How to Prevent and Treat Spider Veins, According to Derms

Close up of legs of four women with various skin tones and body types

Roman Shalenkin/Stocksy

Spider veins, sometimes also known as telangiectasias or thread veins, are prominent clusters of damaged small blood vessels in the skin. The vessels are extremely thin in appearance, but due to the fact that they run close to the skin, they are typically more visible.

Spider veins are generally harmless and more common than you think—we fully support normalizing them and rocking them with confidence. However, if you do want to avoid them for cosmetic reasons, several treatment and prevention methods can help. Ahead, we tapped the experts to discuss ways to avoid or lessen spider veins—keep reading to learn their best tips.

Meet the Expert

  • Rebecca Marcus, MD, is a Dallas, Texas-based board-certified dermatologist and the founder of Maei MD.
  • Adam Tinklepaugh, MD, is a board-certified dermatologist, dual fellowship-trained cosmetic surgeon, and Mohs skin cancer surgeon based in New York City.
  • Joie Tavernise is a New York City-based skin expert, medical esthetician, and the founder of JTAV Clinical Skincare.
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Prevention Method: Exercise

"If you have family members with spider veins, you may be at increased risk of developing them," Tinklepaugh says. "Fortunately, there are several ways to prevent them from developing."

Up first: everyone's favorite activity, exercising. "The most common way to prevent spider veins is to prevent blood from collecting in your leg veins," Tinklepaugh explains. "Exercise moves blood in and out of our veins and helps prevent it from pooling in your legs. If you spend much of your day sitting, it's important to get up and walk throughout the day."

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Prevention Method: Compression Stockings

If you're heading into the office (or having a busy day at home), compression stockings can be a helpful, wearable option to prevent spider veins.

"Spider veins occur when backflow prevention valves in veins weaken or fail, allowing blood to pool in the vessel instead of flowing straight back to the heart," Marcus explains. "Increased pressure in the legs is known to worsen spider veins. Reasons for increased pressure include obesity, pregnancy, and spending a lot of time on your feet. Wearing compression stockings can help to decrease pressure in these vessels, as can leg elevation."

Just like exercise is key for getting your blood flowing to your legs if you spend most of the day sitting down, those who are constantly on their feet should try to sit and elevate your legs throughout the day so that blood flows back to your heart and doesn't collect, Tinklepaugh says.

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Prevention Method: Avoid the Major Causes

How better to avoid spider veins than to understand and avoid the major non-genetic causes of them? Tavernise breaks down the potential contributors, as well as what you can do to stay on alert.

"The first step in preventing spider veins is understanding what is causing them to happen to your skin specifically," she notes. "In my practice, I believe that no two faces or bodies are alike, and this is especially true for spider veins. There is a wide range of causes, including UV and heat exposure, how much alcohol you consume, genetic factors, environmental irritants, skin conditions such as rosacea, pregnancy and hormone fluctuation, and even pressure to your head from vomiting or sneezing."

For certain non-genetic causes, several practices can help prevent spider veins from forming. "Although there are some causes that you can’t prevent, there are habits that you can put in place that have been shown to offset the formation of spider veins," Tavernise says. "I suggest avoiding very hot water in the shower and when washing your face, monitoring and limiting the amount of alcohol that you’re drinking, incorporating a retinoid into your routine, wearing and reapplying SPF daily, exercising, and foot elevation."

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Treatment Option: Sclerotherapy

If you have spider veins and are looking to treat them, our experts assure that there are several options. If you aren't a fan of needles, keep scrolling, but if you're okay with the idea, sclerotherapy might be an option for you.

"Many dermatologists treat spider veins and varicose veins with a procedure called sclerotherapy, [which] is a safe and effective way to treat [them]" Tinklepaugh shares. "A dermatologist will inject a chemical directly into the spider vein using a very small needle and then massage the area. This injection will cause the vein to collapse over time so that it can't fill back up with blood. It is important to speak with your dermatologist about how to prepare for sclerotherapy and how to take care of your legs after treatment."

While this treatment does not guarantee complete removal of spider veins, it typically lightens the appearance significantly and is commonly practiced by dermatologists, including Marcus. The treatment, however, does not stop new vessels from forming. Studies also show that multiple treatments may be necessary to achieve the desired effect. 

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Treatment Option: Laser Therapy

If injection simply isn't your thing, you may consider trying laser therapy instead. "In my office, I use laser and IPL to treat spider veins," Tavernise shares. "Both of these methods use precise technology by way of either a laser beam or a flash of powerful light to treat the tiny area. Since they are so small, there is no harm in destroying these broken blood vessels and the treatment is practically painless."

In spider vein therapy, research shows that the light energy is absorbed by hemoglobin in the damaged vessels. The vessels heat up and occlude secondary to clot formation by photocoagulation, a.k.a. the process of using laser therapy to cauterize blood vessels. This concept of selective photolysis was developed by Anderson and Parrish in 1983 and remains the basis of laser therapy in medicine today.

FAQ
  • Who is most susceptible to spider veins?

    Generally speaking, anyone can have spider veins. If your family members have spider veins, it's possible that you'll develop them, too. "When I see [spider veins] on the legs, it is most likely with someone who is on their feet for long periods of time," Tavernise shares. "Pregnant women also have a higher occurrence of spider veins due to the extra strain on veins and arteries, as well as hormones that cause the walls of the veins to become relaxed and more prone to breaking. So to speak, everyone with blood in their body can experience spider veins, but there are also many causes that are completely out of one's control."

  • Are spider veins dangerous?

    "Spider veins are very common and not dangerous, but they may be a sign that the larger veins in your legs are not working correctly and are allowing blood to collect," Tinklepaugh notes. So while the spider veins themselves may not be an issue, it's important to monitor any issues, including pain or swelling, in areas that spider veins are present.

  • Do spider veins hurt?

    Spider veins should not hurt, and if there is pain, it's time to talk to a doctor. "Occasionally, spider veins and varicose veins can swell and become painful," Tinklepaugh notes. "If you are developing new spider veins or are experiencing leg swelling or pain, it is important to speak with your doctor about prevention and treatment approaches."

The Final Takeaway

All in all, spider veins are typically more of a cosmetic issue than medical, and while you can take action to minimize your chances of getting them from certain causes, the condition can be genetic as well. Leaving them alone is perfectly fine as long as you aren't experiencing pain, swelling, or other certain issues, but there's also no harm in treating them if they make you feel uncomfortable or self-conscious. No matter what you do, just stay in tune with your body and know that your choice is valid.

Article Sources
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  1. Sandean DP, Winters R. Spider Veins. [Updated 2022 Sep 19]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK563218/

  2. Sandean DP, Winters R. Spider Veins. [Updated 2022 Sep 19]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK563218/

  3. Sandean DP, Winters R. Spider Veins. [Updated 2022 Sep 19]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK563218/

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