Spider Veins


Spider veins, or broken capillaries, are medically referred to as telangiectasias. They are dilated capillary veins less than 2mm in diameter that exist just below the surface of the skin on the legs or face. Spider veins are blue, red, or purplish in color with a web-like or linear appearance. Spider and varicose veins coincide 60-80% of the time.


Frequently Asked Questions About Spider Veins:

What Are Spider Veins?

Typically, spider veins are very small veins — less than 1 mm in diameter. Spider veins usually spread out from a feeder vein like the legs of a spider, hence the name. Although spider veins can cause symptoms — usually itching and/or burning — they are most often a cosmetic issue. Spider veins can, however, represent the “tip of the iceberg,” indicating a more serious, underlying, vein-related problem. Dr. Nellestein will help you determine which type you have.


How Does Treatment for Spider Veins Work?

The most common treatment for spider veins is with the injection of a sclerosing solution into the inside of the facial or leg veins. This causes the vein walls to seal together. Treatment for spider veins is done in the vein clinic, takes about 30 minutes per session, and is extremely well tolerated. If the facial or leg veins are even too small for injections, then laser vein treatment can be very effective.


Does Insurance Cover Treatment for Spider Veins?

Insurance does not usually cover treatment for spider veins. Insurance companies break the treatment down into “medically necessary” and “cosmetic” categories. However, a patient may have both medically necessary and cosmetic problems. Nellestein Vein Institute will perform ultrasounds as needed in order to diagnose the underlying vein issues. Then you will know exactly what your situation is, and how it is paid for.


Will the Facial and Leg Veins Look Perfect Right Away?

No. The facial and leg veins are pretty angry after being injected with the sclerosing solution. Patients typically have some mild discomfort and the treated area is red and may itch too. Over time there is brownish discoloration and then things slowly resolve over 3-6 months. Very rarely there is a brownish line or discoloration that is permanent. “Matting” may occur too. This is a response of the spider veins to the medication and is the growth of new tiny blood vessels around the injected vein. Matting is uncommon and usually resolves in 3-12 months.


How Many Treatment Sessions Will I Need?

Commonly, 2-3 sessions spaced 4-6 weeks apart. After your first session, we wait 4-6 weeks to see how much resolution has occurred. Sometimes this is all it takes, but more commonly there are some residual spider veins that warrant treatment.


Can I Get Treatment for Spider Veins on My First Visit?

While treatment for spider veins is most often possible on the first visit, there is a potential exception. If Dr. Nellestein evaluates you and finds there is concern for a deeper vein issue, in addition to the spider veins, then an ultrasound will be needed. This may or may not be able to be performed on the day of your visit. The problem is, if there is a deeper vein issue, it should be treated first — prior to the spider veins — or else the spider veins will not be effectively treated. This would then be a waste of your money. Additionally, if the diseased deeper vein is treated first, then perhaps the spider veins would diminish or go away on their own. The deeper vein issues are usually covered by insurance too.


Will My Spider Veins “Come Back”?

No. Once the spider veins are treated they are gone. But, don’t forget that you have miles of veins in your body, and it is not unheard of that another one may crop up and require treatment. More spider veins would almost certainly occur if there are underlying larger veins that are diseased. Dr. Nellestein will examine you thoroughly to ensure this does not occur.


Why Do I Need Compression Stockings, and for How Long?

Admittedly, the stockings are a nuisance and hard to put on. But, they really are important for spider vein issues and treatments. The compression helps keep the treated vein walls collapsed, thus optimizing the effect of the sclerosing agent. You should wear them for about a week. 


How Long Is a Treatment Session?

We offer 30- and 60-minute sessions. Most commonly, the 30-minute session works great and is very well tolerated.


Nellestein Vein Institute
1341 Village Drive
Saint Joseph, MO 64506
Phone: 816-323-4451
Fax: 816-897-3969

Office Hours

Get in touch