Call Us

Spider Veins

At IVY Cardiovascular and Vein Center, we offer safe and effective treatment options for spider veins. Dr. Rishi Panchal is an ivy league trained cardiologist and advanced peripheral vascular specialist who strives to provide our patients with the personalized care they need.

What Are Spider Veins?

Spider VeinsSpider veins are small, thin veins that are purple and sometimes black in color. They are very superficial and can be seen under the surface of the skin.Patients state they look like a bunch of spiderwebs which are really a small bundle of veins. Spider veins can be a symptom of chronic venous insufficiency and be due to varicose veins. Many patients do not like the unsightly appearance of spider veins. They can cause discomfort and cause patients to be self-conscious of their appearance.

Spider vein and varicose veins are the visible signs of chronic venous disease and can occur without primary venous reflux disease.

Sclerotherapy is a minimally invasive technique that uses foam or liquid to irritate the superficial vein and causes it to close. A liquid is injected into the unwanted vein and the inflammation of the vein causes it to shut and disappear.

Sclerotherapy is gentle only requiring one or two small superficial injections for treatment. There is no downtime, and it is quick procedure that usually takes less than 30 minutes. Most patients only need one treatment to see excellent results. Major insurers will cover the treatment depending on the extent of the treatment.

  • Chronic Venous insufficiency
  • Leg injury or surgery
  • Excess weight or weight gain
  • Pregnancy/hormonal changes
  • Prolonged standing or sitting without movement
  • Age
  • Genetics
  • Family history of vascular disease
  • Your specialized doctor exam
  • Ultrasound
  • Ultrasound Guided Sclerotherapy

Why Do Spider Veins Occur?

Spider veins form when varicose veins have backward flow veins are backed-up with blood due to an issue with the veins in the area that prevents the normal flow of blood to the heart. There are factors that can increase your risk of developing spider veins, these factors include:

  • Aging
  • Obesity
  • Family history of vein problems
  • Excessive periods of no movement
  • Damage to the veins
  • Tight clothing that cuts off circulation

How Can I Prevent Spider Veins?

Spider VeinsRegular exercise regimen

Workout several times a week to enable your veins to push blood to and from your heart. This can help to improve circulation and keep your veins in peak condition. Overweight individuals can undergo low-impact exercise routines such as swimming to improve circulation.

Feet elevation

At the end of each day, elevate your feet to help circulate blood. The flow of blood to and from your heart needs to be facilitated to ease the pressure on your legs.

Get moving

The biggest culprit for most spider veins is lack of movement. Too much sitting or standing are both bad. Take constant breaks every hour to stretch your legs. Simple exercise at your desk won’t cut it: Take a walk.

How Can I Treat My Spider Veins?

Spider veins can be treated through a variety of methods.

Sclerotherapy is the best option. This treatment involves the use of a liquid sclerosing agent that is injected into the veins. This liquid solution makes the veins collapse and diminishes their appearance.

Sclerotherapy is the treatment of choice for most superficial leg veins. When sclerotherapy is dispensed sequentially from larger to smaller superficial veins, over 90 percent of venous vessels can be successfully treated. Spider veins may reoccur if the source of the problem is not fixed. Thus, superficial venous reflux is usually treated initially followed by sclerotherapy to the spider veins.

Patients with bleeding venous ulcers or bleeding from superficial vein sites may benefit from sclerotherapy at that location. Initially, pressure should be held at the site along with elevation of the affected leg. Furthermore, additional investigation of the vein will need to take place in the form of venous ultrasounds.

Patient without no symptoms from their varicose veins or spider veins are not associated with venous reflux disease and thus can be treated per patient preference. Unless there is bleeding from the vein site these veins are usually consider cosmetic. Depending on the patient’s anatomy it may take several sessions to close the superficial veins.

When spider veins are associated with typical symptoms of swelling, fatigue, and pain, then a venous ultrasound is recommended to exclude a deeper venous problem or reflux. Ideally, we close the main creek before treating the downstream creeks or veins.

Laser therapy is another option. Laser therapy makes use of micro pulses of laser to damage and reduce the appearance of spider veins. A combination of both treatments can be performed

What are the contraindications to sclerotherapy?

Acute deep vein clots or venous clots are contraindications to sclerotherapy.
Pregnant individuals should not have sclerotherapy performed until after delivery. Sclerotherapy is not approved in the United States during pregnancy. Given the increased volume of fluid during pregnancy many large and small veins began to swell. The appearance of spider veins will appear much worse during pregnancy. After delivery the volume of fluid in your body will equalize and those veins will begin to disappear and not require any treatment.

Severe critical limb ischemia due to peripheral vascular disease is a relative contraindication to sclerotherapy.


Sclerotherapy agents cause damage to endothelial cells of the veins. In the United States polidocanol is approved for sclerotherapy and is the most common agent utilized.


Polidocanol is available in a liquid or foam preparation. At IVY Cardiovascular & Vein Center we use foam or liquid preparations based on the individualized anatomy of the patient.

Post Sclerotherapy Instructions

We recommend 15-20 mmHg compression stockings for at least 2 days after treatment. This allows the most effective treatment results as the liquid sclerosant will have contact with the vein of interest for a longer period. We recommend compression stockings can then be used lightly for the next 2 weeks.

Ideally, you should avoid sun exposure to the treated exposure. If sun exposure is expected, then you can apply sunscreen to the affected area. If you have symptoms of visual, sensory, motor, or regional pain you should contact the Vein Center immediately.


  • Chiesa R, Marone EM, Limoni C, et al. Chronic venous disorders: correlation between visible signs, symptoms, and presence of functional disease. J Vasc Surg 2007; 46:322.
  • Uptodate venous disease 3.20.2022
  • Eklöf B, Rutherford RB, Bergan JJ, et al. Revision of the CEAP classification for chronic venous disorders: consensus statement. J Vasc Surg 2004; 40:1248.
  • Langer RD, Ho E, Denenberg JO, et al. Relationships between symptoms and venous disease: the San Diego population study. Arch Intern Med 2005; 165:1420.
  • Criqui MH, Jamosmos M, Fronek A, et al. Chronic venous disease in an ethnically diverse population: the San Diego Population Study. Am J Epidemiol 2003; 158:448.
  • Labas P, Cambal M. Profuse bleeding in patients with chronic venous insufficiency. Int Angiol 2007; 26:64.
  • Hamahata A, Yamaki T, Osada A, et al. Foam sclerotherapy for spouting haemorrhage in patients with varicose veins. Eur J Vasc Endovasc Surg 2011; 41:856.
  • Tretbar LL. Treatment of small bleeding varicose veins with injection sclerotherapy. Bleeding blue blebs. Dermatol Surg 1996; 22:78.
  • Rabe E, Pannier F, for the Guideline Group. Indications, contraindications and performance: European Guidelines for Sclerotherapy in Chronic Venous Disorders. Phlebology 2014; 29:26.
  • Rabe E, Pannier F. Sclerotherapy of varicose veins with polidocanol based on the guidelines of the German Society of Phlebology. Dermatol Surg 2010; 36 Suppl 2:968.
  • Reich-Schupke S, Leiste A, Moritz R, et al. Sclerotherapy in an undetected pregnancy – a catastrophe? Vasa 2012; 41:243.
    Varithena prescribing information.
  • Varithena prescribing information. https://www.accessdata.fda.gov/drugsatfda_docs/label/2013/205098s000lbl.pdf (Accessed on January 13, 2022).
  • Abramowitz I. The treatment of varicose veins in pregnancy by empty vein compressive sclerotherapy. S Afr Med J 1973; 47:607.
  • Lupton JR, Alster TS, Romero P. Clinical comparison of sclerotherapy versus long-pulsed Nd:YAG laser treatment for lower extremity telangiectases. Dermatol Surg 2002; 28:694.
  • Coles CM, Werner RS, Zelickson BD. Comparative pilot study evaluating the treatment of leg veins with a long pulse ND:YAG laser and sclerotherapy. Lasers Surg Med 2002; 30:154.
  • Hafner F, Froehlich H, Gary T, Brodmann M. Intra-arterial injection, a rare but serious complication of sclerotherapy. Phlebology 2013; 28:64.

  • Fellow of American College of Cardiology
  • Society for Cardiovascular Angiography & Interventions (SCAI)
  • Chronic Limb Ischemia Global Society
  • Society for Vascular Medicine

Schedule a Consultation

The most important step in your care is choosing a vascular specialist to treat your veins. At IVY Cardiovascular and Vein Center our physician, Dr. Rishi Panchal, was trained at Yale, one of five advanced peripheral vascular fellowships in the nation to treat your veins in an academic fashion. We utilize minimally invasive technology to evaluate superficial as well as deep venous disease. We serve all of Palm Beach County and greater South Florida. Current offices in Wellington and Belle Glade, Fl. Call today to set up your consultation.