Many people have spider veins—they're those bluish, purplish lines that wend their way down the sides of the legs, or around the ankles and down to the heels. Sclerotherapy is a great option for spider vein removal. But it's important to know what the process is actually like.
A few years ago I bought an apartment with an entire wall of mirrors. The mirrors are on sliding glass closet doors, and above them are canned lights that show off every inch of my body. It was in these mirrors that I saw for the first time the pale blue lines that wormed their way down the outsides of both my legs like interstates on a highway map. "I'm turning into my mother," I thought.
Turns out what I had was a case of spider veins, not the varicose veins my mother had running down the inside of her left leg. Still, I worried that the spider veins were a precursor, and so I kept them covered under knee-length skirts in summer. It was just as well that I never was a beach person. No one had to see the veins since I was never in a bathing suit.
And then after a friend convinced me to go to Tulum, Mexico for a week-long beach vacation, my spider veins were outed. So was I. Turns out I'm a closet beach freak. Since bathing suits were now in my future, I became curious as to whether spider veins could actually be removed, and if so, how.
A bit of research led me to The Vein Treatment Center on Manhattan's Upper East Side and to its founder, Dr. Luis Navarro. Dr. Navarro gets rave reviews from the top echelon of New York medicine. Renowned physicians Jahangir Rahman, Patricia Allen, and Lisa Airan all recommended The Vein Treatment Center to longtime Vogue editor Sally Singer, who then wrote an amazing story on the process. She was pleased with the results.
Meet the Expert
Luis Navarro, MD, FACS, FACPh, is a general surgeon and medical expert in the field of phlebology. He has helped to advance minimally invasive procedures for treating varicose veins, including inventing and patenting Endovenous Laser Ablation (EVLT).
If Navarro and The Vein Treatment Center were good enough for Vogue, then they were good enough for me. I booked an appointment for a consultation, wondering if it was really possible to erase 12 inches of blue veins from each leg.
A Meeting with Dr. Luis Navarro
One reason I chose The Vein Treatment Center is that I wanted a specialist who knows veins very, very well. I read plenty of accounts of disappointed patients who had their veins treated at a dermatologist's office and saw no results despite spending hundreds, sometimes thousands of dollars. (Each treatment is about $300–$500 per session, depending on where you go.)
"This is the only thing I do in life so I better do it well," said Dr. Navarro with a good-natured laugh when I met him in his office. In fact, Navarro has been treating veins in the legs, hands, and face for more than 30 years and is the co-creator of the endovenous laser treatment, a method that allows doctors to use lasers to remove bulging varicose veins without cutting into the body. In the past, doctors stripped the offending veins, first putting patients under general anesthesia, then making cuts at the groin and the ankle and pulling out the offending veins. It was a grisly surgery my mother never wanted, so she put up with the pain and discomfort of her varicose veins.
One concern I had with sclerotherapy was the results, which are not at all guaranteed. I asked Navarro what he does that a dermatologist wouldn't do. According to Navarro, dermatologists are not well-trained in treating veins, so they may be unable to find the true cause of the spider veins. "The problem is likely a foot away," he says. A poor sclerotherapy job may cause more veins to appear—and well, I didn't want that.
Spider and varicose veins are largely inherited but can be caused by pregnancy, age, obesity, and prolonged standing. I had one last concern, though: leg crossing. In our meeting, I noticed both of us had our legs crossed and I'd always read that it could cause vein problems. Navarro laughed and shook his head "no" as if he were letting me in on a little secret. It was a major relief.
The Consultation at the Vein Treatment Center
Before you sign up for treatments, you get a free consultation to determine how to proceed. Dr. Navarro's assistant took down my complete medical history and asked me detailed questions about my vein problems. It turns out Mom and I are in good company: approximately 85% of women have chronic venous disease, which includes varicose and spider veins. We would find out during the diagnostic tests, which are part of the consultation, whether my deep veins were in good working order.
For the consultation, I changed into a gown and the assistant did a venous Doppler test on my legs in the front and the back at the two "junctions" where blood flows into the main veins and arteries of the legs. "Defective valves actually sound different," said Navarro. My veins, it turned out, are actually in good working order.
After the Doppler, a few digital photos of my legs were taken. We discussed the best procedure for treating my veins: sclerotherapy, which consists of saline injections (about 25–50 per leg) all along the veins. Then I was told a list of side effects that happen very rarely but legally had to be mentioned (none involving death—phew). I was already sold.
The Sclerotherapy Procedure
The entire procedure lasted about 15 minutes. While I laid on my side and then on my back, Dr. Navarro injected saline all along the offending veins and at their sources.
I took a couple of Tylenol at least an hour before the procedure to help cut down the sting from the needle but I was surprised to find the 50 or so injections were less painful than laser hair removal. Many injections didn't hurt at all, but some really stung. After the injections, I experienced a bit of itchiness, which was the saline working its way through the veins. Fortunately, the itching lasted only a few minutes.
The doctor moved around a lot from side to side and on my stomach so he could work on every blemish. When he finished, a nurse applied ointment to the areas (which looked like mosquito bites), topped each injection site with a cotton ball, then wrapped my legs tightly with an Ace bandage. I left my appointment pleased with the convenience and pain level of the actual procedure. I was instructed to purchase support hose at a local pharmacy, to sleep in them that night and wear them for two full days after the appointment. The support hose not only reduce swelling but keep the solution in the veins. Wearing them to bed the first night was admittedly unpleasant. I had to take a sleeping pill to sleep, and it was still a fitful night.
Dr. Navarro warned me that I would develop what he calls "black and blues"—bruising that could last up to two weeks. And I did. After the injections, my legs looked just as his assistant warned, "like a construction site." I was told I had to endure the messiness knowing that the end results would be beautiful. Having that expectation helped me live through the painful period of the "black and blues." It made me grateful I got the treatment in March when it was too cold out to show off my legs.
While I ended up having a total of five treatments, the number of sessions can vary. Some patients need only a couple of sessions, while others require more than I had. Ultimately, it's dependent on how well your veins take to the treatment and how much you are willing to pay. How frequently you get the treatments depends on your personal preference.
People from all over the world flock to Dr. Navarro's office to get their legs done in a matter of a week or even a few days. "People come to New York to shop and at the same time get their veins done," he says. Sometimes he does three to four treatments in one day. An expert, Dr. Navarro can easily see how treatments are working. "You leave with black and blues, but no live veins."
Each follow-up treatment was the same: Dr. Navarro studied my legs, complimented how well they were healing, and got to work injecting any veins that were still clinging to life. I was covered in ointment and cotton balls, wrapped in the bandages and sent home to the support hose. As the days progressed, I saw amazing results. The blue veins on my left leg disappeared almost immediately. The veins on my right leg took a few treatments but also disappeared. On the final visit, Navarro popped the spots on my legs that were caused by trapped blood. This was actually a little painful because he poked the dots with a sterile needle and then squeezed out the blood.
Two weeks after my last treatment, the black and blues and the blue veins were totally dispersed. However, there's a good chance I'll be visiting Dr. Navarro again, most likely every few years for maintenance since veins naturally develop on my legs. During my last visit, I turned my attention to the ropey blue veins on my hands and wondered if maybe, just maybe, I should have them erased, too. After all, Dr. Navarro said he saw beautiful results on hands. Nah. There is such a thing as too much of a good thing.
Editor's note: The treatments at The Vein Treatment Center were given complimentary to the writer.
American Academy of Dermatology Association. Leg Veins: Why They Appear and How Dermatologists Treat Them.
Malskat WS, Poluektova AA, van der Geld CW, et al. Endovenous laser ablation (EVLA): a review of mechanisms, modeling outcomes, and issues for debate. Lasers Med Sci. 2014;29(2):393-403. doi:10.1007/s10103-013-1480-5
Office on Women's Health. Varicose Veins and Spider Veins. Updated March 1, 2019.
Piazza G. Varicose veins. Circulation. 2014;130(7):582-587. doi:10.1161/CIRCULATIONAHA.113.008331