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" No one wants to spend summer sheathed in long pants or stockings, but it&amp;#039;s not easy to bare your legs after red and purplish veins have surfaced. &amp;quot;Most women will develop small &amp;#039;spider&amp;#039; veins, ropy varicose veins, or both at some point,&amp;quot; says Caron Rockman, M.D., a vascular surgeon at NYU Langone Medical Center in New York City. And although the two conditions are sometimes confused, the treatments for them are very different, as I learned when I took a closer look at clearing up my own legs. Spider Veins WHAT THEY ARE: Small blood vessels near the surface of the skin that are dilated and therefore visible. They can show up as a single thread or as a cluster, like a spiderweb (hence the name). Fortunately, they aren&amp;#039;t essential for circulation. THE TRIGGER: Heredity is the primary cause, though women are more susceptible to spider veins than men are. &amp;quot;It&amp;#039;s not completely understood why, but hormones may weaken the vessels during puberty and pregnancy,&amp;quot; says Dr. Rockman. Hot baths are not likely culprits, she says: &amp;quot;Vessels close to the skin dilate in heat, but the effect is temporary.&amp;quot; Sitting or standing for too long can exacerbate them, though.  THE TREATMENT: Sclerotherapy, a decades-old procedure, is still the gold standard, says Kenneth Mark, M.D., a New York City dermatologist. A solution is injected into the vein, causing it to collapse and be absorbed by the body. The good news: The latest solution doesn&amp;#039;t burn like the old saline. Since I&amp;#039;d had broken capillaries on my face zapped away, I asked about lasers for spider veins. &amp;quot;They&amp;#039;re less effective for treating larger veins and more painful,&amp;quot; Dr. Mark says. And they generally can&amp;#039;t be used on patients with dark skin. However, lasers work for vessels too tiny for injections \u2014 or for the truly needle-phobic.  MY CASE: Not being afraid of needles, and having lived through several summers with scattered squiggles on my legs, I opted for sclerotherapy. Dr. Mark and I identified the most obvious spots to treat on both legs, four altogether: my inside ankle, back of knee, back of calf, inner thigh. I felt a mild cramping with the biggest vein, but for the others just a fleeting pinch.  POST-PROCEDURE CARE: To heal, I wore thigh-high, medical-grade (16 to 20 mm HG) compression stockings made by Mediven for a solid week, day and night, except while showering. The pressure helps keep blood out of the veins so they disappear faster. I had bruising \u2014 not uncommon \u2014 and one tiny hard-to-heal spot at the injection site behind my knee. Dr. Mark also urged me to avoid the sun for three weeks and minimize exposure for three months after treatment, since UV light increases the odds of skin darkening. RESULTS: It can take weeks for the wall of the vein to completely collapse, which is why treatments are spaced three to four weeks apart. Veins may darken before they disappear, or they may need to be re-treated. I had to have one stubborn area redone (the veins were still visible). It was two months before I could appreciate the results, but at that point my legs looked much better. Of course, with the constant inspection, I couldn&amp;#039;t help but notice other little squiggles. That&amp;#039;s the nature of spiders: You can&amp;#039;t prevent new ones from cropping up. COST: While the injections are relatively painless, the price may sting. Because spider veins are a cosmetic concern, the treatment isn&amp;#039;t covered by insurance. A single session ranges from $200 to $1,000, depending on your geographic location and how many areas are being treated. (For example, a $250 syringe \u2014 the cost at Dr. Mark&amp;#039;s \u2014 only treats one or two clusters.) Next:   Quick Camouflagers  The post-op protocol for spider vein treatment \u2014 thigh-high stockings, long healing time, and no sun \u2014 pretty much dictates that the work be done in fall or winter. Luckily, while you&amp;#039;re waiting for next season or still considering whether to invest in treatment, you can buy time with makeup. Before a summer wedding or barbecue, try these options: 1. WHEN YOU HAVE 3 TO 5 DAYS: A fake tan will help cover up spider veins. Eliminate the fear factor by using a gradual tanner, like Jergens Natural Glow &amp;amp;amp; Protect Daily Moisturizer Sunscreen ($9, drugstores): Rub on daily as you would body lotion, and by the fifth day you&amp;#039;ll have the equivalent of one self-tanner application. For less color, use for fewer days. Bonus: This new formula&amp;#039;s SPF 20 also helps prevent UVA damage.   2. WHEN YOU HAVE 10 MINUTES: Apply a bronzing moisturizer or a temporary tanner, like Victoria&amp;#039;s Secret Beach Sexy Airbrush Instant Bronze Body Spray ($12, Victoria&amp;#039;s Secret), on your legs, layering to create an even tint, says Sarah Lucero, Stila global creative director. Then dab a concealer (the same thing you&amp;#039;d use for undereye circles) directly on spider veins with a concealer brush \u2014 a little goes a long way. Try NYX Waterproof Concealer Stick ($5.50, nyxcosmetics.com) and E.L.F. Concealer Brush ($3, Target). As Lucero says, and I concur, &amp;quot;it always does the trick!&amp;quot; The makeup will wash off when you shower. Varicose Veins WHAT THEY ARE: Ropy bulges, usually in superficial veins close to the skin, that are caused by faulty valves. These valves are meant to regulate blood flow back to the heart and prevent backflow, but when they don&amp;#039;t close properly, blood can pool in the lower legs, which can also cause swelling and heaviness in the ankles. THE TRIGGER: Like spiders, varicose veins tend to run in families and to show up in women more than in men \u2014 usually appearing in a woman&amp;#039;s 30s or 40s, says Brian DeRubertis, M.D., assistant professor of surgery at the David Geffen School of Medicine at UCLA. Obesity or a sedentary lifestyle can contribute to their development \u2014 as can pregnancy, since it leads to extra pressure on veins. (Sometimes a vein that becomes varicose during pregnancy reverses itself afterward \u2014 this happened to me.)  THE TREATMENT: A sonogram can locate the leaky valve, says Dr. Rockman. Interestingly, that weak valve won&amp;#039;t necessarily be at the location of the bulging vein; an unsightly vein in a calf might be treated by closing off a vein in the thigh. &amp;quot;Gone are the days when you needed surgery to strip veins and a hospital stay,&amp;quot; says Dr. DeRubertis. Now, with endovenous ablation, you&amp;#039;ll be in and out in less than an hour. Under a local anesthetic, a catheter inserted into the vein heats the lining, causing it to shrink. &amp;quot;In half of patients, the vein collapses and disappears completely; in the other half, the vein flattens but is still visible,&amp;quot; says Dr. DeRubertis. &amp;quot;We can remove those defunct veins, making a tiny incision and pulling them out.&amp;quot; The recovery time for both procedures is minimal: one or two days off your feet and, as with sclerotherapy, no sun. As for preventing additional varicose veins, compression stockings may help when you know you&amp;#039;re going to be standing or sitting for long periods (say, on an airplane). MY CASE: I&amp;#039;ve often felt heaviness in my legs and have noticed a network of green veins snaking up my inner right leg and my outer left leg. Though these veins aren&amp;#039;t distended yet, I had my valves checked with a sonogram (it takes about 20 minutes). As it turned out, my valves worked fine \u2014 I didn&amp;#039;t have varicose veins. Dr. Rockman explained that it was possible to feel heaviness in the legs for other reasons, including simple fatigue. She advised elevating my legs when possible to lessen the pressure, which can also help relieve varicose veins.  COST: Both diagnostics and treatment for varicose veins are generally covered by insurance. "^^<http://www.w3.org/2001/XMLSchema#string>
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