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Treatment of spider veins involves causing scar tissue to form, obliterating the vessels. Treatment options include sclerotherapy, laser treatment, and intense light treatment (Photoderm). Each treatment choice has its advantages and disadvantages. More than one treatment is usually needed for any option selected. No treatment is without risk.

Sclerotherapy involves injecting an irritating solution into the vessels, causing them to scar. Burning in the treatment areas, cramping, and swelling are common. Risks result from the irritating solution causing unplanned injury, either from the solution leaking out of the vessel or from the effects of the solution in other tissue. There is a risk of skin discoloration (usually temporary), skin breakdown at the injection site, deep vein thrombosis, and pulmonary embolism. Although risks of severe complications, such as venous thrombosis and embolism, are very rare, these risks do not occur when vessels are treated with laser or Photoderm.

I have used two different lasers and the Photoderm®. In my experience, the Photoderm has been the most effective. Laser and Photoderm treatment use light energy targeted at either the blood in the vessel or the vessel itself. The problem is that all tissue contains blood, and all tissue is made of the same basic building blocks. This means that there is a risk of unplanned injury. The most common side effect is a burning feeling with some redness at the treatment site. Side effects involve some form of a burn, ranging from a light "sun burn" to a blister. Local color change is possible. Treated areas may become either lighter or darker. Color change is usually temporary, but may be permanent. If the discoloration is present one year after treatment, it will be permanent. To limit risk of injury, before starting treatment, a test area is performed. The test area may be monitored for 2 weeks.  Areas to be treated should be protected from the sun for 3-4 weeks before starting treatment (including test treatment).

After treatment, you can resume normal activity according to your comfort. I don’t recommend aggressive workouts for 3-7 days after treatment. Support stockings help to reduce the risk of vessels recurring, as well as slowing progression of existing vessels. Firmer support stockings are now available in colors and patterns. I suggest knee high firm support stockings. When firm support stockings are not practical, support panty hose, such as Hane’s Alive, are recommended.