If you’re wondering how to get rid of spider veins, you’ve probably already come across a bunch of the internet’s suggestions. When I noticed a series of faint blue lines twisting around my thigh, some of the recommended home remedies I saw included ginger tea, massage, and even exercise. But here’s the honest truth: That’s all B.S. Visible veins aren’t something you can fix at home.
So I talked to dermatologists and surgeons who specialize in treating spider veins and varicose veins (the larger, raised visible veins that often appear on the legs). What I learned is that the underlying causes of these visible veins aren’t always preventable—and they can be a sign of a much deeper vein problem that no home remedy is likely to fix. Here’s how to get rid of spider veins for real—and why it’s so important to see a specialist to do so.
What actually are spider veins?
There are two common types of visible veins: spider veins and varicose veins. “Spider veins are really small superficial veins that are in the outer layer of skin between the dermis and epidermis, so you can see them,” Christopher Hollingsworth, M.D., a general surgeon at NYC Surgical Associates, tells SELF. “If you live long enough, most people are going to get them.” These veins get their name because they look like thin, weblike, blue-and-purple lines on the legs.
Varicose veins, on the other hand, are larger veins that are deeper in the body. “You won’t see them as a discoloration, you’ll see them when they get so stretched out that they kind of bulge,” Dr. Hollingsworth says.
Because these two issues are caused by similar blood-flow situations, varicose and spider veins commonly occur together. That means that people who have varicose veins almost always have spider veins too. However, some people get spider veins and never have a problem with varicose veins.
What causes spider veins and other visible veins?
To understand why these visible veins develop, you’ve got to understand how blood flows through the body. Your heart pumps blood to your entire body through your blood vessels. From there, blood circulates outward toward the extremities (legs, arms, head) through the arteries and back inward to the heart through your veins.
“Think of veins as being a hose that flows from bottom-up toward your heart,” says dermatologist Alicia Barba, M.D., of Barba Dermatology. “And there’s a little valve. When they work well, the blood shoots up and the valve closes. When it doesn’t work, the blood falls back down instead of moving north.”
When blood flows in the wrong direction because of a valve problem, it can get backed up in the veins of the legs, which damages the walls of the vein, the American Academy of Dermatology (AAD) explains. That extra pressure on the vein walls gradually causes them to weaken and then bulge, creating veins we can actually see. In fact, the majority of people who have spider veins and/or varicose veins will be dealing with this type of “venous insufficiency,” Dr. Hollingsworth says.
However, other factors can contribute to the likelihood that you’ll develop visible veins, including genetics, age, and your level of physical activity, the AAD says.
For instance, if you have a job where you are standing still for long periods of time, gravity is at work pulling the blood back down toward the legs, causing the veins to get stretched out and the valves to weaken over time. If you sit all day at your job, you can also start to see visible veins because there is a lack of muscle movement. The muscles in the leg help the veins push the blood back up toward the heart, so moving around during the day can help prevent visible veins. (That rumor that crossing your legs can cause spider veins isn’t true, so go ahead and cross ’em if you like—just make sure that you get out of your chair and move around during the day to get the blood pumping.)
There is some research to suggest that carrying extra weight can impact the function of your veins and, therefore, also increase your risk for visible veins. Having more fat around your stomach (visceral fat) can increase the pressure in your abdomen, Dr. Hollingsworth says, which then creates an obstruction that blocks the flow of blood. “That increased pressure dilates the veins, which extends all the way through the lower vein bridge and all the way up to the veins in your skin,” he explains.
A similar situation happens during pregnancy when the added pressure in the abdomen squeezes the veins. But the hormonal shifts that happen during pregnancy may also play a role. “When women are exposed to excess estrogen or progesterone, what it tends to do is make your soft tissue a little more flexible,” Dr. Hollingsworth says. “That same process, we think, is affecting the veins, making them predisposed to dilate and stretch out.” After pregnancy, the veins generally go away and everything returns to normal. This vein weakening can also happen if you’re taking hormonal birth control.
Although visible veins may seem like a purely superficial issue, they can become painful when left untreated. “Spider and varicose veins make your legs sore because it’s an inflammatory process,” Dr. Hollingsworth says. “Those veins are getting dilated and stretched out. They’re trying to signal for help in the only way they know how, which is sending off a local inflammatory biochemical that causes your legs to swell and to be sore.” So preventing and treating spider veins can save you from a lot of discomfort.
Can you do anything to prevent spider veins?
There are a few different underlying causes of vein issues that are preventable or reversible, while others aren't. For instance, if your visible veins are largely due to inherited factors, pregnancy, or how active you can be during the work day, that’s not likely something you have a ton of control over.
But there are some general things you can do to prevent them, such as maintaining physical activity during the day. If you sit at work all day, the AAD recommends getting up and walking around a bit every 30 minutes. Or, if you stand at work for long periods of time, the AAD recommends taking a break and sitting down every 30 minutes. And exercising in general, elevating your legs when possible, and avoiding soaking for long periods of time in hot baths can help prevent visible veins as well, the AAD says.
However, these strategies can’t treat any visible veins you already have.
You’ll need to see a specialist to actually treat visible veins.
If you’re wondering how to get rid of spider veins for good, know that Dr. Hollingsworth says those wacky home remedies won’t work. Dry brushing? Nope. Fancy body lotions? Nah. Massage? It might feel good, but there won’t be a visible difference.
“There’s nothing really that you can do aside from the small minimally invasive treatments we have that is going to make spider veins look any better,” he says. “Creams, ointments, or rubbing aren’t going to make spider veins go away.”
The primary way that spider and varicose veins are treated is by using different surgical methods to close off the vein so that it collapses and the residual scar tissue stops the blood flow completely. These are all superficial veins, so other healthy veins just take over their circulation duties and the procedure won’t impact your overall health. Also, those with more serious, bulging varicose veins can have them removed completely once the vein is closed off.
Sclerotherapy: This is one of the more popular options for spider veins and varicose veins. A doctor injects a foamy detergent or concentrated saltwater solution into the problematic vein, which irritates the walls of the blood vessel, explains Neil Sadick, M.D., founder of Sadick Dermatology. This causes scar tissue to form, which leads the blood vessel to close. If someone is allergic to the sclerotherapy solution, there are other treatment options.
Laser treatment: A vein surgeon or dermatologist might use a laser treatment to heat the vein, causing it to contract and scar over. Dr Hollingsworth uses a handheld Nd:YAG laser (the same machine that can be used in laser hair removal) on small spider veins. Or, if it’s a larger varicose vein, a laser may be inserted into the vein using a catheter to stop blood flow.
Medical glue: For varicose veins, doctors might also use is the medical version of superglue. “Cyanoacrylate glue is a biologic glue that’s very similar to Krazy Glue,” Dr. Hollingsworth says. Surgeons close off a varicose vein by gluing it shut from the inside. “You inject it, wait for the glue to set, and move further down, and so on and so on.”
Radio frequency ablation (RFA): This is another option for varicose veins that are so large that glue and sclero just float away. “RFA runs radio frequency through the inside of the vein and turns the inside of the vein into a lightbulb filament, heats it up, scars it, and kills it,” says Dr. Hollingsworth.
To prevent visible veins from getting worse, a surgeon might use RFA or internal laser techniques to close off a larger vein deeper in the leg that feeds the smaller varicose veins and spider veins. “There’s a central pipe in the leg called the saphenous vein; it’s the main superficial vein. Coming off those veins are truncal varicose veins,” Dr. Sadick says. Once the larger vein is taken care of, the smaller veins can be treated with sclerotherapy, glue, or a handheld laser.
All of these treatments are performed through tiny punctures in the skin, so you can likely schedule your procedure in the morning and go back to work in the afternoon. However, Dr. Barba warns about getting these treatments on darker skin tones, especially laser and RFA procedures, because those with darker skin tones have a higher risk for hyperpigmentation issues following the treatments. Plus, those pigmentation issues can be stubborn to treat. “Sometimes the pigmentation is a part of the healing process,” Dr. Barba says. “If you care about a little spider vein, you might care about the pigment that’s going to be there for a couple months.”
Whatever treatment you go with, the key is to go to a doctor who specializes in vein treatments, whether that’s a dermatologist or a vein surgeon. “If you want have anything done, go to whoever does a lot of it,” Dr. Hollingsworth says. The good news is that insurance will cover many vein treatments. Without insurance, these treatments can cost $300 to $8,000. “Oftentimes, when it is a deeper vein problem, insurance covers it because it's not [just] a cosmetic issue,” Dr. Barba says.
How can you prevent spider veins from coming back?
Although effective, all of these surgical treatments are really temporary fixes, Dr. Hollingsworth says. Spider and varicose veins can return in other nearby veins once the original veins are closed off or removed. So, if you decide not to treat them at all, they can multiply, Dr. Hollingsworth says. But if you stay on top of them—which will require repeated treatments every one to two years—you can keep them at bay.
After treatment, one thing you can do to effectively prevent spider veins from returning is to wear compression stockings daily, which can be difficult to get on and uncomfortable to wear. "Nobody likes wearing them,” Dr. Hollingsworth says. But, “if you wear stockings religiously during the day, they significantly reduce [the chance that] your spider veins [will come] back.” In some cases, your health insurance may actually cover the cost of medical-grade compression stockings, Medline Plus explains, so check with them before buying any.
Ultimately, if you’re dealing with spider veins or varicose veins, it’s important to check in with a doctor or dermatologist. They can help you understand how serious your particular issue is, talk about what may underlying issues may have caused it, and, if necessary, walk you through your treatment options.
This article was originally published on SELF.
