What are varicose and spider veins?
Varicose and spider veins are dilated veins visible beneath the skin. Spider veins (telangiectasias) are very fine red, blue or purple vessels in a web or branching pattern, and are almost always a cosmetic concern. Varicose veins are thicker, bulging, twisting veins that can cause heaviness, burning or swelling, and sometimes reflect faulty venous valves.
They appear mainly on the legs and are far more common in women. Behind them there is usually a genetic predisposition, combined with factors that raise pressure in the veins: pregnancies, hormonal changes, standing or sitting for many hours, excess weight and age. Facial spider veins (on the cheeks or around the nose, for example) have a different origin —sun damage, rosacea— and are assessed separately.
The distinction matters because it changes both the treatment and, above all, the safety. An isolated spider vein is a surface matter. But when there are large varicose veins, heaviness at the end of the day or skin changes at the ankle, an underlying venous insufficiency may exist: if only the visible veins are treated without studying the cause, the result is short-lived and they come back. That is why the first step is not firing a laser, but understanding what kind of venous problem you have.
If your skin is darker, there is one more question worth settling first: does vein laser work on darker skin? — the guide covers which device matches which vein calibre, and why a protocol written for fair skin can cause pigment change here. Part of Dr. Arístides Arellano’s patient guides.
Techniques used by Dr. Arístides Arellano
Not every vein is treated the same way. The technique is defined at the consultation according to the vessel’s calibre, colour, depth and location —and, when appropriate, only after ruling out a larger venous problem:
- Sclerotherapy (microsclerotherapy): the reference treatment for spider veins and small leg varices. A very fine needle injects a sclerosing solution into the vessel that irritates its wall; the vessel closes and the body reabsorbs it gradually over weeks. It is done in several spaced sessions.
- Transcutaneous vascular laser: delivers pulses of light that the vessel’s haemoglobin absorbs, heating and closing it without piercing the skin. It is useful for very fine vessels, for facial spider veins and for patients who cannot tolerate injections. On the legs it does not always replace sclerotherapy; often the two are combined.
- Combined strategy: some people need sclerotherapy for larger-calibre vessels and laser for the finest or most superficial ones, within the same treatment plan.
- Assessment and referral when needed: when there are large varicose veins or suspected venous insufficiency, the correct step is to study the venous system —often with a Doppler ultrasound— and, if warranted, to refer to vascular surgery before treating the visible veins. Promising cosmetic results without studying the cause would be dishonest.
How is it performed?
Treatment is outpatient and needs no general anaesthesia: you walk in and out the same day. In sclerotherapy the sclerosant is injected into each vessel with a very fine needle; the discomfort is mild, like a pinprick with a slight burning sensation. In vascular laser, pulses of light are applied with skin cooling. Each session lasts 20 to 45 minutes depending on the extent.
The result is progressive, not immediate. Treated vessels fade over weeks, and several sessions are almost always needed, spaced to give the skin time. Right afterwards there may be redness, some welts, and in sclerotherapy a temporary brownish pigmentation along the vein’s track, which usually fades over months.
It should be said plainly: this controls and improves, it does not immunise against the problem. The tendency to form new veins is still there, so over time other spider veins may appear and many patients have maintenance sessions. After treatment, compression stockings, walking and avoiding sun and direct heat on the area for a few weeks are advised, because aftercare influences the result as much as the technique.
Every medical treatment —topicals, peels and energy-based devices included— carries risk and requires a prior assessment. In darker skin (Fitzpatrick IV–VI, the most common phototypes in Mexico) a poorly indicated procedure can darken the patch instead of lightening it. Results may vary according to each patient, their phototype and their individual triggers.
Who is a good candidate?
A good candidate is someone with spider veins or small varices that bother them cosmetically, in good general health and with realistic expectations of a gradual change. The consultation defines what can be treated at the surface and what needs to be studied first:
- Spider veins on the legs or face that you wish to fade for cosmetic reasons.
- Small, superficial varicose veins, once a larger venous problem has been ruled out.
- Patients with realistic expectations, who understand that several sessions are needed and that new vessels can appear over time.
- Not the moment during pregnancy or breastfeeding: many pregnancy spider veins improve on their own after delivery, so waiting is the usual approach.
- Caution is needed in tanned or very dark skin (risk of pigment marks), in people with a history of clots or an allergy to the sclerosant, and in those with large varicose veins and venous insufficiency, who must be studied first.
Recommended post-treatment care
To support a better result and reduce pigmentation and swelling, Dr. Arístides may recommend, case by case, wearing compression stockings for the indicated time, daily walks, avoiding sun and direct heat on the treated area and, where it applies, strict sun protection and manual lymphatic drainage. See the full guide: Post-surgical recovery and care.
Before and after
Most patients want to see before-and-after photographs before deciding. Out of respect for each person’s privacy, Dr. Arístides Arellano shows real cases —always with documented consent— during your in-person consultation, where you can review results from patients with a starting point similar to yours. Results may vary from patient to patient.
Approximate price
A session starts at approximately $5,000 MXN, depending on the area treated and how many sessions your response calls for. Approximate price — the definitive cost is set at your private consultation with Dr. Arístides Arellano.
About Dr. Arístides Arellano
Dr. Arístides Arellano is a plastic surgeon holding a specialty licence: he practises under a Mexican medical licence (D.G.P. 1125959) and a specialty licence in Plastic & Reconstructive Surgery (0002008), both issued by the Directorate General of Professions (DGP), which reissued his certificate of professional standing in 2025. His career began before Mexico’s present-day specialty-board system existed: he belongs to the founding generation of plastic surgery in Puebla, the second generation of a surgical tradition started in 1971 by Dr. Francisco Arellano Ocampo. Trust is verified, not promised: both licences are public and anyone can look them up in the DGP’s National Registry of Professionals.
Related patient guide
Before deciding who should treat you, it is worth getting informed: How to choose a plastic surgeon in Puebla — part of the series of informational guides reviewed by Dr. Arístides Arellano.
Trust is verified, not promised. All 210 scanned documents —degree, licences, diplomas, publications and certificates, from 1977 to 2025— are open in Dr. Arístides Arellano’s credential archive, alongside an explanation of the difference between a specialty licence and a board certification.
Session plan and aftercare
- ConsultationSpider vein is told from varicose vein, venous insufficiency is ruled out, and sclerotherapy, laser or both are decided. Sometimes the conclusion is to study the venous system first.
- Session dayOutpatient procedure of 20–45 min. Compression stockings are fitted and walking is advised; normal activity resumes the same day.
- Days 1–14Possible redness, welts and, in sclerotherapy, brownish pigmentation along the vein. Avoid sun and direct heat on the area.
- Weeks 2–8Treated vessels fade progressively. The temporary pigmentation begins to clear.
- Further sessionsSpaced as indicated, until the desired clearing is achieved. Every case needs a different number.
- MaintenanceThe predisposition remains: new vessels can appear over time and maintenance sessions may be done.
Frequently asked questions
How many sessions do leg spider veins take?
Almost always several, spaced a few weeks apart. The exact number depends on how many vessels there are, their calibre and colour, and how your skin responds. No one serious will give a fixed figure without seeing your legs: the clearing is progressive and adjusted session by session.
Do sclerotherapy or laser remove varicose veins forever?
No. Treatment closes and fades the treated vessels, but it does not remove the tendency to form new veins. Over time other spider veins may appear, which is why many patients have maintenance sessions. The correct term is control and improvement, not permanent erasure.
Is laser or sclerotherapy better?
It depends on the vessel. Sclerotherapy is the reference treatment for spider veins and small leg varices; vascular laser is useful for very fine vessels, on the face, and for those who cannot tolerate injections. Often the best strategy combines both. It is decided at the consultation, not in advance.
Does the treatment hurt?
The discomfort is mild. Sclerotherapy feels like small pinpricks with a slight burning sensation; vascular laser, like a warm snap with skin cooling. It is an outpatient procedure and most patients resume their activity the same day.
Can I treat varicose veins during pregnancy?
Waiting is the usual approach. Many spider veins that appear in pregnancy improve on their own after delivery, and as a precaution sclerotherapy and vascular laser are not performed during pregnancy or breastfeeding. It is best to assess once that period has passed.
When do my varicose veins need more than a cosmetic treatment?
When they are large, bulging and come with heaviness, swelling, cramps or skin changes at the ankle, an underlying venous insufficiency may exist. In those cases the venous system is studied, often with a Doppler ultrasound, and if warranted you are referred to vascular surgery before the visible veins are treated.
Every case is different. Discuss yours in a personal consultation.
Book a consultation on WhatsAppEvery figure published on this site is approximate and is not a quote. Any procedure or treatment first requires a private assessment consultation with Dr. Arístides Arellano —$800 MXN, charged separately— and it is at that consultation that the definitive cost of your case is determined.
Educational content; it does not replace a medical consultation. Results may vary from person to person.