How can middle-aged women reduce spider veins on their face?

Laser or sclero: The best way to treat facial spider veins depends on the size of the veins and the experience of the one who is treating. Sclerotherapy actually works very well for facial spider veins but you need to see a very experienced sclerothrapist for treating the tiniest of veins. It is probly safe to say that laser, ipl, and thermocoagulation (all methods of treating veins with heat) is used more often.

Multiple Options: The first is to avoid sun exposure, smoking and control blood pressure. Treatment options tend to include lasers and intense pulsed light. I have not found topicals to work very well fo treatment.

Multiple options: I don't think that there is a single "best" way but there are mutiple options including sclerotherapy, ipl, laser, veinwave, veingogh and micro needle radio frequency. The size of the veins and the training and experience of the treating physician usually influence what treatment is recommended. You should see a vein specialist.