121 East 60th Street, Suite 8AB, New York, NY 10022

Ph. (212) 285-1110

Long Island

901 Stewart Ave, Suite 240, Garden City, NY 11530

Ph. (516) 512-7616

New York City (212) 285-1110

Garden City, NY (516) 512-7616

Vein Treatment in New York

Varicose and spider veins can leave unsightly discoloration and texture to the skin. The medical treatment that Dr. Cameron Rokhsar will choose for you depends on the following factors:

  • Type– Varicose or spider veins
  • Size– How big they are in diameter. Typically varicose veins are 3mm and spider veins are 1mm in diameter.
  • Location– Legs typically have thicker or larger veins while the ankle, behind the knee, hands, face, breasts, back and genital areas are smaller. However, size can vary anywhere along the body.
  • Severity– Concentration of veins
  • Skin texture and color
  • Age of the skin

Different methods of treating varicose and spider veins1 are sclerotherapy and laser technologies such as Nd:YAG laser. Sclerotherapy is the most common way to treat spider and varicose veins on the leg. It is in the form of an injection and can be found in other forms such as foam, ultrasound, and laser-assisted sclerotherapy. When the chemical is injected the veins collapse and block any further blood flow in that area, which ultimately eradicates their appearance through the skin.

The surrounding veins take over for the collapsed veins and regular blood flow continues. The injection may only feel like a pinprick if anything at all. The number of treatments varies from patient-to-patient based on the criteria listed above. The long-pulsed Nd:YAG laser is an alternative treatment for those patients who wish to avoid the needles. This form of laser treatment is typically used for spider veins and smaller varicose veins2. This new technology effectively treats the veins by sending strong bursts of light into the vein, which will make the vein slowly fade and disappear.


During pregnancy, and to a lesser degree also during periods, fluctuations in the female sex hormone (especially estrogen and progesterone), cause softening of the vein walls and valves. This makes women’s veins more prone to stretching and enlargement with increased pressure. Increased blood volume, which is needed to provide circulation to the fetus, also causes increased pressure on the vein walls. The growing fetus also exerts pressure on the pelvis, which in turn, exerts pressure on the leg veins. Some women see spider veins that develop during their pregnancies and persist after their baby is born. Others see that their veins disappear after the baby is born, only to reappear later in life.

Prolonged standing and sitting

Prolonged standing and sitting cause a great amount of pressure to develop in the leg veins. In both conditions, the calf muscles are inactive and therefore cannot help push the venous blood to return to the heart. This causes blood to pool in the veins, thus resulting in increased pressure on the vein walls.
This pressure drops once one begins to walk, so if your job requires you to stand or sit for prolonged periods, remember to take short breaks and walk around for a couple of minutes every hour.


In some people, spider veins appear after injury or trauma to the vein, such as after a broken ankle, surgery, car accident, or sports injury. Bruising, which is pooled blood resulting from broken veins under the skin, can also lead to an inflammatory response, which in turn, can result in enlarged veins. Sometimes, spider veins can appear many years after the wound has healed.

Vein Conditions

In men, spider veins are usually the result of blow-outs from nearby varicose veins. High pressure from these veins cause adjoining superficial veins to stretch, enlarge, and change in color. These spider veins are usually darker and have larger diameters than the spider veins in women. Spider vein matting, which resembles bruises that do not go away, is often caused by the healing process of injuries and bruises, as well as complications from sclerotherapy. Ankle flares, or spider veins found on the inside ankle, is often associated with chronic venous insufficiency (CVI), a condition where venous blood is not returned efficiently to the heart.

Spider & Varicose Veins

Spider veins are small threadlike veins that lie close to the surface of the skin. They connect to the larger veins but are non-essential. Spider veins are usually not associated with symptoms.

Causes of Spider Veins

Heredity is the number one contributing factor causing varicose and spider veins. Women are more likely than men to suffer from abnormal leg veins with up to half of American women being affected. Hormonal factors including puberty, pregnancy, menopause, the use of birth control pills, estrogen, and progesterone contribute to this condition. It is very common for pregnant women to develop varicose veins during the first trimester since pregnancy causes increases in hormone levels and blood volume which in turn causes veins to enlarge. Varicose veins3 due to pregnancy often improve within 3 months after delivery. However, with successive pregnancies, abnormal veins are more likely to remain. Other predisposing factors include aging, standing occupations, obesity and leg injury.

The Difference Between Spider & Varicose Veins

Arteries carry blood from the heart towards the body parts, while veins carry blood from the body parts back to the heart. As the blood is pumped back to the heart, veins act as one-way valves to prevent the blood from flowing backward. If the one-way valve becomes weak, some of the blood can leak back into the vein, collect there, and then become congested or clogged. This congestion will cause the vein to abnormally enlarge. These enlarged veins can be either varicose veins or spider veins.

Varicose Veins

Varicose veins are very swollen and raised above the surface of the skin. They are dark purple or blue in color and can look like cords or very twisted and bulging. They are found most often on the backs of the calves or on the inside of the leg, anywhere from the groin to the ankle. During pregnancy, varicose veins called hemorrhoids can form in the vagina or around the anus.

Spider Veins

Spider veins are similar to varicose veins, but they are smaller, are often red or blue in color, and are closer to the surface of the skin than varicose veins. They can look like a tree branch or spider web with their short jagged lines. Spider veins can be found on both the legs and the face. They can cover either a very small or very large area of skin.

Treatment Options

New technology in laser treatments can effectively treat spider veins in the legs. Laser surgery sends very strong bursts of light onto the vein. This can make the vein slowly fade and disappear. Lasers are very direct and accurate. So the proper laser controlled by a skilled doctor will usually only damage the area being treated. Most skin types and colors can be safely treated with lasers.

Laser surgery is more appealing to some patients because it does not use needles or incisions. When the laser hits the skin, the patient may feel a heat sensation. Cooling helps reduce pain. Laser treatments last for up to twenty minutes. Depending on the severity of the veins, 2 to 5 treatments are generally needed to remove spider veins in the legs. Typically, patients can return to normal activity right after treatment.

Sclerotherapy is a procedure in which 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 newly enlarged veins appear. Side effects of sclerotherapy4 may include slight swelling, bruising, and redness, and itching at injection sites.

Vein Treatment FAQ

What is the best varicose vein treatment?

Varicose veins can cause discomfort and be aesthetically displeasing. Fortunately, there are several treatment options available to help manage this condition. The best treatment for varicose veins depends on the severity of the veins and the individual’s health status.

For smaller varicose veins (blue veins), reticular veins (green veins), and spider veins (red veins), sclerotherapy or laser therapy on the skin may be the most effective treatment. Sclerotherapy is the most common treatment for both spider, reticular and varicose veins, where a hypertonic saline solution or detergent solution is injected into the varicose, spider or reticular vein which will irritate the lining of the blood vessels to collapse them. Dr. Rokhsar believes that detergent solutions like Asclera are far more effective than hypertonic saline. Asclera injections are also much less painful with almost no burning sensation when injected.

For smaller spider veins and telangiectatic matting, The pulse dye (Vbeam) laser is the treatment of choice. The laser works by heating the lining of the blood vessels to destroy them. The areas of the vein may look bruised after treatment. Care must be taken to avoid the sun after laser treatment of veins on the legs.

Lifestyle and home remedies can also be helpful in managing varicose veins, such as exercise to encourage blood flow, managing weight, and avoiding salt. Additionally, some studies suggest that potassium-high foods, such as almonds and pistachio nuts, can help varicose veins by reducing water retention in the body, while salty or sodium-rich foods can cause the body to retain water. Compression socks or stockings can also help prevent and manage varicose veins by improving circulation in the legs and preventing new varicose or spider veins from forming.

What is the best spider vein treatment?

Sclerotherpy is considered the best treatment due to its high success rate, minimal pain and discomfort, negligible risk of complications, and minimal downtime. Other treatments such as laser therapy are also commonly used and provide satisfactory results with almost no downtime. Sclerotherapy involves injecting a solution into the affected vein, causing it to collapse and fade over time, while laser therapy uses pulsed light energy to cause heat-related damage to the veins. Dr. Rokhsar has treated thousands of patients successfully with leg vein injections through sclerotherapy over the years. More than one injection session is often required. Sclerotherapy injection sessions are spaced 4-6 weeks apart to allow the body to get rid of the damaged injected veins. The procedure is painless because Dr. Rokhsar uses a drug called Asclera as opposed to hypertonic saline which is known to burn a lot when injected. The patient is instructed to wear compression stockings for one week for best results. For veins that are hard to cannulate or insert a needle through, due to small sizeDr. Rokhsar prefers to use a laser to destroy the unwanted leg veins. Dr. Rokhsar performs both sclerotherapy and laser treatment of leg veins in both Manhattan and Long Island office locations in New York.

In addition to treatment options, there are also preventative measures that should be taken to reduce the likelihood of developing spider veins. The most important prevention method is wearing sunscreen to protect the skin from sun damage and wearing compression stocking to reduce the pressure on the superficial venous system in the legs.

It’s important to consult with a board certified dermatologist to determine the best treatment option based on individual circumstances and preferences. Dr. Rokhsar is double board certified in dermatology and dermatologic surgery and is an expert in treatment of leg veins through multiple techniques.

How does sclerotherapy work?

Sclerotherapy involves injecting a chemical solution directly into the varicose or spider vein. The solution causes the vein walls to swell, stick together and seal shut, stopping the flow of blood. As a result, the vein fades within a few weeks. Varicose veins are caused by weak or damaged valves in the veins.

Sclerotherapy does not require anesthesia and is typically performed in your board certified dermatologists’ office. The procedure takes about 15 to 30 minutes, but the exact length of time depends on the size of the area and the number of veins being treated.

Depending on its size, a single vein may have to be injected more than once. Treatment must be performed weeks or months apart. Multiple veins may be injected during one treatment session.
During the procedure, you’ll lie on your back with your legs slightly elevated. Your board certified dermatologist will cleanse the area to be treated before inserting a solution into the targeted vein with a fine needle. The solution causes the vein walls to swell, become sticky and seal shut, stopping the flow of blood. As a result, the vein fades within a few weeks to a few months. You may experience some minor stinging or cramps when the needle is inserted into the vein. The pain is minimal with Dr. Rokhsar’s injections because he uses special small needles made in Japan and also uses a drug called Asclera which burns very little compared to hypertonic saline solutions.

After the injections, your board certified dermatologist will apply compression and massage the treated area to keep blood out of the injected vein and disperse the solution. A compression garment or compression stocking must be worn immediately after the keg vein injections with sclerotherapy.

How long does varicose vein treatment last?

Varicose vein treatment can last for different durations depending on the treatment method used and individual circumstances. Varicose veins that develop during pregnancy often do not go away on their own after delivery. For other people, varicose veins may recur after treatment.

Overall, the duration of varicose vein treatment can vary depending on the severity of the condition, the treatment method used, and individual factors. Patients should discuss their treatment options and expected outcomes with their board certified dermatologist. Wearing compression stocking not only enhances your results from your sclerotherapy procedure, but adds longevity to your results so the unwanted leg veins stay away longer.

How much does varicose vein treatment cost?

Varicose vein treatment cost can vary depending on several factors such as geographical location, the type of treatment, and the extent of the vein disease. There is no insurance coverage for leg vein treatment through sclerotherapy and Vbeam laser treatment of leg veins.

  • Type of Treatment: Different types of treatments are available for varicose veins, such as endovenous laser therapy, radiofrequency ablation, sclerotherapy, and surgical procedures, with each at a different price point.
  • Severity of Vein Disease: The extent of the vein disease can also impact the cost of treatment. If the varicose veins are severe and require extensive treatment, the cost can be higher than mild cases.
  • Geographic Location: The cost of varicose vein treatment can also vary by geographic location.
  • Laser treatments may be more expensive than sclerotherapy.

New York Office Locations

Upper East Side Manhattan Office
121 East 60th Street, Suite 8AB New York, NY 10022
(212) 285-1110

Long Island Office
901 Stewart Ave, Suite 240, Garden City, NY 11530
(516) 512-7616

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  1. Spider Vein Treatment. Available:
  2. Varicose Veins. Available:
  3. Understanding Varicose Veins — Treatment. Available:
  4. Injection Sclerotherapy. Available:

About author - Dr. Cameron Rokhsar

Dr. Cameron Rokhsar

Dr. Cameron Rokhsar, MD, FAAD, FAACS, is the founder and medical director of the New York Cosmetic, Skin, & Laser Surgery Center. Dr. Rokhsar is a graduate of Harvard College and NYU School of Medicine. Dr. Rokhsar is double board certified in dermatology and micrographic dermatologic surgery, being one of the few select dermatologists in the country who is also fellowship trained in laser surgery. A researcher and innovator, Dr. Rokhsar is the creator of the non-surgical nose job and has been instrumental in the research and development of laser systems such as the Fraxel, CO2, Mirady, Vbeam, Themitight, and Ulthera devices. An Associate Professor of Dermatology at Mount Sinai Hospital in NYC, Dr. Rokhsar actively teaches the cosmetic dermatology clinic to the resident at Mount Sinai. An expert injector of fillers, and a trainer for many companies, patients fly in from around the world to see Dr. Rokhsar in his Garden City and Manhattan offices in New York.

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