Maybe you noticed a couple of faint squiggles around your ankles a few years back. Now you see blue lines, like kudzu gone wild, creeping behind your knees, over your thighs. You have several options to get rid of them, depending on the type of veins you're dealing with; all require a doctor's appointment.
Itsy-Bitsy Spiders: The tiniest veins can be zapped with a Vbeam, YAG, or diode laser. The beam destroys the walls of the veins (it will feel like a few quick rubber-band snaps), causing them to disappear within about two weeks. About three treatments, at $300 to $400 each, are necessary.
Smooth Squiggles: When a vein is large enough to be threaded with a small needle, sclerotherapy is the most effective option. A solution is injected into individual veins to irritate and collapse them; the body then reabsorbs them over the following weeks. Glycerin works for smaller veins, and saline or Sotradecol (a sodium sulfate compound) is most effective on larger ones, says Neil Sadick, MD, clinical professor of dermatology at New York–Presbyterian Hospital/Weill Cornell Medical Center. Two or three treatments are usually necessary, and the veins look worse before they get better (in about a month). Treatments cost $300 to $500.
Ropy Bulges: When veins protrude, doctors recommend "endovenous closure," a procedure performed under local anesthesia in which a radiofrequency or laser fiber is inserted into the vein; energy is applied to heat the vein's walls, causing it to collapse. One treatment is sufficient, but can cost from $3,500 to $6,000 per leg (doctors usually treat one leg at a time).
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