Varicose veins and their smaller cousins known as spider veins afflict about 80 million adults in the United States. Varicose veins usually occur in the legs, where their knotted bluish appearance can be substantially disfiguring. They can also be a health hazard if complications develop—for example, venous stasis ulcers, the inflammation of veins known as phlebitis, or blood clots that may become a focus for infection or break away and become emboli to distant organs such as the lungs.

Spider veins are formed by the dilation of small blood vessels near the surface of the skin. They can appear on any part of the body, but are commonly found on the face and legs. The characteristic appearance of spider veins is a "sunburst" pattern of reddish to purplish small veins. They are not a health hazard but they are disfiguring.

The incidence of both varicose veins and spider veins increases with age. They also seem to have a hereditary basis, tending to "run in the family". In women, pregnancy and hormonal changes may contribute to the development of enlarged veins. While there is no sure method of preventing varicose veins and spider veins, a measure of protection against forming varicose veins may be provided by wearing support hose and maintaining a normal weight.

A dermatologist can recommend a form of treatment for varicose veins and spider veins:

Sclerotherapy: A chemical solution is injected into veins to cause them to collapse and form scar tissue that permanently closes them. Nearby veins take up re-routed blood flow. Sclerotherapy requires multiple treatments to close off all affected veins. Additional treatments may be needed from time to time as new enlarged veins appear. Side effects of sclerotherapy may include slight swelling, bruising, and redness and itching at injection sites.

Phlebectomy: Also called ambulatory phlebectomy. An enlarged vein is removed through tiny incisions along its course, in a procedure performed in an outpatient setting. The procedure can be used for large varicose veins and for spider veins. The photo shows before-and-after results of ambulatory phlebectomy:

Electrodessication: An electrical current is used to seal off enlarged veins.

Laser surgery: Pulses from a laser selectively destroy target areas on enlarged veins, closing them off.

Surgical ligation and stripping: A procedure usually reserved for larger varicose veins, often done by a vascular surgeon in a hospital. The varicose vein is tied off (ligated) or completely removed.