Spider veins are small blood vessels that have widened close to the surface of the skin, appearing as fine flat red, blue or purple lines. They are harmless and most commonly appear on the face and legs. They are treated with laser and light at Coastal Dermatology + Aesthetics in San Luis Obispo.
Flat lines, not raised ones
A spider vein is a small blood vessel that has widened and settled close enough to the surface to show through. The branching pattern is where the name comes from. On a face they usually appear beside the nose, across the cheeks and on the chin. On legs they tend to arrive in clusters on the thigh, behind the knee or around the ankle.
They lie flat. Run a finger over one and you feel nothing. That single fact is the most useful thing on this page, because it separates a cosmetic concern that a laser clears from a circulation problem that needs a different specialist entirely.
Spider veins carry no health risk of their own. Nothing happens if you leave them alone for the rest of your life, and people have them treated because of how they look. That is a perfectly good reason and it does not need dressing up as anything else.
Worth having looked at rather than assumed
- A vein that bulges above the skin, or that you can feel with a fingertip
- Leg veins that ache, throb or feel heavy by the end of the day
- Swelling in the ankle on the same leg
- Skin changes around the ankle, or a sore that will not heal
- A cluster that appeared suddenly rather than gradually
The distinction that decides everything. A spider vein lies flat and you feel nothing when you run a finger over it. A vein you can feel or see standing above the skin is a different condition and belongs with a vein specialist.
What causes them
Pressure, over years
Vessel walls have some give in them, and repeated pressure gradually stretches the smallest ones until they stay wide. On legs that pressure comes from standing, from gravity and from anything that raises pressure in the veins over time. On a face it comes from flushing, from heat and from the ordinary mechanical stress of a face that moves all day.
Sun, and the Central Coast version of it
Years of sun thins the skin and weakens the collagen that supports the vessels underneath, so they widen more easily and show through more readily. That is why facial spider veins concentrate on the nose, cheeks and upper chest, and why they are so often accompanied by the rest of what sun leaves behind.
Hormones, family and the rest of it
They run in families, they are more common in women, and pregnancy is a frequent trigger for the leg version. Age plays a part on both. On the face, a flush that comes and goes is one of the most common companions, because the same widened vessels that produce visible lines also produce background redness.
The reduction in visible blood vessels most patients see after one to three treatments with a pulsed dye laser, with visits usually three to four weeks apart. [1]
Spider vein, varicose vein, or rosacea? Three questions
These three get grouped together constantly and they go to three different places. Three questions sort out which one you are looking at, and you can answer all of them yourself.
| Ask yourself | If yes | What that means |
|---|---|---|
| Can I feel it? Run a fingertip lightly over it with your eyes closed | You can feel a cord or a bulge | Not a spider vein. Raised, ropey veins are the varicose kind, and they belong with a vein specialist rather than here |
| Does the leg ache, throb, swell or feel heavy by evening? | Yes | Symptoms point at circulation rather than appearance, and that is a medical assessment first, whatever the veins look like |
| On my face, is there a general flush as well as the lines? | Yes | Likely flushing and background redness alongside the vessels, and the plan should treat both rather than only the lines |
If the answer to all three is no, what you have is a cosmetic concern with a straightforward answer. Flat facial veins and flat leg spider veins clear well with light-based treatment, and most people see a substantial reduction after one to three sessions. [1]
Two things this cannot sort out on its own: leg veins can be flat at the surface and still sit downstream of a circulation problem, which is why symptoms matter more than appearance on legs; and birthmarks and other vessel problems are their own category and are assessed rather than assumed.
Areas we treat
Beside the nose
The most common facial site, and where a single vessel is most noticeable
Cheeks
Fine branching lines, often with a general flush behind them
Chin and around the mouth
Isolated vessels that catch the light and are easy to miss in a mirror
Upper chest
Where sun exposure and thin skin combine
Thighs and behind the knee
The most common leg pattern, usually in clusters
Around the ankle
Worth assessing rather than treating on appearance, because symptoms matter more here
The staff is terrific, front to back. Thank you, Dr. Kilcline, for the great work today.
The Coastal difference
Two lights, and the judgment about which one
Individual vessels and general redness are different targets and they respond to different tools. A pulsed dye laser tuned to the color of blood is what clears a distinct line beside the nose. Pulses of light across a whole area are what lift a background flush. Both are here, which means the choice follows your skin rather than what happens to be in the room. Most faces need some of each, and having both available is what lets a plan say so.
The other half is what gets ruled out first. A vein you can feel is a different condition. Symptomatic legs are a circulation question before they are a cosmetic one. And a face full of fine vessels frequently has a flush that comes and goes underneath it, which is treatable and which most people have never had named. A board-certified dermatologist sorting that out before anything is aimed at your skin is the actual service.
How long results tend to last. Treated vessels do not reappear, though new ones can form over time, which is what occasional maintenance is for. [1]
Is it right for you?
This is a good conversation to have if:
- You have fine flat red or purple lines on your nose, cheeks or chin
- You have flat clusters of leg veins with no aching, swelling or heaviness
- You have both visible lines and a general flush, which is common and treatable together
- Makeup covers it and you would rather it did not have to
Start somewhere else if:
- A vein bulges above the skin or you can feel it. That belongs with a vein specialist
- Your legs ache, throb, swell or feel heavy, which is a circulation assessment first
- There are skin changes around the ankle, or a sore that will not heal
We would rather tell you at the first appointment that a vein specialist is the right call than treat the surface of something that needs looking at properly. That is a short conversation and it is worth having early.
Holding onto the result
Worth doing
- Broad spectrum sunscreen, SPF 30 or higher, water resistant, every day, since sun weakens the support around the vessels [2]
- Note what makes your face flush and how often, because the same triggers drive new facial vessels
- Move rather than stand still where you can, and elevate legs at the end of a long day
- Come back for a top-up when new vessels appear rather than waiting for a full return
Worth knowing
- Treated vessels do not come back, and new ones can form over time [1]
- Results tend to last three to five years, and occasional maintenance is normal rather than a sign anything failed [1]
- Facial vessels and facial flushing often travel together, and treating only one leaves the other doing its work
- Legs and faces behave differently, and a plan for one does not transfer to the other
Treatments we offer
A laser tuned to the color of blood for individual vessels, and pulses of light for a general flush. Pick a treatment to see how it works.
What treatment costs
What a plan costs depends on the area, on how many vessels there are and on whether a general flush is being treated alongside them, which is worked out at the consultation. You get the plan and its cost before anything is booked.
What they are
Small surface vessels that have widened, showing through the skin
What they look like
Fine flat lines in red, blue or purple, often branching
The distinction that matters
Flat is a spider vein. Bulging is a different condition
How they are treated
A laser tuned to the color of blood, or pulses of light across an area
Spider veins frequently asked questions
Can I feel it, does the leg ache or swell, and is there a flush as well as the lines. The three questions above walk through what each answer means and where each one goes.
Offered at
Ready to clear them? Request an appointment
Fill out the form below, book online in Santa Maria (opens online scheduler), or give us a call. Cosmetic and aesthetic appointments need no referral. For medical dermatology, we are accepting new patients by referral from your primary care physician; send the referral across and then use the same form.
Cosmetic consultations are $125, paid at booking and credited toward the cost of treatment.
Sources and medical review
1. American Academy of Dermatology Association. “Lasers and lights: How well do they treat rosacea?” Reports that most patients see a 50% to 75% reduction in visible blood vessels after 1 to 3 treatments, that treatments are usually spaced 3 to 4 weeks apart, and that results tend to last 3 to 5 years, with treated vessels not reappearing but new ones able to form. https://www.aad.org/public/diseases/rosacea/treatment/lasers-lights · Medical Organization
2. American Academy of Dermatology Association. “How to select a sunscreen.” Broad spectrum, SPF 30 or higher, water resistant, reapplied every two hours outdoors and after swimming or sweating. https://www.aad.org/public/everyday-care/sun-protection/shade-clothing-sunscreen/how-to-select-sunscreen · Medical Organization
Content on this page is for educational purposes and is not a substitute for professional medical advice, diagnosis or treatment. The self-assessment described on this page narrows the possibilities and does not replace an examination. Not every visible vein is a spider vein, and leg veins in particular can sit downstream of a circulation problem that requires a different specialist. Laser and light treatment carries risks including temporary bruising, swelling and changes in skin color, and the risk is higher on tanned skin and on deeper skin tones. Results and the number of treatments needed vary from person to person. Individual results may vary. Cosmetic consultations are $125, paid at booking and credited toward the cost of treatment.