Why Do Spider Veins Need Multiple Treatments?

Many patients ask why they need several treatments for spider veins (technically known as telangiectasia). Cosmetic sclerotherapy, a minimally-invasive procedure designed to improve the appearance of spider veins, generally requires multiple treatments. Why can’t treatment be complete in only one session?

To help you understand spider vein treatment, let’s first talk about what spider veins truly are.

What Are Spider Veins?

Spider veins are characterized by a web of dilated veins most often found in the legs, though they can appear anywhere on the body. They resemble a spider web or thin tree branches that are either red, purple, or blue.

Spider veins are commonly found with varicose veins, which are blood vessels that have filled with pooled blood, but can be isolated as well. Although similar in appearance, spider veins and varicose veins are not the same. Spider veins are smaller (less than 1 mm) and are generally asymptomatic and only a nuisance aesthetically, although they can occasionally cause itching, burning, or stinging. However, unlike varicose veins, treatment for spider veins is typically considered cosmetic and is not usually covered by insurance.

What Causes Spider Veins?

Spider veins are thought to be hereditary and occur more often in women than in men. They are frequently caused by various life conditions such as puberty/growth spurts, pregnancy, occupations that require frequent standing, a history of blood clots, menopause, and weight gain. Spider veins occur most often around ages 30-50 but increase with age.

Cosmetic sclerotherapy has proven to be the most effective solution to treat spider veins, known as the medical gold standard, even earning an 88% Worth It rating within the last 24 months.

Cosmetic Sclerotherapy: Treatment for Spider Veins

During cosmetic sclerotherapy, a specialized solution called a sclerosing solution is injected directly into the problematic spider vein via a very tiny needle. The solution irritates the vein lining, causing fibrosis, and thereby closing the vein. The vein typically disappears in 2-6 weeks.

The number of treatments necessary to clear spider veins depends on each individual. In most cases, patients need 2-5 treatments to completely eliminate the appearance of spider veins. If the spider veins are bigger and more prevalent, additional treatments may be necessary. If new spider veins appear, patients will have to revisit their vein doctor. Always discuss with your vein specialist before beginning the procedure.

Spider veins require a slightly different treatment than varicose veins. Vein doctors generally treat underlying venous reflux and perforator venous reflux that contributes to the cause of the spider veins prior to actually performing cosmetic sclerotherapy. This will help prevent spider veins from coming back after treatment and potentially lessen the number of treatment sessions.

Ask Your Doctor

If you’re still not sure if cosmetic sclerotherapy will benefit you and how many treatments you’ll need, set up a consultation with your vein doctor. A professional vein specialist will be able to tell you if cosmetic sclerotherapy is a good option for you.

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Does Minimally Invasive Treatment for Varicose Veins Really Work?

Vein Stripping vs. Ablation Treatment for Varicose Veins

treatment for varicose veins

Do you think you might be suffering from varicose veins? You’ll know by taking a look at the various symptoms of this disease. The most obvious signs of varicose veins are:

  • Visibly bulging veins anywhere on the legs
  • Veins have a dark blue, purplish color
  • Dull, aching, and/or throbbing leg pain that gets worse as the day goes on
  • Your legs are heavier and more tired after extended periods of standing
  • Nighttime cramping or charlie horses
  • Restlessness at night, just can’t get your legs in a comfortable position
  • Swelling around the ankles (“cankles”)
  • Skin discoloration around the shins with open ulcers

Fortunately, patients with chronic vein insufficiency (CVI) do have hope – there are multiple treatment options available for varicose veins. How do you know which procedure is right for you? We will discuss the older method of vein stripping and compare it to modern, minimally invasive methods of varicose vein treatment.

Vein Stripping

Surgical vein stripping is generally performed in a hospital under anesthesia. During the procedure, the patient undergoes numerous incisions to pull the diseased vein out. The surgery usually leaves visible scars along the leg. Given how invasive the procedure is, patients oftentimes reported significant post-procedural pain and discomfort.

The recovery for this older procedure was difficult. Most patients were out of work for potentially long periods of time, accompanied with many restrictions. The stripping method also had a high recurrence rate where the veins grew back, often more severe, years after the procedure.  


  • Performed in an OR requiring anesthesia
  • Multiple large incisions requiring stitches
  • Sometimes required inpatient hospital stay
  • Higher risk of infection and bleeding
  • Visible scars
  • Significant recovery time/requires time off of work  
  • Post-operative bruising and pain
  • High recurrence rate
  • Veins can grow back

Thermal Ablation: RFA (radiofrequency) and EVLT (laser)

Thermal ablation relies on heat energy that is carefully delivered into the diseased vein to form scar tissue, which sufficiently closes off the bad vein. This method is done in a comfortable office setting with only local anesthesia or mild sedative for the affected leg. Patients are awake and they can listen to music or watch TV. Most are able to walk around immediately after the procedure.

There are no major incisions, only a tiny nick in the skin where the catheter is inserted into the vein, which is then covered with a small bandage. The nick is so small that it does not require stitches and heals very quickly. There is generally no scarring. Most patients experience an easy recovery, returning to their jobs, social events, and normal daily activities immediately following the procedure, with only minimal restrictions. Thermal ablation has lower recurrence rate due to the minimally invasive nature of the procedures.


  • Outpatient procedure – patients return home immediately following the procedure
  • No anesthesia
  • No major incisions, just a tiny nick to the skin, so small that it does not require a stitch
  • No blood loss
  • Minimal if any scarring
  • Immediately return to most regular activities
  • Easy recovery
  • Low recurrence rate

Radiofrequency Ablation (RFA) and Endovenous Laser Ablation Therapy (EVLT)

At the initial consultation, all the incompetent varicose veins are mapped out via ultrasound and the procedure details are discussed. On the procedure day, the interventional radiologist numbs the skin and then makes a small nick. A small catheter is inserted using direct ultrasound guidance. After numbing the entire length of the vein, the doctor delivers the RFA or EVLT energy to directly heat the diseased vein. Following the treatment, patients must wear a compression stocking for up to two weeks but can otherwise return to most routine activities right away. In fact, they are encouraged to exercise right away. During follow-up visits, the interventional radiologist uses a duplex ultrasound to ensure the vein is closed.

Still Not Sure If You Need Vein Treatment?

If you’re not sure if you have varicose veins or if you would be a good candidate for treatment, sign up for a free vein screening! You’ll learn more about the symptoms and causes of varicose veins, what treatment is like, and how best to find relief. We’ll perform a limited ultrasound on your legs and educate you if treatment can help. Contact us if you have any questions.

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Why Do My Legs Hurt?

Treating Vein Insufficiency and Leg Pain with VenaSeal™ Closure System

Do you often experience unrelenting pain in your legs? Perhaps an achy feeling or restlessness that won’t go away? You probably assume, “I’ve had a long day. I just need a moment to sit down and put my feet up, and then I will feel better.” You probably don’t think anything is out of the ordinary, but these are all common symptoms of venous insufficiency, or varicose veins.

Unfortunately, up to 40% of people in the US suffer from varicose veins, but many don’t even know it! Varicose veins are often ignored or misunderstood, even by healthcare providers. Fortunately, if you suspect that you are indeed suffering from varicose veins, you have many treatment options available today. If you’re not sure if you have varicose veins or not, sign up for a free vein screen screening and find out for sure. The most revolutionary of all varicose vein treatment options is the VenaSeal™ Closure System.

What is VenaSeal?

VenaSeal is an FDA-approved, medical-grade adhesive used to close veins to stop chronic venous insufficiency (CVI) and to cure varicose veins. Unlike industrial super glue, which is tacky, hard, and seemingly impossible to wash away, VenaSeal is soft, flexible, and gentle, and completely harmless to the body. Medical glue has been used in the healthcare industry for decades, so it should be no surprise that physicians have now begun to use it in the VenaSeal Closure System.

What is the VenaSeal Closure System?

The VenaSeal Closure System uses this non-toxic medical glue to seal diseased veins, preventing backward blood flow and stopping varicose veins. Clinical studies have proven this treatment option to be perfectly safe, with high success rates.

  • No swelling
  • No heat
  • No stripping
  • No sclerosant agents
  • Minimal needle injections
  • No anesthesia
  • No hospital stay – procedure is done in comfortable office setting

What to Expect During the Procedure

First, an ultrasound confirms the location of the varicose veins. Your vein doctor will numb the target area, so you may feel an initial tiny needle prick. Patients usually find themselves to be comfortable throughout the procedure.

Next, VenaSeal is inserted intravenously into the vein via a long hollow tube, or catheter. An ultrasound guides the placement of the tube at the diseased vein. VenaSeal is intermittently placed at varying locations along the vein. Your vein doctor will apply gentle pressure to the skin to press the seal closed and allow the medical glue to dry, which is fairly instantaneous. Once the medical adhesive comes into contact with blood, it polymerizes and is eventually absorbed by natural body processes.

What Happens After a VenaSeal Closure Procedure?  

Once the physician extracts the catheter, a small bandage is placed on the entry site. Bruising is uncommon. For most patients, there is no downtime once the procedure is complete. Your vein doctor can help you decide if you need a rest period. Patients usually return immediately to home, work, or the gym. The diseased vein shows visible improvement very quickly.

Many patients prefer the VenaSeal closure system over traditional treatment options for varicose veins, such as stripping and radiofrequency vein closure. Patients finally have a treatment option that eliminates the need for anesthesia (other than numbing at the target area), includes no risk of damaging nearby nerves, requires only minimal needle injections, and does not require the use of post-procedural compression stockings.

If you aren’t sure you have varicose veins, schedule a vein screening completely free of charge at our next available time slot!

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Dr. Pyne Addresses Varicose Veins at Society of Interventional Radiology (SIR)

Raj Pyne, MDDr. Raj Pyne recently had the honor of being invited to host a webinar for the Society of Interventional Radiology (SIR) to share his experience in developing a vein practice that concentrates solely on the proper treatment of varicose veins.

The Society of Interventional Radiology is a professional organization of over 5,400 physicians, scientists, and allied health professionals that share a common goal of improving public health through minimally invasive, image-guided procedures, such as varicose vein treatment.

Dr. Pyne shared his expertise in vein anatomy, disease, and treatment with dozens of viewers across the country. To view the webinar, click here.

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Latest “Super Glue” Vein Treatment Performed at The Vein Institute

Do you remember the 1980s ads featuring the construction worker whose helmet was Krazy Glued to a steel beam? Or, maybe you’ve seen the more recent ad where a man goes bungee jumping using a harness secured with Krazy Glue? Either way, the product is aptly named – those ideas seem crazy! Catchy marketing aside, super glues such as Krazy Glue in general have proven useful in countless household applications. We’re betting that there’s probably a bottle or tube of it in your house somewhere.

TVI-Glue-500xBut, we’re also betting that using super glue to fix varicose veins is probably something you’ve never considered. You may have just made a face at that idea, and rightfully so! The super glues we know are industrial, stiff, stinky, and don’t wash off your hands for days. How can it be used in the human body? Continue reading

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RVT Added to Sonographer Credentials

MichelleThe Vein Institute is proud to announce that sonographer Michelle Hook, RDMS, has added the Registered Vascular Technologist (RVT) credential to her name.

Highly respected and recognized worldwide, the RVT distinction is earned by passing the American Registry for Diagnostic Medical Sonography’s board examination in Vascular Technology.

The board evaluates sonographers in several areas of vascular imaging, including the peripheral venous system, to the highest of standards.

Congratulations, Michelle!

Meet more of our team >

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What Sets Interventional Radiologists Apart?

Best TVI GroupDid you know that there are over 45 medical specialties in North America that are recognized by the American Medical Association? You can probably name several – family medicine, pediatrician, cardiologist, gynecologist, dermatologist, and general surgeon are a few that readily come to mind. One you may not have named is the Interventional Radiologist.

You may have heard of radiologists as the doctors who read X-rays. They also commonly read CT (also known as cat scans), MRI, mammograms, and ultrasounds. They make a diagnosis based on their interpretation of images. A subset of radiology involves doing procedures using imaging guidance. The doctors who perform those procedures are Interventional Radiologists. Continue reading

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The Vein Institute’s Clinical Supervisor Earns RPhS Credential

kelleyCongratulations to Kelley Swagler, Clinical Supervisor, who added another credential to her name on Saturday, September 26th, 2015. Kelley passed the registry examination to become a Registered Phlebology Sonographer (RPhS). To qualify for the exam, applicants must have experience in performing diagnostic ultrasounds for venous disease and must have completed 36 Continuing Medical Education credits within the past four years. The RPhS exam measures competency in venous disease process and progression, ultrasound physics, regulatory and compliance standards, venous treatment procedures, and compression therapy, among several other areas of proficiency. Congratulations, Kelley!

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The Vein Institute First in Region to Earn Distinguished Vein Practice Accreditation

iac-sealThe Vein Institute has been awarded the distinction of accreditation in Superficial Venous Treatment and Management by the Intersocietal Accreditation Commission (IAC). This prestigious honor is highly respected in the medical community and is granted only after a strict, peer review process analyzing all daily operations of the medical practice, including personnel, quality of care, safety, equipment, and patient outcomes. All accredited facilities must demonstrate the highest level of patient care.

The Vein Institute is the fifth vein practice to be recognized in the entire state of New York, and the only one in New York accredited outside of the New York City/Long Island area. The accreditation symbolizes Continue reading

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The Vein Institute Earns ACR Accreditation

ACR-Gold-SealWe are proud to announce that The Vein Institute has been accredited by the American College of Radiology (ACR) in Peripheral Vascular Ultrasound. Peripheral vascular ultrasound focuses on the blood vessels in the arms and, most importantly to The Vein Institute, the legs. The core purpose of the ACR is “to serve patients and society by empowering members to advance the practice, science and professions of radiological care”.  Accredited facilities must meet rigorous standards and have proven their proficiency in the areas of image acquisition, physician reporting, and quality control. The accreditation process is just one way The Vein Institute’s ultrasound team, led by Kelley Swagler, RT, RDMS, shows their commitment to remaining leaders in their field.

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