Sweet Relief for Spider Veins

More than 50% of women have visible spider veins. The good news is that there are some very effective professional solutions to help make them less visible.

By Gina Way
shoe shopping legs


What causes visible leg veins?

Ultimately, it stems from floppy valves inside the vessels that don’t open and close properly, causing blood to flood the vein which makes it stretch and sometimes even protrude through the skin.

“Varicose and spider veins are 60 to 80% genetically predisposed,” says Dr. Luis Navarro, founder and director of The Vein Treatment Center in Manhattan, “Having a pregnancy tends to exacerbate the condition due to an increase in blood flow and sky-high female hormones.” Getting older doesn’t help either, probably because everything gets floppier with time, including our valves. 

Treatment for both spider and varicose veins

Unfortunately, there are no topical potions or DIY hacks to diminish the appearance of visible veins, but working out can help:

“Getting your blood pumping helps fight gravity and push it up and away from the legs,” says dermatologist Ellen Marmur, president and founder of Marmur Medical in NYC. You can also avoid standing for long periods of time and constantly crossing your legs when you sit down: “This compresses the vessels and can cause engorgement in the lower leg.” And, keep in mind, you can  hide leg veins temporarily with body makeup like Dermablend Leg and Body Makeup

When it comes to treatment, size does matter. For delicate, starburst spider veins on the upper calves, ankles or outer thighs, sclerotherapy is the gold-standard treatment (lasers that zap away broken capillaries on the face don’t do the trick below the neck where the veins are larger and skin is thicker). Sclerotherapy involves injecting a detergent-based solution directly into the vein which irritates the inner lining enough to destroy it (numbing cream is applied first, and the procedure is painless).

Navarro always performs an ultrasound on first-time patients in order to see the underlying vascular system and spot faulty valves. “Spider veins near the surface are typically offshoots of a larger ‘feeder’ vessel that needs to be treated as well,” he says. Over the next 2 to 4 weeks, the body will break down the damaged veins and they’ll dissolve away. (Price: $250-$500 per session)

This brings us to an important point: It’s key is to plan ahead.

“Ideally, you want to do this in the fall or winter when your legs aren’t bared,” Marmur suggests. “You’re going to have a week of redness and inflammation in the area that was treated with sclerotherapy, and it can take up to 6 weeks before the veins fade away and residual ones can be retreated.” Most people require two to three treatments spaced four weeks apart, so it can take a couple of months to see the vein-free outcome. 

Large varicose veins call for a slightly more aggressive approach. In the old days, the only way to remove those bulging blue-purple vessels was with a Game of Thrones-esque surgical technique called “vein stripping.” Thankfully that’s been replaced with endovenous laser ablation, a minimally invasive procedure that’s performed by a vein specialist or vascular surgeon. Here’s how it works: After lidocaine is injected into the area, a catheter is inserted into the offending vein and pushed through the length of it. As the thin cable is withdrawn, pulses of heat energy are released to destroy the vessel. Then, the body clears it away over the next four weeks. “The procedure takes about 25 minutes, and requires only one treatment,” says Navarro. However, there is a caveat: “Over the years, new visible veins will likely appear and be touched up.” (Price: $4000 - $6000) 

Preparing for your leg vein treatment

Marmur, who’s had sclerotherapy and  endovenous laser ablation done on her own legs to banish spider and varicose veins alike, has some realness and first-hand advice to share: “On the day of your sclerotherapy appointment, be sure to drink a lot of water since this expands the veins, making them easier to inject into. To help prevent bruising, avoid blood-thinning medications or vitamins like aspirin or omega-3s for two weeks beforehand. Also, abstain from alcohol at least three days prior since it thins the blood, too.”

And, wear a pair of thick exercise tights to your appointment. They hide the after-effects and add some compression to the legs, which helps accelerate the healing process.

“Trust me, for someone who has these ugly purple veins, it’s worth the investment and the ordeal to have them treated. I was too self-conscious to wear shorts or skirts on the hottest summer days. I’m so happy with the results I’ve had that I would do it all again, even laser ablation treatment. But next time I might do it with a Valium.”


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