to work against gravity, pushing blood up. Muscle contractions in your lower legs act as pumps, and elastic vein walls help blood return to your heart. Tiny valves in your veins open as blood flows toward your heart then close to stop blood from flowing backward. This brings us to the root cause of spider veins on legs – the one-way valve malfunctions. This allows the blood to seep back through the valve, and it causes a major backup, leading to clotting and swelling. Thus, it’s important to realize varicose and spider veins can be a major circulatory issue that requires medical attention.

Spider veins are generally near the skin’s surface and are often red or blue. They occur mostly on the legs, but also may appear on your face. Spider veins vary in size and often resemble the eponymous spider web.

Causes of spider veins are varied. The top ten spider veins causes include:

1. Heredity

2. Doing anything repetitively that involves a lot of standing or sitting for long periods

3. Obesity or sudden weight gain

4. Hormonal influences of pregnancy, puberty, and menopause

5. The use of birth control pills

6. Postmenopausal hormonal replacement

7. A history of blood clots

8. Conditions that cause increased pressure in the abdomen, such as tumors, constipation, and externally worn garments like girdles.

9. Sun exposure

10. Leg injuries

Related causes of spider veins include trauma or injury to the skin and previous vein surgery.

All of this begs the question: Can anything be done to prevent spider veins? While there is no surefire way to prevent them, there are things you can do to reduce your risk. Common ways to prevent spider veins include:

· Exercising regularly and watching your weight

· Proper diet: high in fiber, low in salt

· Avoid sitting or standing for extended periods of time; change your (sitting or standing) position frequently

· Keep legs uncrossed and elevated when sitting

· Ladies: avoid high heels and tight hose!

In general, improving your circulation and muscle tone reduces your risk of developing spider veins on the legs and face or at least acts as a preventative for additional ones. Remember, the key to avoiding unsightly spider veins is avoiding things that restrict blood flow.

The Minneapolis Vein Center (MVC) specializes in state-of-the-art treatment of medical and cosmetic vascular conditions, primarily varicose veins and spider veins. We believe in tailored treatment options as we are not a one-size-fits-all population. MVC offers innovative, minimally invasive and cost-effective treatments. Call us anytime to schedule a free vein screening: (763) 398-8710.

AuthorMinneapolis Vein Center

Spider Veins

What causes spider veins?

Malfunctioning valves in feeder veins are the underlying cause.

Spider veins in the leg, hand, and face are caused by unhealthy valves inside feeder veins, allowing blood to flow backwards instead of upwards toward the heart. Some of this backed-up blood can lead to non-functional, “dead end” veins that appear underneath the surface of the skin as spider veins. Watch the video below and learn more about spider veins and the available treatment options.

Read Video Transcript

Overview

Spider veins are tiny varicose veins that appear as thin, squiggly lines just under the skin. They are common on the legs and the face, and most frequently affect women.

Causes

Spider veins occur when blood pools in veins near the surface of the skin. They can be caused by heredity, obesity, trauma, and fluctuations in hormone levels. In many cases, the exact cause is not known. They tend to become more numerous with age, and are common among people over 30 and in pregnant women. Menopause or birth control pills may increase the risk.

Symptoms

Spider veins may form a web-like pattern of red, blue or purple lines in the skin. They can also cause the skin to darken. People who have spider veins in the legs may feel a dull aching or burning sensation when they stand for prolonged periods of time. Some women may notice that their symptoms worsen during certain parts of their menstrual cycle.

Treatment

Most cases of spider veins do not require treatment, but there are many options for patients with cosmetic concerns or painful symptoms. Spider veins can be treated with compression stockings, laser therapy, or sclerotherapy. Regular exercise and weight control may help prevent the development and progression of spider veins.

Request an Appointment at Vein Clinics of America

Who Gets Spider Veins?

Men and women of all ages develop spider veins.

Many of us will eventually encounter vein health issues. It’s usually hereditary, so if your parents or grandparents have or had spider veins, you are more likely to develop them as well. If you become pregnant or have a job or lifestyle that requires standing for long periods of time, this may make them worse, or increase the probability of getting them.

Spider Vein Diagnosis & Treatment

Quick, effective outpatient visits treat the root cause of spider veins.

Some of our patients seek treatment for cosmetic improvement, and others are looking for relief from pain. The good news is that spider veins and their underlying cause are quite treatable, and our comprehensive approach at Vein Clinics of America handles the entirety of vein disease–not just the symptoms of it.

There are two main spider vein treatment procedures–UGFS and VGS–both are quick, minimally invasive, and require no hospitalization. Treatment is designed to seal off any feeder veins with unhealthy valves. Once those veins are sealed, blood circulation returns to veins with properly working valves, and dead-end spider veins are eventually absorbed back into the body.

Learn more about Sclerotherapy >

What Causes Spider Veins?

To show just how common spider veins are, a group of researchers looked at 1,566 people and found that 84 percent had spider veins — called telangiectasia in medical jargon — on their right legs alone. While they don’t usually cause medical problems, they can be eliminated for medical or cosmetic reasons with procedures such as laser treatment and sclerotherapy.

Who Gets Spider Veins?

Spider veins are caused by increased pressure in the veins, Dr. Joseph says. Doctors don’t know exactly why some people develop spider veins and others don’t, but they do know that the tendency to get them is hereditary, and that they’re more common as you get older. It’s also known that people who stand for a long time, such as nurses and teachers, tend to increase the amount of pressure in the veins of the legs and are more likely to develop spider veins, Joseph says.

In addition to the appearance of a patchwork of red and blue veins that you can see through the skin, people with spider veins may also experience:

  • Swelling in the legs
  • A feeling of heaviness in the legs
  • Tiredness in the legs

Lower Your Spider Vein Risk

You may not be able to totally prevent spider veins from appearing, but there are steps you can take to try to lower your risk:

  • Relieve some pressure. You can try to lessen the pressure on your legs that can lead to spider veins by keeping your weight down, and by avoiding standing or sitting for long periods. Experts recommend taking a walk every 30 minutes if you have to sit for long periods and avoiding crossing your legs while seated.
  • Keep the blood flowing. Exercising your legs by running or walking can increase leg circulation and strengthen your leg muscles.
  • Get support. If you’re going to be on your feet, Joseph recommends wearing a lightweight compression stocking, which he says can go a long way towards preventing and managing spider vein symptoms, including swelling. Try a lightweight compression sock with a gradient of 15 or 20 milliliters of mercury (a measure of how much pressure it puts on your veins). You can find these stocking in pharmacies and medical supply stores. “It’s best if you can get a certified stocking fitter to look at your leg and measure you properly,” Joseph says. While you can buy compression stockings over the counter, Joseph doesn’t recommend skipping a trip to the doctor about spider veins — you want to be sure you don’t have another significant vascular problem.
  • Prop up your feet. Elevating your legs is another main treatment for spider veins, Joseph says. Your legs must be elevated higher than your heart for best effect.
  • Slather on sunscreen. If you have light skin, sun exposure can lead to spider veins on your cheeks or nose, so wear sunscreen to minimize the damage.
  • Have any varicose veins treated. Varicose veins are larger, ropy looking veins with nonworking valves, a problem that allows blood to collect inside them. Having your varicose veins treated can reduce the pressure in the legs and prevent the development of additional spider veins, Joseph says.

Effective Treatments for Spider Veins

Two treatment options offer great results. Just keep in mind that these procedures may not be covered by insurance:

  • Sclerotherapy. Sclerotherapy is the most common treatment for spider veins, Joseph says. It involves injecting a solution into the vein that forces it to collapse, which stops blood flow. The vein will turn into a scar and fade after a few weeks. Most people who receive this treatment see a 50 to 90 percent improvement.
  • Laser treatment. While sclerotherapy is more common, the smaller, fine, reddish spider veins respond best to laser treatment because they’re harder to inject, Joseph says.

Spider veins are mainly a cosmetic issue and can be left alone if they don’t bother you. But if you’re unhappy about the way they look or if they’re painful, you can do something about them.

What are varicose veins? Are spider veins different? Do I need to worry if I think I have either of them? Can anything be done?

These are all very natural, common questions that many people have when they’re experiencing what they think may be varicose or spider veins.

Varicose veins, and the smaller version known as spider veins, are abnormal, dilated blood vessels. They often form in the legs. They develop when the valves and walls of the veins are weak, which causes blood to pool in the veins.i This pooling increases the pressure in the veins, and they become enlarged. Whether your doctor has already told you that you have this condition, or if you just suspect that you may have it, there are probably some questions that you have about varicose veins and spider veins.

Varicose Veins and Spider Veins – What is the Difference?

While varicose veins and spider veins have the same cause, there are differences between them:

  • Varicose veins are twisted, bulging blue blood vessels that can be seen and felt right under the surface of the skin.
    • They can cause a feeling of heaviness, discomfort or swelling in the legs.
    • Rarely, they can lead to more serious health conditions such as non-healing sores and/or blood clots.ii
    • Treatment may be necessary to prevent varicose veins from worsening and to improve how the legs look and feel.
  • Spider veins appear as tiny red or blue lines, usually less than 1 mm in diameter, that look like branches or a spider web just below the surface of your skin.iii
    • They’re almost always painless, do not cause leg swelling and generally do not lead to other health problems.
    • The cause of spider veins is not always leaky one-way valves in the veins, they can be caused by different forms of venous insuffiency.iii
    • While someone can have both varicose veins and spider veins, it’s important to point out that spider veins do not always turn into varicose veins.iii
    • Treatment of spider veins alone is usually considered cosmetic.

22 Things About Varicose Veins and Spider Veins That You May Not Be Aware Of

  1. They’re common –About 50 to 55 percent of women and 40 to 45 percent of men in the United States suffer from some type of vein problem. Varicose veins affect half of people 50 years and older.iv
  2. In the case of varicose veins, they’re not always just a cosmetic problem – they can impact how you enjoy life and can potentially lead to serious health problems.v
  3. Both varicose veins and spider veins are hereditary – if you have family members with either, it’s not uncommon if you develop them as well.ii
  4. They can be related to body weight – if you are overweight, you’re more likely to develop them.vi
  5. They’re gender-related – women are more likely to develop them than men.v
  6. They’re age-related – as you age, varicose and spider veins are more likely to develop.v
  7. Varicose veins can develop during pregnancy – but they tend to go away within 3 months after the pregnancy.vii
  8. Varicose veins are thought to be hormone-related – medications containing female hormones, such as birth control or hormone replacement therapy, increase your risk of developing varicose veins.v
  9. They can be job-related – if you have a job that involves sitting or standing all day, this may worsen your varicose veins. Crossing your legs can also make them worse, as this position impedes the flow of blood.v
  10. Varicose veins can cause discomfort – heaviness, tightness, pain with walking and cramps in the legs can be caused by varicose veins.viii
  11. A doctor may be able to easily diagnose your condition – sometimes a diagnosis can be made based on what you’re feeling and the physical appearance of your legs.
  12. Duplex ultrasound is the best way to look for varicose veins– this ultrasound imaging test uses sound waves to visualize the veins and measure blood flow.v
  13. Varicose veins are typically found in the legs – but spider veins are common on both the legs and face.
  14. Over time, varicose veins can worsen and cause changes in the skin – changes might include sores that do not heal, increased leg swelling and hardening of the skin.v
  15. Itchy ankles may not just be dry skin – varicose veins can cause itching around the ankles.
  16. If a varicose vein is injured, it may bleed more than you might expect – excess bleeding can be the result of the increased amount of blood that has pooled within the vein.
  17. 2-3% of people with varicose veins will develop blood clots – while rare, 25% of the time a clot forms, it can move into the deeper veins, becoming a deep vein thrombosis, a serious condition that needs immediate medical attention.ix Improving the blood flow in your legs now may help you avoid getting blood clots.
  18. If you develop pain, redness or swelling around a varicose vein, or if you have a sore that is not healing – you should make an appointment to see your doctor.
  19. Lifestyle changes may help – committing to changes in your daily life such as losing weight and elevating your legs, as well as avoiding sitting or standing for long periods of time, may improve your symptoms.v
  20. Compression stockings might help – these special knee- or thigh-high stockings are made of elastic and compress the leg. They are often the first treatment for varicose veins.v
  21. If lifestyle changes and compression stockings don’t help your symptoms, there are other options – some varicose vein treatments that can relieve symptoms and improve the look of your legs may include minimally invasive procedures, such as endovenous ablation, sclerotherapy or microphlebectomy. Or, there are more invasive options like vein ligation and stripping surgery, which involve tying off the veins and removing them.
  22. Your insurance may cover varicose veins treatment

RELATED: 6 Hidden Dangers if You Don’t Treat Varicose Veins

Hopefully, by now, you feel confident in knowing the difference between varicose veins and spider veins. If you suspect you have varicose veins and you’re wondering what you can do to prevent them from worsening or you’re hoping to find relief from any discomfort or swelling, you should see your doctor. Talk to your doctor about the best options for treatment and ask if minimally invasive procedures are right for you. You may not need surgery to get relief. And remember, if you have pain, redness, warmth and/or swelling around a varicose vein, seek medical attention now.

Treatment and prevention of spider veins

  • plastic surgeons
  • cosmetic surgeons
  • trained nurses
  • These professionals can carry out sclerotherapy or closure system in their office as the procedure does not usually require anesthesia.

    After undergoing sclerotherapy or closure system, the person usually wears compression stockings for several days or weeks. Spider veins will gradually start to disappear after these procedures, but the process may take up to 6 weeks.

    Some people need multiple treatments to get rid of spider veins.

    Laser treatment

    A healthcare professional can use a laser to treat spider veins that are smaller than 3 millimeters and close to the surface of the skin. The laser is a strong, focused beam of light that causes the spider vein to clot and dry up.

    Laser treatments are less invasive than sclerotherapy or closure system because there is no injection.

    Endovenous laser therapy (EVLT)

    EVLT is a newer procedure for the treatment of spider veins and small varicose veins.

    A healthcare professional makes a small incision in the affected vein and then inserts a laser fiber. The laser applies heat directly to the vein and causes it to collapse. The vein may take several months or up to a year to disappear.

    EVLT involves the use of local anesthesia.

    Surgery

    Although some surgical treatments can be effective for larger varicose veins, doctors usually do not perform them on spider veins. The reason for this is that spider veins are small, so they often respond well to the less invasive treatments above.

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