10752 N 89th Place, Ste 122B · Scottsdale, AZ 85260 (480) 567-8180
Desert Bloom Skincare

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Spider Veins

Spider veins are small, red, blue, or purple veins that appear just below the surface of the skin. They are most commonly found on the legs and face and can be caused by a variety of factors such as aging, genetics, hormonal changes, or sun exposure. Spider veins can be unsightly and a source of self-consciousness for some people. A specialist can evaluate the veins and recommend the best course of action to help minimize their appearance.

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Spider veins

Why fine vessels start showing through

Spider veins — fine red and purple threads on the face and legs treated at Desert Bloom Scottsdale

Spider veins — the fine red, pink, or purplish threads that branch just under the skin — appear in two distinct zones, each with its own cause and treatment route. Facial telangiectasia is driven by UV damage, rosacea-related vascular reactivity, hormones, and genetics. Leg spider veins share genetic and hormonal drivers but add venous pressure as the dominant mechanism. The route differs accordingly: vascular laser or IPL for the face, sclerotherapy for the legs.

What drives spider veins

Four overlapping drivers — identifying which dominates shapes both the treatment route and how likely vessels are to return.

Cumulative UV exposure

Sun damage

UV radiation degrades the collagen and elastin that support vessel walls. Vessels dilate and stay visible, concentrating on the nose, cheeks, and chin. SPF 30+ daily is part of the treatment plan, not optional aftercare.

Strongest single predictor

Genetic predisposition

Family history governs vessel-wall integrity and skin thickness. Patients with strong heredity often see facial telangiectasia in their 20s and 30s — earlier treatment and proactive maintenance fit best.

Estrogen and vascular dilation

Hormonal factors

Pregnancy, hormonal contraceptives, HRT, and perimenopause promote vessel dilation. The treatment route is unchanged, but maintenance frequency may shift for patients on ongoing hormonal therapies.

Chronic vascular reactivity

Rosacea overlap

Repeated dilation cycles eventually become permanent vessels. IPL is particularly effective here because it addresses both discrete vessels and the diffuse background redness in one treatment.

Leg spider veins share these drivers but add chronic venous pressure from prolonged standing as the primary mechanism — which is why the treatment route changes.

Treatments we use for spider veins

Energy-based and referral options matched to vessel location, depth, and your Fitzpatrick skin type.
Vein & Redness Removal

Facial telangiectasia · all skin types

Vein & Redness Removal

Quanta EVO vascular laser with KTP 532nm for Fitz I–III and Nd:YAG 1064nm for all skin types including Fitz IV–VI. Point-by-point closure of broken capillaries and cherry angiomas on the nose, cheeks, and chin. Most areas clear in 1–3 sessions.

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Photo Facial (IPL)

Diffuse redness + vessels

Photo Facial (IPL)

Broad-spectrum filtered light treats an entire field per pass — first-line option when rosacea-style redness overlaps with visible vessels. Typically 3–5 sessions for rosacea overlap; 1–2 for primarily discrete vessels.

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Leg vessels · gold standard

Sclerotherapy (referral)

Sclerosant solution injected into target leg vessels causes wall collapse and reabsorption — the most effective single treatment for leg telangiectasia under 3mm. Performed at vascular specialty clinics; Desert Bloom coordinates the referral.

Adjunct · very fine leg vessels

Nd:YAG laser for legs

For very fine leg vessels under 0.5mm or needle-phobic patients, Nd:YAG 1064nm is an option. Less effective than sclerotherapy for vessels over 1mm — best used as adjunct after sclerotherapy clears larger vessels.

Start with what you see

Which path fits your spider veins?

Three common presentations — pick the one closest to yours to find the right next step.

I have a few visible threads on my nose or cheeks

→View Vein & Redness Removal — Isolated facial telangiectasia — Quanta EVO vascular laser (KTP for Fitz I–III, Nd:YAG for all skin types) clears most cases in 1–3 sessions.

My face is flushed and I have clustered vessels

→View Photo Facial — Diffuse redness overlapping with discrete vessels — IPL Photofacial often produces superior global results when rosacea-type reactivity is part of the picture.

I have spider veins on my legs

→Book a consultation — Sclerotherapy at a vascular specialty clinic is the gold standard. Dr. Borakowski coordinates the referral and can plan any adjunct laser treatment.

“Spider veins are one of the most satisfying things to treat — patients see the result immediately, and with the right wavelength for their skin type the clearance is excellent. The critical step is the skin-type assessment before treatment. For Fitz IV–VI patients, Nd:YAG is the safe route. I won't use KTP on deeper skin tones regardless of how superficial the vessels look.”
— Dr. Natalya Borakowski, NMD

Spider veins — common questions

What causes spider veins on the face — and are they different from leg spider veins?
Facial and leg spider veins share some drivers — genetics and hormones affect both — but they develop through different mechanisms and need different treatments. Facial telangiectasia is driven by UV damage, rosacea-related vascular reactivity, and genetics; the vessels involved are superficial capillaries responding to environmental and inflammatory triggers. Leg spider veins are driven primarily by venous pressure: gravity, prolonged standing, and vascular insufficiency dilate the superficial venules until they become permanently visible. The routes are accordingly different — energy-based laser or IPL for the face, sclerotherapy (chemical injection) as the gold standard for legs. Using a facial laser protocol on leg veins, or sclerotherapy on facial telangiectasia, produces poor results.
Can spider veins be permanently removed?
Treated spider veins are permanently closed — the target vessel is thermally or chemically destroyed and reabsorbed by the body. The cleared vessels do not return. However, new spider veins can form over time if the underlying drivers persist: continued UV exposure, hormonal changes, genetic predisposition, rosacea flares, or ongoing venous pressure. Permanent removal is accurate for the treated vessels; it is not a guarantee that no new vessels will ever appear. Sun protection, rosacea management if applicable, and one or two maintenance sessions per year are how most patients keep results stable long term.
How many laser sessions are needed for facial spider veins?
Most isolated facial telangiectasia — fine vessels on the nose, cheeks, or chin — respond in 1–3 sessions. A single session clears the majority of treated vessels in most cases; a second session 4–6 weeks later addresses any remaining or newly visible vessels. Patients with extensive telangiectasia covering a large area or combined with rosacea-type diffuse redness may benefit from a series of 3–5 IPL Photofacial sessions as the primary treatment. At your consultation, Dr. Borakowski will assess the density and distribution of your vessels and give you a realistic session estimate.
Is vascular laser safe for darker skin tones (Fitzpatrick IV–VI)?
Yes — with the correct wavelength. Nd:YAG 1064nm is safe across all Fitzpatrick types including IV–VI because its longer wavelength bypasses epidermal melanin and targets hemoglobin selectively. KTP 532nm is NOT recommended for Fitz IV–VI: the 532nm wavelength is absorbed by melanin as well as hemoglobin, creating a meaningful risk of post-inflammatory hyperpigmentation and surface burns. At Desert Bloom, Fitz IV–VI patients with facial spider veins are treated with Nd:YAG 1064nm only. Alexandrite 755nm is also not used for vascular treatment in darker skin. If KTP or Alexandrite has been recommended for spider vein removal on darker skin, ask about Nd:YAG as the alternative before proceeding.
What is the difference between spider veins and varicose veins?
Spider veins are small (under 3mm), flat or barely raised, and purely cosmetic in most cases — they cause no pain or functional impairment and appear as fine red, pink, or purple threads in a branching pattern. Varicose veins are larger (typically over 3mm), visibly raised or ropy above the skin surface, and often symptomatic — causing leg heaviness, aching, swelling, or cramping. Varicose veins are a sign of venous insufficiency: the one-way valves in the leg veins are failing and blood is pooling backward. Varicose veins require medical evaluation by a vascular specialist — ultrasound mapping of the venous system, and potentially endovenous ablation. Sclerotherapy and cosmetic laser are not appropriate first-line treatments for varicose veins. If you have both, the varicose veins are evaluated and treated first.
Do spider veins come back after treatment?
Treated vessels do not return — they are permanently closed and reabsorbed. However, spider veins are a condition driven by ongoing biological and lifestyle factors, not a one-time injury. New vessels can form if the underlying drivers — UV exposure, hormonal fluctuations, rosacea, genetic predisposition, venous pressure — continue. The practical expectation is that treated areas stay clear long term while new vessels may appear nearby as the skin ages. Daily broad-spectrum SPF, consistent rosacea management if applicable, and compression for leg veins are the best available tools for slowing new formation between treatment sessions.
Can men get vascular laser treatment for spider veins?
Yes. Vascular laser and IPL Photofacial are appropriate for all adults regardless of sex. Men with spider veins on the face — common after years of outdoor activity, sun exposure, or with rosacea — respond to the same KTP and Nd:YAG protocols as women. Men often present with telangiectasia on the nose and cheeks and may have delayed treatment due to the perception that it is primarily a women's concern. Treatment is identical; downtime and results are the same.
Dr. Natalya Borakowski, NMD

Medically reviewed by

Dr. Natalya Borakowski, NMD

Founder, Desert Bloom Skincare · 17 Years Experience

References

  1. 1.

    Anderson R.R., Parrish J.A.. Selective photothermolysis: precise microsurgery by selective absorption of pulsed radiation. Science; 1983;220(4596):524-527.

    DOI: 10.1126/science.6836297

    Foundational principle underlying all vascular laser and IPL treatment of telangiectasia.

  2. 2.

    Adamic M., Pavlovic M.D., Troilius Rubin A., Palmetun-Ekback M., Boixeda P.. Guidelines of care for vascular lasers and intense pulse light sources from the European Society for Laser Dermatology. Journal of the European Academy of Dermatology and Venereology; 2015;29(9):1661-1678.

    DOI: 10.1111/jdv.13177

    ESLD guidance on wavelength selection for vascular lesions across skin types, including Nd:YAG for Fitz IV–VI.

  3. 3.

    Karppinen T., Kantola E., Karppinen A., Rantamäki A.H., Kautiainen H., Mordon S., Guina M.. Treatment of telangiectasia on the cheeks with a compact yellow (585 nm) semiconductor laser and a green (532 nm) KTP laser: a randomized double-blinded split-face trial. Lasers in Surgery and Medicine; 2019;51(10):876-882.

    DOI: 10.1002/lsm.23051

    Comparative efficacy data for KTP 532nm in facial telangiectasia.

  4. 4.

    Bossart S., Daneluzzi C., Cazzaniga S., et al.. Skin hyperpigmentation after sclerotherapy with polidocanol: A systematic review. Journal of the European Academy of Dermatology and Venereology; 2023;37(1):37-44.

    DOI: 10.1111/jdv.18639

    Systematic review of post-sclerotherapy hyperpigmentation risk in leg telangiectasia.

  5. 5.

    Wat H., Wu D.C., Rao J., Goldman M.P.. Application of intense pulsed light in the treatment of dermatologic disease: a systematic review. Dermatologic Surgery; 2014;40(4):359-377.

    DOI: 10.1111/dsu.12424

    IPL evidence base across vascular and rosacea indications.

Scottsdale, Arizona

Start with a conversation, not a treatment plan

A consultation with Dr. Borakowski is a screening first. If the treatment you came in asking about isn't the right tool, she'll tell you — and point you toward what is.

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Address

10752 N 89th Place,
Ste 122B · Scottsdale, AZ 85260

Phone: (480) 567-8180

E-mail: info@desertbloomskincare.com

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Location & directions

Conveniently located in the Shea Corridor of North Scottsdale, within Edwards Professional Park I — minutes from HonorHealth Scottsdale Shea and the Mayo Clinic Scottsdale Campus.

  • From the North / South: Take Loop 101 and exit at E Shea Blvd, just East of the freeway.

  • Parking: Ample free parking directly in front of Suite 122B.

Areas we serve

  • Scottsdale

    North Scottsdale · McCormick Ranch · Gainey Ranch

  • Paradise Valley

  • Cave Creek & Carefree

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