Spider veins or telangiectasia on the legs often cause considerable distress because of their unsightly appearance. Sometimes they are associated with underlying varicose veins so it is important that you are properly assessed before proceeding with treatment. This may involve having a venous colour duplex ultrasound performed on your legs to assess the underlying saphenous veins.

In women the most common places for spider veins to appear are on the outside of the thighs and inside the knees.

Treatment almost always involves sclerotherapy. Vascular laser is most unlikely to clear spider veins if they are significant.

The most common agents used for sclerotherapy are the two detergent sclerosants

  • Polidocanol (“Aethoxysklerol”)

  • Sodium tetradecyl sulfate (“Fibrovein”)

Hypertonic saline historically had a role in treating spider veins but it is rarely used today because it is relatively inefficient, has a tendency to cause ulceration and worldwide has been superceded by the detergent sclerosants.

Lateral thigh

Before and after

AuthorNicholas Kemp