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Treatments for Spider Veins and Varicose Veins

Many women want to do something about unsightly veins, but don’t know what treatment options are out there. A doctor from Jarra Herron Medical Spa in Tulsa answers our questions.



Spider veins or varicose veins can send many women running for cover. For those who have legs that look like a Rand McNally road map, with spider veins crisscrossing them with increasing frequency, there are treatments.

We asked Anne May, MD, medical director for Jarra Herron Medical Spa and Salon in Tulsa, what causes these unsightly blemishes and what treatments  are available.

What are spider veins and varicose veins?

Varicose veins and spider veins on the legs are normal superficial veins that have dilated under the influence of increased venous pressure. The difference between the two are the size of the veins. Varicose veins are usually larger than 4mm in diameter and spider veins are generally less than 2mm in diameter.

How do they form?

Anything that increases pressure in the veins can contribute to their formation. This includes prolonged standing or walking and, although not clinically proven, prolonged sitting with the legs crossed. Being overweight and wearing tight clothing are thought to contribute as well. Hormones such as estrogen (particularly during pregnancy) can cause the vein walls to be more pliable and dilate more easily. The tendency to form spider and varicose veins is also hereditary. Their formation can begin as early as the teenage years in susceptible people; however, most often they begin to occur during pregnancy or when people are in their 30s and 40s.

What are the treatment options?

Spider veins can be effectively treated in two primary ways: Sclerotherapy and laser therapy, also known as endovenous thermal ablation. Sclerotherapy is a procedure in which a solution is injected into the vein causing damage to the lining of the vessel. After one or more treatments the veins are damaged enough to shrink and become less visible, or disappear completely. Similar results can be obtained using a laser to cause damage to the vein.

Both options require one to five treatments for most patients and both are somewhat painful. However, applying ice to the area before and after treatment is very helpful in alleviating pain. A topical anesthesia (numbing cream) can also be helpful in certain cases, but is usually not required.  

Treatment of varicose veins usually requires surgery or more aggressive applications of sclerosing agents and/or laser treatment.

What can I expect after treatment?

Initially the treated area may be somewhat red. Blistering and bruising, though uncommon, may occur. After treatment it takes up to a week for the area to heal and for results to become evident. Normal activity is encouraged after treatment; however, on the treatment day it is advisable to avoid vigorous exercise and prolonged standing or walking.

Compression stockings are advocated by some practitioners after treatment and are most important after the more aggressive varicose vein treatments. Once the veins respond to the treatment and are no longer visible, they generally are thought to be gone permanently. Unfortunately, the forces that created them continue to be present, so it is not unusual to have new ones form over time.

Is there a way to avoid getting problem veins?

To minimize the risk of developing spider veins one should exercise regularly, especially the leg muscles, to keep the blood moving out of the veins. Additionally, it is important to stay at a healthy weight and avoid prolonged standing as much as possible. Finally, it is a good idea to keep the feet elevated when relaxing to encourage circulation.

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