As they get older, many people will notice the appearance of veins on their legs. Spider veins appear as fine purple or blue veins that have a branched or spiderweb pattern. Larger, raised veins that are darker in color are know as varicose veins. While more commonly seen in women, men suffer from spider or varicose veins too.

In some cases, leg veins are merely a cosmetic nuisance, detracting from an even skin tone and making the individual look older. But in other cases, leg veins can cause physical discomfort and will require medical treatment. When seeking treatment, it is important to work with a dermatologist who is highly experienced in treating leg veins. Utilizing his vast experience and expertise, Dr. Frank has been helping people in New York find relief from leg veins with the latest techniques and therapies available.

Types of Leg Veins

Before treating your leg veins, Dr. Frank will first determine the type of veins that you have on your legs – spider or varicose. The type and severity of the veins will determine the best treatment option for you.

Spider Veins

Also referred to as telangiectasias or angioectasias within the medical community, spider veins are typically the less severe type of leg vein. They rarely cause physical discomfort, but can be very unsightly. Spider veins are smaller and appear in a branched or twisted pattern, hence their name. They are easily visible through the skin’s surface and can be red, purple or blue in color. In addition to appearing on the legs, spider veins can be seen on the face, particularly around the nose, cheeks and mouth. On the legs, they are most commonly found on the upper thighs, under the knees, and around the ankles.

Varicose Veins

When veins become enlarged, raised, and twisted, they are referred to as varicose veins. They most frequently develop on the legs, but can be found on other parts of the body as well. Varicose veins form when there is a weakness in the vein valve, allowing blood to flow backwards and pool in the veins. Varicose veins can cause persistent soreness and become very painful, particularly when standing for prolonged periods. People often seek treatment to relieve the physical symptoms of varicose veins, as well as improve the appearance of their legs.

Treating Leg Veins

Show off your legs, not your veins! Here my nurses and I are treating varicose and spider veins on a male patient with Sclerotherapy, a quick minimally invasive procedure to help treat leg veins.

It’s important to work with a dermatologist and team who are highly experienced in treating leg veins when seeking treatment.

Causes of Leg Veins

A number of factors are associated with the development of spider and varicose veins on the legs. Risk factors include:

Gender – in comparison to men, women are four times more likely to develop leg veins

Age – leg veins tend to develop past the age of 30


Pregnancy – it is very common for veins to form on the legs during pregnancy. This is due to the extra blood that circulates in the body during pregnancy, increased weight, and pressure on the veins of the lower extremities. Leg veins occasionally resolve without treatment after pregnancy

Hormonal influences such as puberty, menopause, and the use of birth control or hormone replacement pills


Medical conditions such as blood clots, tumors and constipation


In some cases, the only symptom associated with leg veins is the appearance of these unsightly veins, especially when it comes to spider veins. Many people who suffer from varicose veins, however, will feel an aching or cramping in their legs. They may also complain of tingling, throbbing, burning or heaviness in their legs. In more severe cases, the legs may swell, ulcers may form, and the skin may darken. Symptoms may be exacerbated when standing, during pregnancy or at certain times of the menstrual cycle. Patients often find temporary relief by elevating their legs or wearing compression or support garments.


In order to diagnose leg veins, Dr. Frank meets with patients for an initial consultation at his fully accredited New York City office. He examines the veins and reviews the patient’s medical history to determine the type and severity of leg veins that are present. Allergies may be discussed, along with current medications and supplements, lifestyle factors, past treatments, and any pre-existing medical conditions. Once he has diagnosed spider veins or varicose veins, he will suggest appropriate treatment options. These options will be discussed in depth with the patient so that they can voice their thoughts on their ideal treatment option. Patients are encouraged to ask any questions that they may have at this time.

Treatment Options

Dr. Frank has been treating leg veins in NYC for nearly two decades. He is proud to offer sclerotherapy with Asclera, laser therapy with the Vbeam laser or the Excel V+ laser, and ambulatory phlebectomy to treat leg veins.


Sclerotherapy is one of the oldest and most reliable forms of leg vein therapy. During the treatment, Dr. Frank injects the Asclera solution into the targeted veins, causing them to shrink and eventually be unnoticeable. It is commonly used for spider veins and varicose veins up to 1cm in diameter and provides relief for the physical symptoms associated with these types of veins. Sclerotherapy is not suitable for all types of leg veins. For example, sclerotherapy may not be able to reduce very deep veins or extensive networks of veins. In these instances, Dr. Frank may suggest an alternate therapy.

V-Beam Laser Therapy

Laser therapy is less commonly used to treat leg veins, however it can be used when treating smaller spider veins that cannot be reduced with sclerotherapy. For such cases, Dr. Frank uses the V-Beam laser, which is particularly effective for use on red veins as the wavelength emitted by the V-Beam targets this color. During the treatment, Dr. Frank moves the laser across the targeted area. The laser’s energy heats the red veins beneath the surface, causing them to break into many tiny fragments and be absorbed by the body. The results of the treatment can be seen immediately and no downtime is required afterwards.

Excel V+ Laser Therapy

Excel V+ laser therapy is another excellent alternative to Asclera sclerotherapy treatment. Like the Vbeam laser, this treatment option uses non-ablative laser energy to safely destroy targeted veins.

The Excel V+ combines 1064 nm Nd:Yag laser energy and 532 nm KTP laser energy for a powerful and effective solution. This increases treatment speed while reducing the number of necessary treatment sessions.

The Excel V+ laser is incredibly precise and can treat unwanted veins on the legs very effectively. Usually, the Excel V+ laser treatment process only lasts around 15 minutes. After the treatment, patients can return to their schedule without any need for recovery time.

Ambulatory Phlebectomy

Large, protruding varicose veins can be reduced through ambulatory phlebectomy, a minimally invasive procedure. Dr. Frank performs ambulatory phlebectomy at his state-of-the-art NYC facility using only local anesthesia. During the procedure, he makes tiny incisions near the vein and surgically ties off the offending vein. That section of the vein is then removed and he moves onto the next section, if necessary. Ambulatory phlebectomy reduces unsightly leg veins, but also stops surrounding vessels from worsening. The treatment requires only minimal downtime afterwards.

What Causes Spider Veins?

Spider veins, medically known as telangiectasias, are small dilated blood vessels located near the surface of the skin. These characteristically small, purple and/or red filaments can develop anywhere on the body, but are most commonly seen on the face and on the legs, particularly on the upper thigh, below the knee joint, and around the ankles.

There is no single cause of spider veins, but certain risk factors can predispose an individual to the development of them. In the legs, the presence of underlying varicose veins–large bulging, knotted veins that arise due to poor circulation and pooled blood in the vein–may contribute to the appearance of spider veins. However, spider veins are not always associated with visible varicose veins and may exist independently of swollen blood vessels. Some factors that may increase the occurrence of spider veins include:

Genetics: If you have a family history of spider veins, you are more likely to develop them.

Age: Spider veins are frequently an age-related issue, commonly appearing in individuals over 50. However, individuals may see them as early as their twenties.

Hormonal fluctuations: In general, women tend to have spider veins more often than men. Often seen as the result of pregnancy, hormone fluctuations are considered to be linked to the emergence of spider veins.

Lifestyle: Occupation, consistently long periods of standing, physical inactivity, and sun damage may cause spider veins to take shape.

Dr. Paul Jarrod Frank Discusses Treatments for Spider Veins

Spider Vein Treatment with Dr. Frank

Although there is no sure-fire way to prevent new spider veins from appearing, there are treatments available to minimize and reduce existing spider veins. In his practice, Dr. Frank uses the most advanced sclerotherapy and laser techniques to treat spider veins.

Sclerotherapy: Sclerotherapy is the “gold standard” and is preferred over laser for reducing telangiectasia and smaller varicose leg veins. During sclerotherapy, Dr. Frank will inject the vein with a saline solution, which causes the veins to collapse. The injections are relatively painless, with most patients reporting a mild stinging sensation*. Most patients are responsive to sclerotherapy.

Laser treatment: Less frequently, Dr. Frank may use the Vbeam or Excel V+ laser to treat broken capillaries on the face or complement sclerotherapy. In these non-invasive treatments, Dr. Frank will zap the vein with the high energy laser pulse, which causes it to fade.

Multiple treatments may be needed to improve spider veins, particularly in areas of dense spider veins. A treated vein fades gradually as it is reabsorbed, therefore, Dr. Frank will space successive treatments approximately one month apart. This way, he can be precise and achieve maximum coverage in the treatments.

Cost of Leg Vein and Spider Vein Treatments

The price of treatments for frustrating leg veins and spider veins varies depending on a number of factors. Typically, the number of veins being treated can play a role in the overall cost of treatment, as can the specific treatment modality that was chosen.

Schedule a Consultation

Whether you’re suffering from pain associated with leg veins or are simply unhappy with the appearance of your legs due to veins, Dr. Frank and his team can offer the best solution for you. Schedule your free consultation today by contacting the PFRANKMD team at (212) 327-2919.

Before & After

Leg Veins Before and After photo by Dr. Paul Jarrod Frank of PFRANKMD in New York City, NY