Hi, I'm Dr. Raphael Darvish with Skinpeccable Dermatology and Cosmetic Laser Center, here in Los Angeles, California. Today, I'm going to be speaking with you about how to remove spider veins from the legs. So, spider veins are those reddish, bluish thin veins that you can see on the legs. They are differentiated from the reticular which are the kind of deeper, larger flat blue veins and differentiated from varicose veins which are the kind of bulging, rope like veins that you'll see on some women. Spider veins on the legs are removed one of two ways mainly. The first way being Sclerotherapy which is the injection of a Sclerosant or scarring solution to eliminate that vein. So, the way we go about injecting those Sclerosants, we start from the top down approach, treat the top of the leg and work our way down. We can use one of a few different kinds of Sclerosants available to us, Polidocanol is probably the most popular of Sclerosants used in the United States. Secondly, Sotradecol and thirdly Saline. Saline really isn't used so much any more by the younger generation of physicians. Older physicians were trained in Saline Sclerotherapy but the side effect profile of Polidocanol and Sotradecol is better, and so most physicians are using those to Sclerosants these days. Aside from Sclerotherapy, there is laser treatment of the spider veins on the legs. Most often we use the 1064 Nanometer NdAG Laser though you can most definitely use the V Beam, which is a pulse dye laser, or an IPL Laser to treat those veins, and generally what we do when we treat veins on the legs is we draw some lines using a white line or pencil to make sure that we get every single area that has the spider veins. So we make sure that we treat an area and when we're done treating that area we put a check mark in that little box or circle that we drew around the area to make sure that in fact it was treated and wasn't skipped because sometimes in a situation where somebody has a lot of veins, you can get disoriented and lost as to really what you have treated and what you haven't treated. So, a good endpoint generally is going to be either the vein gone or the vein slightly darker. With laser vein removal treatments, you will generally do five treatments spaced out a month apart, and the treatment endpoint at each time, again, will be the vein gone or slightly darker with an associated swelling of the skin surrounding that particular vein, swelling and a pinkness to that skin. Now, why choose Sclerotherapy versus laser vein removal treatment? Generally, the end result is pretty equivalent meaning they are both very effective. Some patients prefer the laser vein removal treatment because there is no needles involved. Some prefer Sclerotherapy because they have done it before and they know it works and they are happy with it and for many many years it was considered the gold standard in therapy for spider veins on the legs. I'm Dr. Raphael Darvish, and that's a brief overview of how to remove spider veins on the legs. Thank you.