Dilated blood vessels on the legs, so-called spider veins, are often a nuisance to those affected.
At derma competence center, dermatologist Dr. Schnitzler can gently remove these with lasting results.

Either sclerotherapy or a vascular laser is used to treat spider veins

unsightly spider veins on the legs – @T.Agrici – AdobeStock

Table of contents

1. What are spider veins?

Magnification of spider veins @andriano_cz – AdobeStock

Spider veins are fine veins that can be seen through the skin. They typically appear on the legs of women but affect many men as well. Spider veins often accumulate on the lower legs as well as on the thighs.

The small veins are clearly visible under the skin and lessen the overall impression of attractive legs.

2. How can spider veins develop?

These tiny skin veins are dilated blood vessels that are reddish or bluish in color which become visible at the skin’s surface due to excessive blood pools. They can also develop when the valves in the small veins that help transport blood back to the heart stop working properly.

The blood backs up in the existing skin veins, which then expand and become visible under the surface of the skin as spider veins.

The cause, among others, can be hereditary vein weakness, excessive standing or sitting, or poor blood circulation due to a lack of exercise. Spider veins are by no means “broken veins”, as is sometimes assumed.

How spider veins lie in the skin
– @iuliiawhite – AdobeStock

3. What should you watch out for with pronounced spider veins?

Unattractive spider veins and varicose veins on legs

Spider veins and varicose veins – @Classic – AdobeStock

If the spider veins are very pronounced, the deeper veins should be examined to rule out a backflow of blood to the heart.

If such enlargements (varicose veins) are excluded, there are various methods of successfully treating spider veins.

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4. How are spider veins best treated?

If the spider veins are very pronounced, the deeper veins should be examined to rule out a backflow of blood to the heart. If such enlargements (varicose veins) are excluded, there are various methods to successfully treat spider veins.

4.1. Sclerotherapy

The most prevalent and established therapy since many years is sclerosing with a liquid sclerosing agent.

This is known as “sclerosing” or “sclerotherapy”.

With the use of ultra-fine needles, a liquid sclerosing agent is injected directly into the swollen vein. The sclerosing agent is a highly diluted alcohol-based solution, Aethoxysklerol®. For larger spider veins it is advisable to use this sclerosing agent in a foam-like form, a “micro-foam” that is produced when combined with air.

The preparation irritates the inner wall of the vein – this causes the vein to collapse and seal off. Afterwards the collapsed veins are broken down and absorbed by the body.

Sclerosing of spider veins – @andriano_cz – AdobeStock

4.2. Laser Therapy

Spider veins can also be treated with laser. There are many different types of lasers, certain types of lasers are very good and others completely unsuitable for treating spider veins.

The color of the vein to be treated is decisive.

The color of the vein also determines the wavelength of the laser with which the vein should be treated. Only lasers with light energy that can be absorbed by the blood pigment “hemoglobin” whereby the light is converted into heat which then heats the vein are suitable.

Older procedures that are offered (e.g., electric needles) should no longer be considered for the treatment of spider veins these days. They pose a significant risk of side effects that can result in scarring.

Remove annoying veins - laser varicose veins - fire paint laser

Laser treatment of unsightly spider veins

Q-switch and long pulsed Neodym:
YAG-Laser treatment,
Quanta Q-plus®

5. What side effects can Laser and Sclerotherapy have?

Like sclerotherapy, laser therapy is not painless. Minor burning or stinging sensations arise directly during the treatment. This however is minimal and well tolerated.

After sclerotherapy, the veins often appear dark blue due to bruising and clotted blood.

Afterwards there is no more pain.
Occasionally, after spider vein therapy discoloration or brown spots may form on the skin. The discoloration does break down eventually, but the length of time for this varies.

A supplemental laser therapy can also be used to accelerate the disappearance of these spots.

6. What should be considered after spider vein treatment?

After sclerotherapy or after laser therapy, patients should wear compression stockings for a few days or even weeks. Compression socks or stocking recommended for long air travel are of sufficient strength and suitable for this purpose.

With both methods, however, sun and UV rays should be avoided afterwards.

7. Facts on spider vein removal

  • Spider veins are harmless, however regarded as unsightly
  • For pronounced spider veins, a vein examination should first be conducted
  • Spider veins can be easily sclerosed or treated with laser
  • Following spider vein treatment, compression stocking must be worn, and UV rays must be strictly avoided.
Spider veins - laser - Dr. Schnitzler Zurich-Enge

Dermatologist Dr. Schnitzler treats spider veins with a vascular laser

Autor - Dr. med. Hero P. D. Schnitzler

I am Dr. Hero P. D. Schnitzler and founded the derma competence center in Zurich Enge in 2015, which I have been managing with heart, soul and professional competence ever since.

I am a member of various Swiss and international professional societies and a long-time lecturer for aesthetic laser medicine (D.A.L.M.) at the University of Greifswald, and for the Swiss skills program FMCH laser treatments of the skin.