Options for removing unsightly veins

Now you see them -- and now you still see them.

For many people, that's the problem with ugly leg veins: They never seem to go away. But those who seek help find that physicians today have ways to eliminate unsightly veins, whether they hurt or just look bad.

"Most new patients tell me that if they had known this was so simple, they would have done it much sooner," said Dr. Lee Schulman, a vein treatment specialist with offices in Manhasset and Commack. "The veins don't get better with time. They only get worse."

The most common cause of spider veins (they're thin, like a strand of spaghetti) or varicose veins (they're larger, often discolored and may cause pain) is genetics, Schulman said.

"It's nothing that people did or didn't do," he said. "It's more like a gray hair."

Getting rid of varicose or spider veins can cost from hundreds to thousands of dollars, depending on the procedure. Insurance may not cover a procedure unless the veins are causing a health problem.

Popular options include:

Pulling the vein out

For this procedure, called phlebectomy, a physician simply pulls veins out of the body. People do just fine without a few veins, Schulman said. "If the veins are varicose, they're actually counterproductive," he said. "If anything, you're improving the circulation without them."

There are newer methods, however. says Dr. Deborah S. Sarnoff, a clinical professor of dermatology at New York University Medical Center, who has offices in Manhattan and Greenvale.

Destroying the vein with an injection

Called sclerotherapy, this procedure involves injecting the vein with a substance that causes it to become blocked. "When the blood can't run through, your body reabsorbs the vein," Sarnoff said. "We're making them useless."

Zapping the vein with a laser

Lasers send heat through the skin at the site of the targeted vein, causing it to become inert. "The lasers are particularly helpful when the spider veins are so thin that you can't really get a needle through them," Sarnoff said. Some physicians do the same thing with radio-frequency waves, she said.

Some people choose to treat themselves at home, though this may be the least effective option. Compression stockings may help, as may weight loss, but Sarnoff said that high-impact exercise can actually make visible veins worse.

Because unsightly veins are often harmless, though, some people also decide to just let them stick around. But the medical experts urge anyone who has leg veins that are painful or worrisome to see a doctor to make sure that their circulation system is working properly because the veins could be a sign that something is wrong.