Spider Veins

Las Vegas Vein Center is a comprehensive vein clinic for spider vein treatment.

Spider veins are thin, red vessels that commonly appear on the cheeks, chin and nose are not truly veins, but rather dilated capillaries. Spider veins (red vessels on the surface of the skin) are called telangiectasias and can be treated by the staff of Las Vegas Vein Center with sclerotherapy, and laser treatments called IPL (Intense Pulsed Light) therapy and Laser .

Remove Las Vegas Spider VeinsSpider veins, also known medically as telangiectasia or venulectasias, are the mildest manifestation of venous insufficiency, similar to varicose veins but smaller. They are small, often tangled groups of tiny blood vessels just under the skin surface that frequently resemble spider webs or tree branches. They are generally red, blue or purple and are clearly visible, usually on the thighs, lower legs and face. Spider veins can sometimes cover large areas of skin, but they are a cosmetic problem only, rarely causing physical symptoms. At least a third of all women and a smaller percentage of men are believed to display the condition.


Spider veins are capillaries, thin vessels directly connected with the larger venous system, and like varicose veins they are caused by venous reflux. Spider veins may be isolated or associated with “feeder” veins or with larger underlying varicose veins, but they are not varicose veins – they do not bulge above the skin surface and do not require medical treatment.

Spider veins can be diagnosed merely by sight. They tend to take on one of three characteristic patterns – a “sunburst” or spider-web pattern radiating outward from a central point, a “tree-branch” pattern, or a “matting” or linear pattern that may be nothing more than a set of thin lines. Even in the absence of physical discomfort, some physicians observing spider veins prefer to conduct ultrasound exams to determine the extent of the problem and the underlying causes of the condition.

Although spider veins generally don’t have symptoms, the veins deeper in the skin that feed them may cause discomfort. Women are more likely than men to develop spider veins.

Exactly what happens in the body that leads to spider veins isn’t certain, but there are several theories on what leads to the abnormal blood flow that causes them. One theory is that spider veins, which occur near the surface of the skin, are fed by underlying varicose veins that are either too small or too deeply embedded to reach the skin’s surface. These underlying veins disrupt circulation, causing spider veins to appear above them. Another theory is that spider veins are actually little arteries that join the network of veins closest to the surface of the skin. Because arteries are under high pressure and surface veins aren’t, the combination of arterial blood and venous blood would cause spider veins to become visible.

What you should know about spider veins

Risk factors for spider veins are similar to those for varicose veins

The exact cause of spider veins is unknown, although heredity, pregnancy, trauma, aging, sun damage and hormonal influences are believed to be primary factors contributing to the condition.  Extended periods of standing – as well as sun exposure, particularly in fair-skinned people More than 40 percent of women have some form of varicose vein condition including spider veins, with an increasing incidence of venous disease as one gets older, so that up to 80 percent of women have some form of venous disease by age 80. Slightly more women than men have varicose and spider veins.

Some physicians believe that exercise, weight loss and the wearing of support hose and flat shoes instead of high heels can reduce the incidence of spider veins.

Spider vein treatments are non-invasive or minimally invasive and include sclerotherapy and laser procedures. They are considered cosmetic procedures and are not covered by health insurance or Medicare unless a more serious underlying condition is diagnosed.

Causes & Risk Factors

Las Vegas Spider Veins DiagramSpider veins are the mildest manifestation of venous reflux disease. They are small, often tangled groups of blood vessels just under the skin surface that frequently resemble spider webs or tree branches. They are generally purple, blue or red in color and are clearly visible, usually on the legs and face. Spider veins are not varicose veins – they do not bulge above the skin surface like varicose veins and do not require medical treatment except for cosmetic purposes.

Many of the risk factors for spider veins are similar to those for varicose veins – heredity, advancing age, pregnancy, obesity, hormonal changes and occupations requiring extended periods of standing. They can also be triggered by exposure to the ultraviolet rays of the sun, particularly in fair-skinned people, and by certain medications. Spider veins may also develop at the site of an injury to the skin surface, sometimes years after the injury. As with varicose veins, spider veins appear more often in women than in men.



Spider veins usually take on one of three basic patterns:

A. Thin separate lines

B. Tiny branchlike shapes

C. A true spiderlike shape radiating outward from a dark center

Linear spider veins are commonly seen on the inner knee, whereas the arborizing (branch- or spiderlike) patterns often appear on the outer thigh in the form of a sunburst or cartwheel.



Doctors often diagnose spider veins based on a physical exam alone. Sometimes tests or procedures are used to find out the extent of the problem or to rule out other condition

Symptoms associated with spider veins include:

There typically aren’t significant symptoms of spider veins. They may cause minor aching or discomfort, and some people have complained of a heavy feeling in their legs or legs that tire easily.

All these symptoms generally worsen later in the day. Relief comes from walking or elevating the legs. Still, many patients say they have no symptoms at all.

  • Throbbing pain
  • Dull, generalized aching (especially after standing for a long time)
  • Night cramps
  • Tiredness
  • Burning
  • Tingling
  • Heaviness in the legs
Before and After Examples

Typical results after 4 treatments

Typical results after 3 treatments

Typical results after 3 treatments

Do's and Don'ts Spider Veins
  • Listen to your body. Both spider and varicose veins tend to be a cosmetic concern; however, they can lead to serious health complications such as fatigue, night cramps, leg swelling or itching around certain veins. If you are experiencing any of these symptoms, an ABVLM physician should be contacted for further assistance. 
  • Keep active. Activities such as walking, cycling and swimming all help to keep up blood circulation in the legs and will reduce pressure and blood pooling. 
  • Maintain a healthy weight. Reducing body weight will eliminate excess pressure on the legs that causes veins to surface.
  • Wear compression stockings. Properly fitted graduated support hose ensures that pressure is properly distributed on legs so that blood is directed toward the heart. Be careful, however, not to restrict blood circulation.
  • Sit or stand for long periods of time. Being in one position for an extended period of time can place pressure on veins. Change positions every 30 minutes to increase blood flow. Flex calf muscles frequently to keep up circulation while sitting at a desk or during long car or plane trips.
  • Assume all treatments will work. Speak to an ABVLM physician about a variety of treatment options available, such as lasers or injections. Depending on the severity of vein damage, experts can determine the best treatment option for you.
  • Subject legs to excessive heat. The heat associated with long hot baths and hot tubs will actually increase vein swelling and lead to blood pooling.
  • Fall for bogus advertisements. While tempting, such treatments may not be legitimate. It’s best to consult with an ABVLM physician to explore treatment options.
  • Wear overly restrictive clothing. Clothing around specific body parts – including waist, legs and the groin area – can restrict circulation and lead to spider and varicose veins.

Test & Diagnosis

Spider veins are diagnosed visually. The small red and blue vein tangles located just under the skin do not cause physical symptoms, but some physicians observing spider veins prefer to conduct ultrasound exams to determine the extent of the problem and the underlying causes of the condition.

Treatment Options for Spider Veins

Non and minimally invasive treatments for spider veins are frequently and readily available in a doctor’s office. Both kinds of procedures are considered safe and allow the patient to return to normal activity immediately following vein treatment.

Dr.  Ralph Carullo is a ABVLM certified vein specialist with years of experience performing sclerotherapy and provides treatments that are safe and effective. Previous sclerotherapy procedures using hypertonic saline were painful and often left permanent brown spotting behind from the vein destruction. Dr. Carullo’s advanced procedures does not have these side effects.

Dr. Carullo personally performs sclerotherapy. He has never delegated this responsibility to any assistant and this fact is important to the integrity of his practice and to his patients’ consistent care and his high patient return rate. 

Sclerotherapy is performed by injecting an irritant solution, either concentrated saline or a specialized detergent solution, directly into the spider veins themselves. The irritant damages the spider vein walls of the spider veins, causing them to swell, adhere and seal shut. The vein then slowly turns into scar tissue and gradually disappears over a period of weeks. Sclerotherapy (“sclero”), which was first developed in the 1930s, sclerotherapy is generally performed in the doctor’s office in less than 30 minutes and is considered highly effective when properly done, although the same vein may require multiple injections and repeat treatments over time. The treatment can be painful, with a burning or stinging sensation common, but the discomfort usually passes in a few minutes. Side affects are generally mild and temporary, and can include skin sores, superficial phlebitis, bruises and discoloration around the treatment site.

  • Laser and Intense Pulsed Light

Laser and Intense Pulsed Light devices treat spider veins non-invasively by delivering heat through the surface of the skin to the vein, sealing the vein walls. Laser energy can be directed with a high degree of accuracy to minimize the damage to the tissues adjoining the treated vein. The patient will frequently feel a painful burning sensation during the vein treatment and depending on the severity of the vein condition, two to five treatments lasting 15 to 20 minutes a piece may be required to eliminate spider veins in the legs. Facial vein procedures require less time for treatment. Side effects of laser can include postoperative redness or swelling and discoloration of the skin, which will disappear within days or weeks. Side effects of laser can include postoperative redness or swelling, superficial phlebitis, and discoloration of the skin, which will disappear within days or weeks.

Spider veins treatment questions to ask a ABVLM Physician

  1. Which spider veins procedure is the correct one for me? (What are the options?)
  2. What is the estimated cost of the procedure?
  3. How long is one appointment?
  4. How often will I need to receive treatment to treat my spider veins?
  5. How far apart are the treatments?
  6. What are the common side effects or complications associated with the procedure?
  7. How can I prepare for the treatment/procedure?
  8. Does the treatment hurt?
  9. What are my pain management and anesthesia options?
  10. Do you have before-and-after patient images to help prepare me for what to expect?
  11. Will someone walk me through the process before going in for treatment?
  12. What are the risks?
  13. What should I expect after the procedure is performed? (i.e. short-term and long-term effects; activity restrictions; expected recovery period)

General questions to ask before spider veins procedures

  1. Is a doctor on site?
  2. Is the doctor board-certified in Venous and Lymphatic Medicine?
  3. Was my medical history taken?
  4. Was I given an initial evaluation to determine if the technique or procedure is appropriate for my skin type?
  5. Did the doctor show me before-and-after photos?

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