The spider veins are small purple and red blood vessels. They are due to venous deficiency or hereditary reasons and most commonly are found on the thigh or lower leg. They can also form virtually anywhere on the leg, from the uppermost region of the thigh to the ankle. Occasionally, spider veins will appear on the face. Sclerotherapy for the bigger ones and Diode laser/hand cautery for the smaller ones are the treatments of choice. 

A sclerosing agent (such as athexoxysclerol) is injected into the vessel with a micro-needle. The solution causes the vein to turn white (blanch), and then gradually disappear. A typical treatment lasts from 30minutes-1hour and the discomfort is very little. The patient is advised to refrain from vigorous activities for 4-7days and will be asked to wear compression stockings for 7days to help keep treated veins closed and reduce bruising. The remaining small vessels will be treated by Diode laser. At the area of the face (facial telangiectasias) we usually use hand cautery with pretty fair results.

3-4treatments are generally required for more than 70% improvement. 

Management of Facial Telangiectasias with Hand Cautery