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Spider and Reticular Vein Treatments Los Angeles

Spider vein removal is one of the most sought-after vein treatments in California because leg, face, chest spider veins are much more common than bulging varicose veins. Most people who have spider veins will not develop bulging varicose veins. However, most (but not all) patients with varicose veins will also develop spider and blue veins.

Most spider and reticular veins (small blue veins) do not cause symptoms, and if untreated do not cause any significant health problems. Accordingly, spider vein removal is considered cosmetic in nature. Occasionally however, leg spider vein clusters and reticular veins may cause significant symptoms like aching, burning sensation and itching, especially at the end of the day, in hot weather, or during the menstrual cycle. Note that in many patients, vein symptoms do not necessarily correlate with vein size. Sometimes huge bulging veins remain completely without symptoms, whereas a cluster of spider veins may cause significant discomfort.

If untreated, spider veins always get worse over the years, multiplying, branching out, getting thicker and more unsightly. As a consequence, these veins would then take longer to treat, require more treatment sessions, would take longer to heal and with higher chances of side effects, like pigmentation.


Spider veins treatment with sclerotherapy
*Individual results may vary.

Spider and Reticular Vein Treatment Options

Despite the fact that many ads promise to eradicate spider veins with dietary supplements, vitamins, or topical ointments and creams, sadly, studies to support these claims are scarce. At best, some are only effective to prevent their progression or reduce the discomfort associated with their occurrence. Although compression therapy brings some alleviation of symptoms, currently the only effective method for getting rid of reticular and spider veins is through their destruction or elimination.

Compression therapy

Compression therapy with stockings may provide temporary relief from symptoms associated with leg spider veins. In fact, many people whose jobs require prolonged standing benefit from everyday use of low pressure compression stockings (10-15mmHg). These stocking, however, would not eliminate any spider/blue veins already present, but could potentially prevent new ones from appearing in the future, although scientific evidence on this particular issue is rather soft. On the other hand, wearing high pressure compression stockings (20-30 mm Hg) may be more effective, but unacceptable by most patients for lifetime use.

Minimally invasive vein treatments

Except in rare cases, spider and reticular veins are considered dysfunctional veins that allow backwards flow and pooling of blood. Eliminating these veins will generally improve the circulation by channeling the venous blood through more efficient routes back into the deep vein system and the heart.

Spider and reticular vein treatment involves the destruction of the veins either by means of a chemical or heat energy. The two main spider vein removal options are slerotherapy, a procedure involving the destruction of veins by an injected solution into the vein (chemical destruction of veins) and laser vein removal (vein destruction with heat energy). VeinGogh or VeinWave are two other heat-based techniques for spider vein removal, but work only on the very fine surface spider veins, like the ones on the nose; not for clusters of thicker spider veins or subsurface larger blue veins.

Which Spider Vein Treatment to Choose

Generally speaking, for considerations of effectiveness and safety, sclerotherapy is considered the best treatment option for spider veins and the small blue veins of the leg; whereas, laser and light treatments are ideal for facial vein removal. On the other hand, both sclerotherapy and lasers can effectively and safely treat chest veins of the same type.

Besides the fact that leg spider vein removal with vascular lasers ends up being a lot more painful than a comparable sclerotherapy treatment, lasers are less effective for removing these veins. Following are the characteristics of leg veins that make them unsuitable for laser treatment:

  • Due to gravity and direct communication with small feeding arteries, leg spider veins veins tend to have higher blood pressure in them than chest or facial veins.
  • Unlike facial veins, leg spider veins are often present under the skin as interconnected network of veins of different colors, depths and sizes and these characteristics imply the use of different laser settings.
  • Topical lasers may not be able to penetrate deep enough to treat the feeder reticular veins that supply the surface leg spider veins with blood. Note that these veins are absent in the face and failure to treat these feeder veins in the leg is one of the more common reasons for leg spider vein treatment failure.
  • The large amount of heat generated during the treatment of veins that are somewhat deep may result in skin burns.

It should be pointed out that treating leg spider and reticular veins with sclerotherapy often brings alleviation of the pain and other symptoms associated with them, and therefore improves the quality of life.

Spider and blue vein removal in the foot and ankle areas are considered more challenging and higher risk to treat. These veins should be treated more cautiously and conservatively; preferably by experienced vein doctors.

Dr. Dishakjian, the experienced phlebologist (vein doctor) and cosmetic surgeon at Nu Vela Laser and Vein Center, will personally perform all the required spider vein treatments, and then carefully monitor your progress in your follow-up visits, ensuring a smooth, rapid healing process and the best possible cosmetically appealing outcome. Dr. Raffi Dishakjianwill work with you on a one-on-one basis to discuss your symptoms and concerns to determine the best course of spider vein treatment you may need.

The Sclerotherapy Spider Vein Removal Procedure

After signing of a detailed informed consent form and discussing any questions with your doctor, a set of baseline photographs are taken of the spider veins to be treated. These standardized, high-resolution pictures would serve as a baseline for future reference. During the treatment session, you will be seated in a comfortable position and the skin will be cleansed with a disinfectant. Dr. Dishakjian will then use a hand-held device, which when in contact with the skin illuminates it from beneath and enables the doctor to clearly see even the smallest spider veins and the underlying feeding reticular veins. Once the spider and problematic reticular veins are identified, they are sequentially injected with multiple injections of a very small amount of sclerosing solution, using the finest possible needles. In a few minutes, the injected areas will appear a little swollen, raised, sometimes red or blue, like a bruise.

Transilluminated Sclerotherapy for spider vein removal

Transillumination by the hand-held ring device allows the doctor to locate thin and/or deeper feeder veins.

In the hands of experienced vein doctors, the discomfort of vein treatment by means of sclerotherapy should be minimal or at least easily tolerable for the vast majority of patients. An occasional spot may be more sensitive than others, but generally the procedure should be well tolerated for most patients; even the needle phobic ones. In fact, most patients are pleasantly surprised at how little discomfort occurs during spider vein removal with sclerotherapy. More about the procedure can be accessed by clicking sclerotherapy for vein removal or sclerotherapy FAQ.

The Laser Reticular and Spider Vein Removal Session

Spider vein treatment with laser

The large sapphire window of the laser allows the doctor to see the blood vessel response while treating it.

After signing a detailed informed consent form and discussing any unanswered issues that you may have, a potent numbing cream is applied in the area for about 45 minutes before the laser vein removal procedure. Just before treatment, the numbing cream is removed and standardized baseline pictures taken and you will wear eye protection goggles. The contact cooling system of the laser, the numbing cream, and the cooling gel applied after the treatment, will minimize the pain and make the procedure tolerable for almost all patients. More about laser vein therapy.


Sclerotherapy leg spider veins treatment
*Individual results may vary.

Preparing Yourself for a Spider Vein Removal

In the week before your treatment, whether sclerotherapy or laser treatment, avoid tanning, avoid taking NSAID medications, vitamin E, or herbal supplements that increase your chances of bruising. You should also stop the use of photosensitizing medications before having laser or IPL spider vein treatment, as these may exaggerate the skin’s response to the treatment.  Don’t shave your legs on the day of the treatment as the solution used for cleansing purposes may cause some stinging. It is also recommended that you bring a short that you can wear during a leg spider vein removal session.


Sclerotherapy leg veins treatment
*Individual results may vary.

Number of Sessions Required for Spider Vein Removal

There is a maximum safe dose for each sclerotherapy solution that can be safely used in a single session, limiting the number of veins that can be treated in a single session.  Most patients need 2-3 treatment sessions for any given area, with each treatment session resulting in at least 50-60% improvement compared to before. At the end of the process most patients can expect about 80-90% clearance of spider veins, the remaining veins often being hardly visible except at a close range. The larger blue veins on the other hand, may need several treatment sessions before they disappear.

As for laser treatment of facial or chest spider veins, not all spider veins may respond to one session and a few additional repeat treatments may be required.

Recurrence of Spider Veins

Once treated effectively either with laser or sclerotherapy, the treated spider veins should not come back. For a lasting leg spider vein treatment, the feeder reticular veins of the leg should be eliminated even before the elimination of superficial spider veins and any source of venous reflux in the leg should be identified and treated.

Periodic Follow up Spider Vein Treatments

Regularly wearing sunscreen on your chest and face may significantly delay the appearance of new spider veins. However, over time, your body will make new spider veins. Remember, sclerotherapy  and laser treatments do not a cure this condition and do not stop your body’s predisposition to make new spider and blue veins in the future. Accordingly, most patients need to have periodic follow up leg spider vein treatment sessions to maintain optimal results. The frequency varies from a year to several years.

Insurance Coverage for Spider and Reticular Vein Treatment

Unfortunately, reticular and spider vein treatment, whether with sclerotherapy or vascular lasers is considered cosmetic in nature and the cost, regardless of the technique used, is not covered by insurance plans.

For more information about injection treatment of spider veins, please click sclerotherapy injections  or sclerotherapy FAQ. Click laser spider vein treatment for information related to the latter.

Questions about the Cost of Spider Vein Removal or the Treatment?

You may reach our vein center by clicking the “Contact ” button at the top of the page, or by calling 818-832-4500. Our receptionist at the front desk will be delighted to assist you with any enquiries regarding cost, additional information, or scheduling a comprehensive consultation session with Dr. Dishakjian.