About one third to one half of all adults are affected by spider veins. Spider veins are a cosmetic issue, but they can also signify more serious medical problems of the veins. These veins tend to be purple or blue in color, and are common in the outer thighs, knees, ankles, face, and chest. The lower extremities can be affected by spider veins because gravity impacts the structures that change as people age, though they are often present in the facial skin as well. Rosacea and sun exposure often contribute to their formation on the cheeks or nose. Hudson Valley facial plastics & laser expert Dr. Rubinstein offers spider vein treatment at Laser & Cosmetic Surgery Specialists, PC using three non-surgical light therapies: laser spider vein removal, IPL Photofacial, and Laser Genesis.
How Do Arteries and Veins Differ?
While both arteries and veins are blood vessels in the circulatory system, arteries are mostly responsible for carrying oxygenated blood from the heart to the rest of the body, while the veins cycle the deoxygenated blood from the body back to the heart. This transport process delivers oxygen that is vital to each cell’s health to the various areas of the body on a constant basis.
How Do Spider Veins Form?
Commonly called thread veins, broken veins, or by their medical term, telangiectasia, spider veins form when veins within the skin or close to the layers of skin become enlarged. This can occur for various reasons. In other cases, the superficial veins develop a valve issue. The venous valve is the interior structure that helps the blood to flow in one direction, regardless of gravity. When the valve is defective, like when the vein expands, the blood may pool in the opposite direction, causing vein abnormalities and discoloration. However, sometimes the cause of spider veins is unknown.
Scrubbing the face too hard can lead to broken capillaries, and the continual irritation of rosacea can damage the blood vessels. High blood pressure and obesity are chronic health conditions that can lead to the formation of facial spider veins. Most spider veins of the face form under the eyes where the skin is very thin, the cheeks, and on the nose. These structures are also visible on a woman’s décolletage or a man’s chest.
What is the Difference between Spider Veins and Varicose Veins?
The saphenous vein is most commonly responsible for varicose veins—the raised and painful bluish structures that can be both seen and felt through the skin, as well as spider veins of the lower extremities. The saphenous vein is the largest in the human body, spanning the entire length of the leg, while reticular or feeder veins are found throughout the body under the surface of the skin. In vein abnormalities of the legs, it is common to also notice visible skin changes like hyperpigmentation (brown skin discoloration), eczema (dry skin), and even ulcers (open sores). While varicose veins are raised, spider veins are flush with the plane of the skin. Varicose veins are thicker in diameter while spider veins generally measure less than 1mm. Genetics, certain pregnancy hormones, and other factors affect varicose and spider veins of the legs. Doctors generally recommend a specialist to perform and review a screening ultrasound to determine the best course for venous repairs. In many cases, varicose veins are treated out of medical necessity, while spider veins are generally more of a cosmetic issue.
Why Treat Spider Veins?
Though spider veins sometimes have an underlying medical cause, they mostly seen as a cosmetic problem when located on the face. Even through layers of cosmetics, these dark-colored veins can still be visible. Some people even complain of looking ill, as the redness around the cheeks or nose can cause them to appear as though they have a head cold. Patients with very light-colored skin may notice a stark contrast between their pale skin and the darkness of the veins. Treating facial spider veins can improve a patient’s self-esteem by rejuvenating the appearance of the face and chest.
Cosmetic procedures for the legs can be performed during the same session. The legs will appear more uniform in color, and more youthful. Patients who avoid wearing certain types of shoes or shorts that expose their ankles, or more revealing bathing suits can once again enjoy the look of their legs.
Dr. Rubinstein at Laser & Cosmetic Surgery Specialists provides three main treatments used to reduce the appearance of spider veins on the face and legs. These options are non-surgical and typically non-invasive or minimally invasive. The sessions may have to be performed more than once for optimal results. Prior to any cosmetic intervention, Dr. Rubinstein suggests that patients undergo an exam to determine why venous issues are occurring and if any conditions require additional medical intervention, like surgery, to correct the issue long term.
Laser Spider Vein Treatment
First, a topical numbing cream, or local anesthesia may be offered for patient comfort as he or she requests, and eye protection will be provided. During the laser session, intense light is focused on the vein which can cause a slight snapping sensation on the skin. The darkened vein absorbs the laser’s output of light, which heats up the blood inside the vessel, causing it to coagulate and the blood vessel walls to collapse and seal shut. Eventually, this vessel will be naturally carried away from the site by the body and disposed of. Because the body is made up of an extensive network of blood vessels, this simple removal is not harmful to the body.
With the professional laser systems Dr. Rubinstein offers, the surrounding health tissue is preserved during a laser spider vein removal session. It can take about 15-30 minutes to complete treatments on the face and 30-45 minutes to treat veins of the legs. Sometimes patients see results right away, while larger veins may disappear over the course of a few weeks. It should be noted that veins (typically found in the legs) measuring greater than 4mm may be best treated with sclerotherapy, or injections that cause venous collapse. Following either form of venous leg treatment, compression stockings should be worn for the best outcome.
IPL Photofacial for Spider Veins
Another treatment available through Dr. Rubinstein’s practice that can eliminate spider veins is the IPL (Intense Pulsed Light) photofacial. Through photo rejuvenation, a heating energy is delivered to the skin to constrict both the collagen and blood vessels. An IPL photofacial eliminates broken capillaries by heating the walls of the structure so they become damaged enough to disintegrate. The capillaries will then disappear from the skin’s surface.
IPL treatments differ from laser treatments in that they are composed of different wavelengths of light (a broad spectrum), and are utilized for specific treatments in aesthetic medicine. The energy is intended to reach just beyond the skin’s surface to treat issues like spider veins, hyperpigmentation, and even hair removal. Numbing cream and personal eye protection are also used during an IPL photofacial for patient safety and comfort.
As a different type of laser treatment, Laser Genesis, a YAG laser treatment, heats the middle layer of skin. Sometimes known as a laser peel (though there is no peeling action) or a warm laser facial, the most common uses for this device are to minimize redness of the skin and to eliminate minor spider veins. Laser Genesis causes the blood to clot, collapsing the surrounding vessel, and therefore eliminating visible spider veins. Typically, this gentle yet effective laser does not require anesthetic, but patients will still wear protective glasses. Sensitivity can vary, though most patients report only a mild discomfort. The Laser Genesis is unique in that is actually has a built-in setting for vein removal and also stimulates collagen rejuvenating the skin.
Benefits of Light Treatment
While the intended target of these light treatments are the patient’s spider veins, the skin will also begin to produce more collagen as a side benefit of these sessions. When the skin is treated at certain wavelengths, the skin is encouraged to create more collagen and elastin, smoothing out lines and wrinkles or scars. In addition to these aesthetic changes, the spider veins will have improved without compromising the remainder of the skin. These light treatments do not damage the outer layer of skin, and all the procedures involve fast recovery times.
Candidates for Spider Vein Treatment
While spider veins are common post-pregnancy in women or among older individuals, they can occur in patients as young as their 20s. The first step in determining whether or not a person may be eligible to undergo one of the treatments described above is to have a diagnosis for their spider veins, if possible. Dr. Rubinstein may refer the patient to a specialist for potential medical intervention, or can possibly determine if a person has a condition like rosacea. After a health assessment and an in-office exam, Dr. Rubinstein can explain the options he is able to offer at his practice. Patients accepted for light therapy are generally healthy with visible spider veins, and do not have any conditions that preclude possible treatments.
Spider Vein Treatment FAQs
This depends on which part of the body and how many spider veins are present. On the face, 1 to 2 treatments spaced 1 month apart are usually sufficient. Dr. Rubinstein has the most advanced spider vein laser, Excel V Cutera laser, allowing for more superior results, with less risk, and less treatments. Patients with Rosacea may need 3 to 4 laser treatments and Laser Genesis typically requires more treatments as the goal is both spider vein reduction and rejuvenation. On the legs, 1 to 3 laser treatments spaced 2 months apart are typically required. As with other treatments, yearly maintenance treatments are recommended as new spider veins will develop.
The cost per treatment ranges from $ 175 to $ 850 per treatment depending on the extent of the spider veins and location. Most patients will purchase laser packages which significantly lowers the cost.
The risks of spider vein treatments are relatively low. There is a risk of skin color change both hyper-pigmentation (darkening & usually temporary) and hypo-pigmentation (lightening & can be permanent). This risk is minimized by using different types of lasers for different skin color types as well as experience in proper use of these devices. There is a small risk of burns and blistering which can lead to scarring. Again, customizing the treatment to match the skin type minimizes these risks. This is why Dr. Rubinstein uses 3 different types of laser modalities. Larger spider veins can sometimes leave a void after treatment creating a skin indentation which will improve over time but may require other treatment modalities if they persist including resurfacing lasers and or dermal fillers.
What are spider veins?
Spider veins appear as small veins that are red, purple or blue in color and commonly appear on different areas on the legs as well as the chest and face. These veins may be present as a single line or a cluster of lines that can occur on their own or alongside feeder veins or varicose veins.h3
How do spider veins develop?
Spider veins can form after changes to the body occur, including weight changes, hormone fluctuations, genetics, or regular work or activities where a person stands or sits for prolonged periods of time. Additionally, trauma to the area can also cause damage to the veins, leading to spider veins.
Sclerotherapy was mentioned as one treatment for spider veins. What is sclerotherapy?
Sclerotherapy is a prescription solution that is injected into spider veins by a medical professional. During this treatment, the vein walls break down and scar together to eliminate the visible vein. It may take up to 6 months for the full effect.
Are spider vein removals covered by insurance?
Unless spider veins cause discomfort or are a part of more extensive venous insufficiencies, insurance will not likely pay for their treatment.
Ran Y. Rubinstein, MD
Dr. Rubinstein has been a practicing cosmetic physician in the Hudson Valley for close to two decades, providing specialty treatments like aesthetic laser procedures and facial plastic surgeries. A top-rated New York facial plastic surgeon, Dr. Rubinstein has developed a close following. His passion for both patient health and cosmetic beauty are recognized in his doctor-patient consultations and every meeting thereafter.
The doctor holds double board certifications from the American Board of Facial Plastic and Reconstructive Surgery and the American Board of Otolaryngology – Head and Neck Surgery, and is an active member of the American Society for Laser Medicine & Surgery.
Dr. Rubinstein’s Hudson Valley office can be reached through the Patient Contact Form or at 845-863-1772.