Vein Health Articles

Most spider veins are cosmetic — small surface vessels that aren't causing harm. But some are an outward sign of an underlying problem called venous reflux, in which the valves inside the deeper leg veins don't close properly.

Clues that spider veins may be more than cosmetic include leg aching, heaviness, swelling at the end of the day, itching over the veins, and the presence of larger varicose veins nearby. When any of these are present, a duplex ultrasound is the right next step.

If ultrasound confirms reflux, treating the source first (often with EVLT) leads to better, longer-lasting results from sclerotherapy. If your veins are purely cosmetic, sclerotherapy alone is usually appropriate. Either way, an honest evaluation is the starting point.

EVLT (endovenous laser treatment) is performed in the office in about 30 to 60 minutes. Before the procedure, your physician reviews your ultrasound and treatment plan and answers any remaining questions.

Local anesthesia numbs the treatment area. A thin laser fiber is placed inside the affected vein under ultrasound guidance. Gentle heat from the laser closes the vein from the inside. Most patients describe the experience as comfortable, with mild pressure or warmth.

Afterward, you'll walk for a short period, then go home the same day. Compression stockings, regular walking, and avoiding strenuous exercise for a short time are typical. Most patients return to normal activity within one to two days.

Insurance — including Medicare and many private plans — may cover treatment of varicose veins and venous reflux when there are symptoms and ultrasound findings that support medical necessity. Purely cosmetic spider vein treatment is generally not covered.

Most plans require a clinical evaluation, an ultrasound documenting reflux, and a record of conservative therapy — often a defined trial of medical-grade compression stockings — before approving a procedure.

Our team will help verify your benefits, explain what your specific plan typically requires, and submit the documentation needed for prior authorization. We will be straightforward about what is and is not likely to be covered, so you can make an informed decision.