Spider Veins (also called telangectasias) are small superficial blood vessels. Spider veins get their name because their appearance is similar to that of a spider. They most commonly appear on the thighs, calves, back of the knees, and the ankle area. They are usually red or purple in color and tend to appear in multiples, looking like a pattern. The cause of spider veins is similar to the causes of varicose veins and venous insufficiency - faulty valves. Pressure on the veins can cause the walls of the veins to weaken and create spider veins. There are a number of factors that can contribute to spider veins which include hormones (pregnancy and menopause) weight gain, occupations or activities that require prolonged standing, and heredity. Sclerotherapy for spider veins is not a simple injection. It requires a methodical step by step elimination process in which an understanding of the complexity and anatomy of the venous system is understood. First, there must be a careful assessment. On physical examination, certain types of vein patterns and vein locations may indicate deeper vein problems. A Doppler study may be ordered to rule out a deeper component such as varicose veins. If varicose veins are present, they must be dealt with to ensure a more successful treatment of the spider veins. At the beginning of the treatment session, a "vein light" exam, in which a light source is used to shine through the skin, will be performed because it usually reveals veins that "feed" the spider veins. These are called "reticular veins". These reticular veins must also be eliminated, otherwise the spider veins seen on the surface of the skin will return. Spider vein treatment is a rather simple procedure in which the trained practitioner injects a small amount of solution (called a sclerosing agent) into the diseased vein. The sclerosing agent irritates the lining of the vein and causes the vein to become inflamed. Eventually the inflamed vein dries up, is replaced with fibrous tissue and disappears. Multiple treatment sessions of an area are frequently necessary, and it is usually best treated at a specific area at a time to get the desired results. Compression hose are an important component of the treatment to ensure success. Compression stockings help to keep the veins closed and decrease bruising. They should be worn for the first 24 hours after treatment and then daily for a week. Normal activities can be resumed with the exception of vigorous exercise for the first 24 hours. Patients should avoid the sun for the first week and then use sunscreen (SPF 30) as long as bruising or darkness is visible on the legs. All of the practitioners at Vascular Vein Centers are members of the American College of Phlebology and have received special training in the diagnosis and treatment of varicose and spider veins. While complete elimination of the spider veins is not always possible, it is our goal to provide the education and treatment to our patients and ensure that they have a high level of satisfaction.