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The Best Treatments for Spider and Varicose Veins

If you hate the way your legs look, there are treatments to erase those vein lines.


You used to flaunt your gorgeous gams in miniskirts and rompers. Now you cover up in maxi dresses and capri pants to better hide the bruise-hued streaks and bulges dotting your once blemish-free legs. This is no way to live. We spoke with Clifford Sales, MD, president and managing partner of the Vein Institute of New Jersey, to get the low down on treating veins gone wrong.  

What’s the difference between spider veins and varicose veins?

Spider veins are red, blue and purple blood vessels located close to the leg’s surface. They’re not harmful, just unsightly. “[Spider veins] are just extra veins you don’t really need,” says Sales. 

Varicose veins, distinguished by their twisty, ropey look, are caused by poorly working valves that allow blood to back up, pool and bulge. They can also cause fatigue, heaviness and leg pain, especially at the end of the day. 

Is it my fault I have vein issues? 

Varicose veins affect up to 35 percent of people in the country, according to the Society for Vascular Surgery in Chicago, IL. In many cases, genetics are to blame. “If your mom or grandmother had bad veins it’s likely you’re going to have them too,” says Sales. “There are lots of old wives’ tales about crossing legs and wearing high heels, but nothing has ever been proven.” Obesity as well as multiple pregnancies can increase the chances of having issues thanks to cycling estrogen, which causes veins to dilate and contract. “It’s like a pair of elastic waist pants. If you stretch and shrink them enough times, the
elastic will wear out.”

How do I make them go away?

A variety of treatments are available, all minimally invasive, performed in-office and in a short amount of time. For spider veins, sclerotherapy calls for injecting a solution directly into the vein causing it to scar, collapse and eventually disappear. Lasers work similarly, scarring problem veins via light waves. 

And for varicose veins, brute vein stripping has mostly given way to EVLT (Endovenous Laser Therapy), a less-invasive technique that calls for snaking and heating a laser fiber in a damaged vein, causing blood to coagulate and the vein to collapse. In any case, different treatments work best on different people, and doctors may employ a combo of the above to achieve the best results.

Does it hurt? 

According to Sales, treatments are “pretty painless” and recovery time is minimal, noting that patients treated on a Friday are typically back to work by Monday. Patients who’ve had the treatment mention some post-procedure soreness and bruising. Compression stockings worn for a few days afterwards help with healing. 

Are they gone forever? 

Yes, treated veins are gone for good—but new ones can and probably will pop up (thanks, Mom). Most patients book two to three treatments the first year, followed by annual touch-ups. “It’s important to keep on top of it over the years,” says Sales. 

Who should I see for treatment? 

According to the Mayo Clinic, your primary care doctor can recommend a phlebologist (a doctor who specializes in treating vein disorders), a dermatologist or a vascular surgeon. Look for a board-certified vascular surgeon with an accredited vascular lab, suggests Sales. That said, dermatologists and other board-certified doctors are fine, provided they understand the underlying disease. As with any medical or cosmetic procedure, doing your research is essential.  

The only downside to having your veins erased? You’ll wish you’d done it sooner…and that you hadn’t given away all your short shorts. 

Jennifer Kantor is a parenting and lifestyle writer. She lives in Brooklyn with her husband and two kids.

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