Seeking Out Treatment For Spider Veins

The purpose of this discussion is to review options for spider vein treatment and provide some guidance on how to find top-quality vein treatment in NYC.   

The most important consideration is to have a thorough evaluation that goes beyond the skin. An expert will take the time to evaluate for signs and symptoms of underlying venous insufficiency. Spider veins can be the result of valve dysfunction in one or more saphenous veins, rarely it can also reflect the damage of the deep veins. Venous insufficiency can be elucidated from a history of leg cramps, leg pain, swelling, skin discoloration, and leg ulcerations. Spider veins and varicose veins are visible signs of vein disease but do not always indicate underlying venous disease. 

How Does Venous Insufficiency Impact Spider Vein Treatment?

Venous insufficiency should be excluded prior to treatment of spider veins. In most cases, this can be done with a complete history and physical exam. In some instances, your NYC vein doctor may recommend a venous ultrasound. If present, larger insufficient veins considered symptomatic are treated prior to cosmetic injections. The resolution of underlying venous reflux is associated with better results and outcomes.  

The options for spider vein treatment using medical treatment include:

1. Cosmetic sclerotherapy-- This is generally the preferred treatment by vein doctors for most types of veins. The few exceptions are tiny, matted veins (very wispy, small veins in small tight gatherings), facial spider veins, and those on the feet. Spider veins on the legs are preferably injected with medical agents such as polidocanol or STS with great effect. The procedure is office-based and can take 15 minutes to 1 hour depending on the severity. In the initial 2 weeks, the veins may appear reddened and inflamed, but will subsequently begin to fade over the next 4 weeks. Most patients require several treatment sessions over the course of a few months to achieve desired results.
2. Laser treatment-- This is performed by the vein doctor or one of the clinic's assistants. It achieves spider vein removal by a focused beam of light on the target veins. This causes the spider veins to collapse and disappear similar to sclerotherapy. There are no needles involved, which may be favorable for some patients. It cannot penetrate much beyond the skin, so it's mostly reserved for surface spider veins rather than varicose or reticular veins (blue, or green veins often seen next to spider veins and can be referred to as feeder veins). Laser is preferred for the face and feet where the skin texture is not ideal for sclerotherapy injections. 

Where Should I Go for Spider Vein Removal?

In either case, it’s probably best to visit a dedicated vein clinic to determine the best vein treatment for you. A full-service vein treatment center can order appropriate testing such as ultrasound for underlying venous insufficiency. The test can be performed directly in the office over 40 to 60 minutes and is covered by medical insurance.

Based on the information achieved from this scan, a vein doctor can curate the appropriate vein treatment plan for your condition. Spider and varicose vein clinics in NYC cost have considerable variation. Important determinants for cost of treatment include:

• Geography
• Physician experience and demand
• Location of service (hospital-associated costs can run higher)
• Severity of disease
• Medication used (STS or Polidacanol versus hypertonic saline)
• Number of treatments required

We recommend taking your time to find not only a cost-friendly treatment but also one that is most likely to achieve the results you seek. Not uncommonly, patients spend more out of pocket correcting unsatisfactory results.