Spider Veins? If a spider web comes to mind, you’re right. These red or purple veins, which appear mostly on women, often create a sunburst or web-like pattern on the skin. And while they are not medically harmful, spider veins can cause a burning sensation or achy feeling from prolonged standing. To top it off, they’re visually unappealing and may have you thinking twice about baring your otherwise sexy skin.

It’s no wonder that many of us feel self-conscious about those pesky spider veins and want to get rid of them. Otherwise known as telangiectasia (three Greek words meaning: end, blood vessel and stretch out), they are also referred to as broken capillaries.

“I see spider veins mostly in women, although men can get them, too,” says Tanda Lane, MD, a board-certified dermatologist who has a private practice in Columbus, Ga., and is also a clinical professor at Emory University in Atlanta. “And you’ll find spider veins mostly on the legs,” she says, although they “are also seen on the face around the nose and cheeks. I see a lot of patients, at least 80 patients per month, with a primary complaint of spider veins.” We get spider veins from multiple sources. Often, they’re a result of using birth control pills or hormone replacement therapy because high progesterone levels dilate the veins. Obesity, pregnancy and trauma can also cause spider veins. In terms of age, Dr. Lane sees patients from their teens to their 70s, though it’s women in their 30s she sees most often. She also sees high numbers of teenage patients whose spider veins are attributed to genetic factors.

Solution Savvy

Lots of us have spider veins, so it’s no surprise that there are a variety of ways to cosmetically treat these imperfections. You can have them zapped with a laser or injected with a solution (aka, “sclerotherapy”). Dr. Lane prefers sclerotherapy for the legs, but uses a pulse-dye laser for the face. Regardless of method, she says, one treatment is usually all that is needed.

This was the case for 59-year-old Pat Booher, a patient of Dr. Lane’s who had multiple spider veins on both legs, around the knees and thighs. She was treated by Dr. Lane last year and in one visit had great results. “I didn’t want to wear shorts and would always wear Capri pants,” she says. “After the treatment, I was able to wear shorts in a few weeks.”

For sclerotherapy, there are a variety of solutions (detergent, osmotic and chemical) that are FDA-approved. Dr. Lane uses an osmotic solution called Sclerodex by Omega Laboratories that contains an anesthetic to help control pain. “I find that osmotic solutions work best and hurt the least,” she says.

For a full sclerotherapy treatment for spider veins, the amount of solution used is fairly minimal (usually less than 10 ml). “It depends on how many vessels and feeding vessels there are,” says Dr. Lane. Dr. Lane injected Pat’s spider veins with about 6 ml of solution, which Pat says turned the red and purple veins to white almost immediately. “[The procedure] was so amazing to watch,” says Pat.

So how does it work? When the solution is injected into the blood vessel, its cells are disrupted and the vein (typically) becomes inflamed. It then closes, turning into tiny scar tissue that fades over time. And while the notion of “injecting” a solution sounds unpleasant, a very fine, thin needle is used.

Even though Pat needed multiple injections because her spider veins covered about 10 percent of her body surface area, she says she experienced only a little bit of stinging and burning. She says she would recommend the treatment to anyone.

Dr. Heidi Waldorf, a board-certified dermatologist in private practice in Nanuet, N.Y., who is also the director and associate clinical professor of laser and cosmetic dermatology at Mount Sinai Hospital in New York City, says, “I agree that sclerotherapy is more effective than laser for the size vessels that I treat.” And though she’s safely and effectively used saline solution for 15 years, “it is quite painful,” she points out.

According to Dr. Waldorf, another solution—Asclera (Merz Aesthetic/BioForm)—may be available later this year, which is virtually painless and even safer (less risk of ulceration if it leaks out of the vessel into the surrounding skin).

A Leg Up

After the treatment is over, Dr. Lane says that physicians have different opinions regarding exercise. Some tell their patients to begin strenuous exercise in order to clear their system, but Dr. Lane recommends caution. After the injection sites are wrapped with cotton balls and tape, she tells her patients to go home, relax and not do any strenuous exercise. “The trip home is plenty of exercise,” she says. She also recommends that patients wear support hosiery for one to seven days. The vessels will shut down and fade out over the ensuing couple of weeks with a recovery that takes eight to 10 weeks.

Dr. Lane always invites her patients to return for a touchup, if needed, at no charge. In the case of Pat, the results were so impressive that she didn’t opt for additional treatment. “I am very happy with the results,” says Pat.