24 doctors weighed in:
Spider veins how to eliminate or reduce?
24 doctors weighed in

Dr. Steven Zimmet
Aesthetic Medicine
10 doctors agree
In brief: Can be treated
I disagree that a total vascular examination must be performed.
In selected cases where there is suspicion of underying veins (significant symptoms, presence varicose veins or swelling, certain patterns of spider veins), then an ultrasound should be done. Otherwise, many patients with spider veins can simply be treated, generally with sclerotherapy. See a vein specialist/phlebologist.

In brief: Can be treated
I disagree that a total vascular examination must be performed.
In selected cases where there is suspicion of underying veins (significant symptoms, presence varicose veins or swelling, certain patterns of spider veins), then an ultrasound should be done. Otherwise, many patients with spider veins can simply be treated, generally with sclerotherapy. See a vein specialist/phlebologist.
Dr. Steven Zimmet
Dr. Steven Zimmet
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Dr. Todd Sisto
Breast Surgery
6 doctors agree
In brief: Must treat large...
...Valve problems if present first or spider veins will quickly recur. Sclerotherapy is injection of chemicals thru a tiny needle then add laser for vessels too small or squiggly to get a needle in.

In brief: Must treat large...
...Valve problems if present first or spider veins will quickly recur. Sclerotherapy is injection of chemicals thru a tiny needle then add laser for vessels too small or squiggly to get a needle in.
Dr. Todd Sisto
Dr. Todd Sisto
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Dr. ELizabeth Kinsley
Surgery - Plastics
4 doctors agree
In brief: 2 options
Either laser or sclerotherapy( injections), both will require multiple treatments.

In brief: 2 options
Either laser or sclerotherapy( injections), both will require multiple treatments.
Dr. ELizabeth Kinsley
Dr. ELizabeth Kinsley
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Dr. Annette Occhialini
Surgery - Plastics
3 doctors agree
In brief: Laser or sclera
These are usually treated with either sclerotherapy or laser or both.
Larger veins may also need to be treated.

In brief: Laser or sclera
These are usually treated with either sclerotherapy or laser or both.
Larger veins may also need to be treated.
Dr. Annette Occhialini
Dr. Annette Occhialini
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Dr. Francisco Agullo
Surgery - Plastics
3 doctors agree
In brief: NdYag laser
Ndyag laser is very effective in removal of spider veins.
Will typically need 4-6 treatments.

In brief: NdYag laser
Ndyag laser is very effective in removal of spider veins.
Will typically need 4-6 treatments.
Dr. Francisco Agullo
Dr. Francisco Agullo
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Dr. John Landi
Phlebology
2 doctors agree
In brief: Sclero or laser.
Spider veins get their name because they look like spider legs.
The short answer is that topical laser or sclerotherapy usually works well. The longer answer is that if you have many spider veins and/or combinations of spiders, reticulars and varicose veins then you should first have a venous reflux exam. You should see a vein specialist.

In brief: Sclero or laser.
Spider veins get their name because they look like spider legs.
The short answer is that topical laser or sclerotherapy usually works well. The longer answer is that if you have many spider veins and/or combinations of spiders, reticulars and varicose veins then you should first have a venous reflux exam. You should see a vein specialist.
Dr. John Landi
Dr. John Landi
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2 comments
Dr. Thomas Fiala
Start with sclerotherapy. Save laser for final clean-up of remaining spiders.
Dr. John Landi
I agree with Dr. Fiala. Sclerotherapy is first line then laser for what is left.
Dr. Otto Placik
Surgery - Plastics
2 doctors agree
In brief: Sclero or laser
Scleeotherapy or laser ablation are reasonable and acceptable treatment options.

In brief: Sclero or laser
Scleeotherapy or laser ablation are reasonable and acceptable treatment options.
Dr. Otto Placik
Dr. Otto Placik
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Dr. Ted King
Phlebology
1 doctor agrees
In brief: Spider vein tx
Spider veins on the legs are probably best treated with sclerotherapy.
Sometimes a combination of both laser and sclerotherapy is used on the legs, but sclerotherapy can treat veins of any size in the legs and laser is often not needed.

In brief: Spider vein tx
Spider veins on the legs are probably best treated with sclerotherapy.
Sometimes a combination of both laser and sclerotherapy is used on the legs, but sclerotherapy can treat veins of any size in the legs and laser is often not needed.
Dr. Ted King
Dr. Ted King
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Dr. H. William Song
Aesthetic Medicine
1 doctor agrees
In brief: Sclerotherapy
Sclerotherapy or laser are easy solutions for treating spider veins.

In brief: Sclerotherapy
Sclerotherapy or laser are easy solutions for treating spider veins.
Dr. H. William Song
Dr. H. William Song
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In brief: Indeed,
If one has spider veins, and there is no history of a deep vein clot, no visible varicose veins one does not need ultrasound examination.
Even if they would com up with some minimal degree of reversed flow it would be insignificant. Many heart murmurs are insignificant. All it is done do get more money and to suggest ablative not needed treatments also for financial gains only. Caveat emptor!

In brief: Indeed,
If one has spider veins, and there is no history of a deep vein clot, no visible varicose veins one does not need ultrasound examination.
Even if they would com up with some minimal degree of reversed flow it would be insignificant. Many heart murmurs are insignificant. All it is done do get more money and to suggest ablative not needed treatments also for financial gains only. Caveat emptor!
Dr. Gabriel Goren
Dr. Gabriel Goren
Thank
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