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Popular Treatments for Spider Veins

spider vein treatments in NYCWe came across a recent article in the New Beauty Mag blog about spider vein treatments, and since our very own plastic surgeon, Dr. Nicholas Vendemia, does quite a few sclerotherapy injections for spider veins on a weekly basis, we wanted to get his feedback.

We’ve included the full text of the original article so that nothing can be taken out of context, and so that you can get the full opinions of not one, but two experts on this subject… Dr. Downie (the original doc interviewed by New Beauty), and New York Plastic Surgeon Dr. Nicholas Vendemia. After all, two heads are usually better than one.

Keep reading to learn more about treating spider veins of all types…


–from New Beauty with Dr. Vendemia’s comments after each section

For anyone who suffers from them, spider veins can cause some serious stress when it comes to how your legs look, even if they are toned, tanned and otherwise terrific. But, don’t despair, there are things you can do if you are desperate to get rid of them, and some of them may come as a surprise. We spoke to Montclair, NJ, dermatologist Jeanine Downie, MD, to get the inside track.

They Don’t Just Happen on Your Legs
Spider veins (which are the same as varicose veins, just smaller in size) are nothing more than enlarged veins that have become strained due to increased pressure on the lower body from prolonged standing and walking. Even though they tend to occur in the legs and feet, any vein in the body can be affected. In most cases, varicose and spider veins don’t cause any pain, but the look of them alone can be reason enough to do something about them.

Dr. Vendemia adds, “This is completely true. I see a few patients a week who ask about treating spider veins on their stomachs (most common request after the legs), arms, and around their eyes. The problem is that none of the injectable agents are FDA-approved as safe for use above the waist, so there aren’t any proven options for treating spider veins on areas of the body other than the legs. Most of the injectable agents work by creating local inflammation inside the tiny spider vessels, so they should never be injected into the face for any reason, and no matter how annoying or unsightly the vessel is. I personally choose not to inject any vessels where the products haven’t been evaluated to be safe and effective, which means at this point my recommendation is to keep the injections to thighs, calves, and ankles. Spider veins on the torso can sometimes be treated with lasers, but the results are usually disappointing because the amount of laser energy required to penetrate that deeply runs the risk of burning the skin which can cause a permanent scar if it occurs. Veins and other vessels the face can also be treated with laser, but only if they are in specific locations or types, so if this is your concern, it’s definitely a good idea to schedule a consultation for a full examination of the vessel size, color, and type prior to scheduling any treatment.”

You Can’t Control One of the Causes
According to Dr. Downie, there are three things here that are to blame: Genetics (that old standby source you just can’t do anything about), standing constantly and crossing your legs (yes, this one is true!). Luckily, the solutions for the two you can control are rather simple: “I recommend people exercise and don’t cross their legs,” she says.

Dr. Vendemia adds, “I agree 100% with Dr. Downie here about genetics being a major factor in an individual’s predisposition towards developing spider veins, and it’s by far the most powerful factor involved. The worst case of spider veins I’ve ever seen was in a 24 year old woman, which clearly proves this point. Being on your feet a lot can also contribute to the problem, but I am not convinced that crossing your legs has anything to do with spider veins. In the thousands of sclerotherapy injections I’ve done, I’ve tried to correlate the worse leg with the way people describe crossing their legs, and there is absolutely no correlation that I can see. My stance is that genetics is so by far and away the most predominant factor here that almost nothing else matters. Should you wear compression stockings if you have a job that requires you to stand all day? Absolutely. Stockings will definitely help prevent new spider vein formation, but only to a point. If you are genetically predisposed towards developing spider veins, in other words if your mother has them, your grandmother has them, maybe even your father has them, you will have spider veins too. Crossing your legs won’t change that fact.”

Winter Is the Best Time to Treat Them
Sure, this supercold season gets a lot of slack, but, according to Dr. Downie, now is the time to take control of your spider veins. Why? “I recommend that they should be treated as I treat mine, and winter is the best time, as they can bruise for a week or more.” One of the most surefire ways to get rid of them: sclerotherapy, an in-office procedure where your doctor injects a solution (it usually takes more than one treatment) to collapse the veins. For smaller veins, lasers may be your best bet.

Dr. Vendemia adds, “I don’t really agree with either of the statements made here. First off, I see no benefit to waiting until the winter months to have sclerotherapy treatments. Dr. Downie mentions that bruising is behind her reasoning for this recommendation, and while bruising is certainly a risk of any injectable treatment, I don’t commonly see bruising in my patients. The technique of sclerotherapy is a very delicate one that should be taken very seriously by only the most skilled practitioners to minimize bruising, and special attention should be paid towards this outcome. The use of very very small needles, taking the time to apply pressure to each injection site, and a meticulous evaluation of the vascular structure to ensure that the absolute minimum number of injections are used, are the ways to minimize bruising after sclerotherapy. The injection sites will be red for a day or two, but nothing worse than a run of the mill mosquito bite, but beyond that I don’t see any reason to delay treatments to the wintertime. I have just as many patients see me during the summer months as in the winter, and since most treatments need to be repeated 3-5 times with 6-8 weeks in between each treatment, it makes more sense to open up the entire year of scheduling to make this possible. 

Secondly, I don’t agree that laser may be a better option than sclerotherapy for smaller spider veins. Lasers have a very difficult time penetrating deeply enough to have any meaningful affect on vessels of any kind, and doing so requires that a very high amount of energy be delivered to the skin. This runs the risk of either burning the skin, which can leave a permanent scar, or producing no results at all. Sclerotherapy is particularly effective with the smaller spider veins, but the trick is in the injection technique, which is quite difficult. As you might imagine, injecting a solution into a micro-sized blood vessel is a rather difficult undertaking. Magnification lenses, very small needles, and a very steady hand are necessary for success when it comes to the smallest vessels, but when the injections are on target, the results are actually much better for the smaller vessels than they are for the larger ones.”


How can I get more information about spider vein treatments including sclerotherapy?

Take a look at our Before & After photo gallery for sclerotherapy by clicking here, or feel free to give us a call at 917-703-7069 to schedule a personal consultation about your vein treatment options. Alternatively, you can click here to read more on this website about the details of sclerotherapy in our practice.

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Photo Credit: New Beauty Magazine, ManhattanAestheticSurgery.com

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