Cosmetic Procedures: FAQs

What causes spider veins?

No one is totally sure. Certain families are predisposed to this condition so it is partially genetic. Estrogens (female hormones), pregnancy, birth control pills, tight girdles and garter belts, prolonged standing or sitting, and trauma make spider and varicose veins worse.

How does cosmetic work?

The solution destroys the tiny cells which line the blood vessels without damaging the surrounding tissue.

How soon will the vessels disappear?

Each vessel usually requires one to three treatments. The vessels disappear over a period of 2 weeks to 3 months. Recurrences may rarely occur over a period of 1 to 5 years. This treatment does not prevent new vessels from developing.

Are there certain vessels which tend to recur more commonly?

Yes. There are the types of vessels which occur in a mat of very fine radiating vessels. This can occur on its own or may even come on after the injection itself. Large veins also may not respond well to injections.

How often can I be treated?

The same veins should not be injected for 3 to 4 weeks to allow for complete healing. Different areas may be treated every week if necessary.

How many times do injections have to be done?

This varies with the number of areas that have to be injected, how numerous the veins are, as well as the response to each injection. It usually takes 1 to 3 injections to obliterate any vessel; 10 to 40 vessels may be treated in any one session.

Are there certain kinds of spider veins that can’t be treated?

Certain types of large varicose veins may not respond readily to cosmetic procedures alone. These vessels may require a minor surgical procedure to remove them with follow-up procedures for the smaller vessels at a later time.

Are there other methods of treating spider veins?


Cutaneous(skin) Laser Surgery
To date, this method has only been effective for tiny blood vessels. The present laser systems tend to produce a greater risk of scarring. The laser is an expensive device and treatment is thus more costly

Surgical ligation and stripping

This operative procedure is carried out in an operating room. It is best reserved for large varicose veins.

There is a new method called “PhotoDerm” treatment. It is expensive and not all that impressive. It does work for some.

Is there any way to prevent spider veins?

The use of support hose may be helpful. Reducing your weight and exercising regularly may also be of help.

What are the side effects to injection treatments?

Slight stinging or burning may occur with injection of certain types and concentrations of solutions in certain areas.

Sometimes a clot develops at the injection site (especially if the recommended pressure stockings are not worn for the proper amount of time or if large veins are injected). This clot will not generally cause internal problems, but its removal within 2 weeks of the injection will speed the healing process and decrease the incidence of discoloration. Removal is simple and only requires a minute incision.

Swelling over the injection site may rarely occur. It is particularly common when patients have jobs at which they stand for long periods of time or when vessels in the ankles are injected. The swelling is rarely dangerous but occasionally must be treated with elevation and compression dressings.

Superficial thrombophlebitis, an irritation of the injected vessel, occurs in less than 1 per 1000 patients. It may have to be treated with anti-inflammatory agents and compression stockings.

10% to 30% of patients develop a small freckle-like tan to brown spot around the injected vessel. This usually resolves in 80% of these patients within 3 to 6 months. A few patients will have a persistent discoloration for up to a year.

A small superficial ulceration of the skin overlying the injected vessel may occur. This does not usually leave a scar but needs to be seen as soon as possible by your doctor. It can take 6 to 8 weeks to heal.

Sometimes the body replaces the injected vessel with a “mat” of very fine vessels causing an apparent darkened area. This may need follow-up injections.

The injected sites will definitely look worse for a few weeks before they look better!

What should I do before my appointment for treatment?

  • Discontinue aspirin and blood thinners 1 week prior to your appointment.
  • Do not apply any creams or lotions on the day of injection.
  • Do not shave your legs on the day of injection.
  • Eat a light breakfast or lunch an hour or so prior to your appointment.
  • Bring loose shorts to wear during the procedure and slacks to wear out of the office since there will be bulky bandages.

What should I do after the procedure?

  • While riding home, keep legs moving. Flex and relax your muscles. Make frequent stops for walking (every 20 minutes) if it’s a long drive.
  • Maintain normal daytime activities.
  • No hot baths for 2 weeks.
  • Avoid standing without moving about. If you must stay in one place, move your feet and toes frequently.
  • If the legs become painful after the injection, walk.
  • Do not remove the stockings at all for 3 days and 3 nights.
  • Avoid strenuous physical activity (aerobics) for the first 2 weeks.
  • After the first 3 days, you may remove the stockings at night but it is recommended that you wear them when not reclining for at least 2 weeks. Ideally you would use support hose the rest of your life.

Remember that injection therapy is only treating the symptoms. Whatever the cause of your abnormal veins is, it’s still there after the injection. New abnormal veins can form and may recur, requiring future treatments in 1 to 2 years. Wearing support hose regularly may reduce the need for repeat follow-up treatments.