Spider VeinsSpider Veins

Spider veins are small, damaged blood vessels visible just below the skin, where they appear as thin red, blue, or purple lines that often branch into a web-like pattern. They form when small vessels weaken and dilate. Unlike varicose veins, which bulge above the skin, spider veins are flat and sit closer to the surface. For treatment, location matters more than appearance. Sclerotherapy is the standard first-line approach for leg spider veins at Wall Street Dermatology, and clinicians have used it since the 1930s. A sclerosant is injected through a fine needle, scarring down the vessel wall so it disintegrates and blood reroutes into the main circulatory branches. Each injection permanently reduces 50 to 80 percent of the treated vessels. Dr. Julia Tzu uses polidocanol, which is less painful and carries a lower risk of tissue necrosis than the older hypertonic saline and sodium tetradecyl sulfate options. Facial vessels are treated differently, with the pulsed dye laser. Because leg spider veins occasionally signal underlying venous insufficiency, this is assessed before cosmetic treatment begins.

4 min read · Last updated: 2026-01-29 · Reviewed by Dr. Julia Tzu , MD, FAAD, FACMS

• Spider veins form when small blood vessels weaken and expand, becoming visible under the skin [1]
• Sclerotherapy causes treated spider veins to go away in approximately 3-6 weeks [1]
• Laser therapy is typically preferred for facial spider veins, while sclerotherapy works well for leg spider veins [1]
• Spider veins are flat and near the skin surface, unlike raised, bulging varicose veins [2]

• Thin red, blue, or purple visible lines
• Web-like or branching patterns under skin
• Flat appearance (not raised like varicose veins)
• Usually painless
• May cluster in specific areas
• Occasionally accompanied by mild aching in legs
• Can appear on legs, face, chest, or other areas

• Visible web-like veins on the legs or face that bother you cosmetically
• Leg pain, aching, or a feeling of heaviness accompanying the veins
• Swelling in the legs or ankles alongside the veins
• Skin changes or discoloration near the affected veins, which need evaluation before anything cosmetic
• Concern about underlying venous insufficiency, particularly with a family history
• Veins that appeared or worsened during pregnancy or with hormonal medication
• Interest in treatment where your work involves long periods standing, which both drives the problem and affects aftercare planning

Have questions about spider veins? Our team is here to help.

• Weakening of blood vessel walls
• Valve dysfunction in leg veins
• Sun damage (facial spider veins)
• Hormonal changes
• Pregnancy
• Prolonged standing or sitting
• Obesity
• Genetic predisposition
• Aging
• Previous trauma or injury

We offer a service to help manage this condition: Laser Treatment .

• Spider veins are typically benign
• Sclerotherapy success rates are high (60-80% improvement)
• Treated veins usually go away in 3-6 weeks
• Multiple sessions often needed for best results
• New spider veins may develop over time
• Underlying venous issues may require additional treatment

1. What are the symptoms of Spider Veins?
2. When should you seek care for Spider Veins?
3. What causes Spider Veins?
4. How are Spider Veins treated?
5. Prognosis
6. FAQs
7. Sources

This article draws from 3 peer-reviewed sources.

• [1] Cleveland Clinic – Spider Veins
• [2] Cleveland Clinic – Varicose Veins vs Spider Veins
• [3] Cleveland Clinic – Varicose Veins

Medically reviewed by Dr. Julia Tzu , MD, FAAD, FACMS · Last reviewed: 2026-08-31