A: Among the many useless, inane things I've often wondered about: Wouldn't those intricate patterns of blood vessels be more appropriately called spiderweb veins? Anyway, if they're large enough to be threaded with a tiny needle, sclerotherapy—the injection of various solutions into the blood vessels—is the best option, says Tina Alster, MD, clinical professor of dermatology at the Georgetown University Medical Center in Washington, D.C. The solution irritates the vein's lining and the resulting tissue inflammation causes the blood vessel to collapse and fade.
The procedure used to sting because of the nature of the solutions. Now that there are better ones it's nearly painless, says Dr. Alster. Most people experience mild redness and swelling along the course of the treated veins. The treatment takes 10 to 30 minutes, depending on the number of veins. Often both legs can be done in a single session. If you hate needles, you could try vascular laser treatments instead, which are a little more uncomfortable because they zap the veins with heat, says Dr. Alster.
Bottom Line: The best time to have treatments for spider veins is in the winter, when your legs are covered and more easily protected from the sun. Tanned skin reduces visibility of the veins during the procedures and increases the risk of post-treatment hyperpigmentation. Avoid sclerotherapy immediately before or during menstruation because of heightened sensitivity. You can expect to pay $350 to $1,000 for either procedure.