Varicose Veins & Spider Veins: Treatments


What are varicose veins and spider veins?

Varicose veins and spider veins commonly develop as we grow older. Varicose veins are large, raised and swollen blood vessels. They usually develop on the legs and feet. Spider veins are smaller, red to purple and blue dilated vessels. They most often develop on the legs and thighs.

Who is affected by varicose veins and spider veins?

An estimated 30% to 60% of adults have varicose veins or spider veins. Varicose veins and spider veins develop more often in women than in men. They increase in frequency with age.

Symptoms and Causes

What causes varicose veins and spider veins?

A number of factors predispose a person to varicose and spider veins. These include:

  • Genetics
  • Occupations that require standing for prolonged periods of time (such jobs as nursing, hair styling, teaching, working in a factory)
  • Obesity
  • Hormonal changes during pregnancy
  • Birth control pills
  • Post-menopausal hormonal replacement therapy
  • History of blood clots
  • Conditions that cause increased intra-abdominal pressure (such as tumors, pregnancy, constipation)

Other reported causes include topical steroids, trauma or injury to the skin, previous venous surgery, exposure to ultraviolet rays, and abdominal girdles.

What are the symptoms of varicose veins and spider veins?

Many patients with varicose veins complain of an aching pain or cramping in the legs. Other common symptoms include tiredness, restlessness, burning, throbbing, tingling, or heaviness in the legs. Pain caused by varicose veins is usually relieved by elevating the legs or by wearing support hose.

In women, symptoms might be worse during the menstrual cycle or during pregnancy. Patients also might develop swelling, ulcer formation, and darker pigmentation or color of their skin, especially in the ankle region. Occasionally, varicose veins may develop superficial phlebitis (inflammation of a vein) which is characterized by pain and redness along a varicose vein.

Management and Treatment

What are the treatment options for varicose veins and spider veins?

There are three major treatments for varicose veins and spider veins:

  1. The most conservative approach is simply to wear properly fitting medical grade support hose, especially when the veins cause painful or uncomfortable symptoms. These stockings can be purchased at any surgical supply store and at some pharmacies. They come in below-the-knee, above-the-knee, and pantyhose styles. They also come in different compressions strengths, from 15 to 20 mmHg and up to 40 to 50 mmHg.
  2. Weight loss (if needed), and exercise also can help improve varicose veins and or prevent spider veins.
  3. Sclerotherapy has been available since the 1930s and is another treatment option. This procedure uses a highly concentrated saline solution or a medical detergent that is injected directly into the vein, causing the vein to disappear gradually over 3 to 6 weeks. The procedure is simple, relatively inexpensive, and can be performed in an outpatient setting. Complications are minimal but do include pigment staining, blisters, and — rarely — the formation of a skin ulcer. Patients are encouraged to maintain their active lifestyles immediately following the injections. They are able to drive themselves home after the procedure because no sedation is needed for this relatively painless procedure.

Another treatment option is a treatment with specialized vascular lasers or intense pulsed light. These devices use heat energy from laser light to selectively damage or destroy abnormal veins. The advantage of this method is that no needles or sclerosing solutions are required. However there might be some minor discomfort. Side effects do occur, including discoloration or staining and blister formation.

Not all patients need treatment for their varicose veins or spider veins. Many people have no pain or other symptoms. For these individuals, no treatment is necessary unless they want the veins removed for cosmetic reasons.

Are there any people who should not receive sclerotherapy?

Sclerotherapy generally is not advised for pregnant women and people who are not able to walk or move around.

Will my insurance cover the cost of support hose, sclerotherapy, or surgery?

Some insurance companies cover the cost of treating varicose veins, but generally not spider veins. The best approach is to check with your insurance company before considering treatment options.

Last reviewed by a Cleveland Clinic medical professional on 07/17/2019.


  • Bartholomew JR, King T, Sahgal A, Vidimos AT. Varicose veins: newer, better treatments available. Cleveland Clinic Journal of Medicine. 2005;72(4):312-314.
  • American Academy of Dermatology. “Below the Belt” Dermatological Conditions Fact Sheet ( Accessed 7/17/2017.
  • National Heart Lung and Blood Institute. What are Varicose Veins? ( Accessed 7/17/2017.
  • National Heart Lung and Blood Institute. Vein Problems Related to Varicose Veins ( Accessed 7/17/2017.

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