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Spider Veins
Spider Vein Treatments: Laser Spider Vein Removal and Sclerotherapy Vein Injections



Are you one of the many women who have spider veins on their legs?  If you are, there are many treatments available for you.  Dr. Raffy Karamanoukian now provides comprehensive evaluation and treatment for spider veins on the legs and thighs.  Most treatments are simple and require no surgery.  Dr. Karamanoukian is the only surgeon in the United States who holds the distinct privilege of board certification in Plastic Surgery and Phlebology (Vein Surgery).  He employs the latest advancements in spider vein treatment and is the surgical director of the Santa Monica Vein Center. 

best sclerotherapy los angeles


The causes of spider veins and varicose veins vary from person to person.  Not everyone will have the same risk factors for spider veins, and the common denominators include family history and your overall lifestyle and activity level. Here are some common causes for unwanted spider veins.

  1. Genetics – family history of spider veins.
  2. Being female – female hormones play a major role in spider and varicose vein formation.
  3. Pregnancy – again, female hormones play a major role.
  4. Oral contraceptives - influence of female estrogen and progesterone on spider veins.
  5. Occupation – prolonged sitting or standing can contribute to spider and varicose vein formation. 
  6. Trauma - injuries are associated with neovascularization and spider vein development.


Of the many reasons to have spider veins, your family history and activity level will largely determine the extent to which you will develop spider veins on your legs and thighs.  Patients who have spider veins on the feet may have additional underlying vein problems that should not be ignored.  Venous reflux, a medical condition that can affect overall vein health, can cause significant problems with the development of varicose veins and spider veins.  




Asclera before and after spider vein treatment Los Angeles




Sclerotherapy is a very effective treatment for spider veins which has been around for decades.  Unlike the saline injections and sclerotherapy that was performed ten or twenty years, the newer sclerotherapy agents used by Dr. Raffy Karamanoukian are more effective for medium sized veins and have less pain and complications.  Dr. Karamanoukian has been featured on popular media shows such as the Emmy award winning The Doctors television show, Fox TV, Associated Press, and KTLA for his innovative approach to spider and varicose vein injections. This makes Dr. Raffy Karamanoukian's office one of the leading spider vein treatment centers in the Beverly Hills, Los Angeles, and Santa Monica areas.  


Sclerotherapy is designed to eliminate unwanted spider and varicose veins in the feet, legs, and thighs.  The treatment is performed by injecting a tiny amount of medicine into an unwanted spider or varicose vein.  Once injected, the medicine destroys the inner cell lining of an unwanted vein and begins the process of absorption wherein the body naturally closes off and absorbs the unwanted vein.  The procedure can be as simple as a needle poke, and works effectively to improve the cosmetic appearance of the legs and thighs.  There are many new options for sclerotherapy that reduce risks and offer less pain than those performed a decade or two ago.  Although saline or salt water injections are useful, there are now better and safer options for spider veins that you should consider. 


Microsclerotherapy is a newer type of spider vein treatment that utilizes an ultrafine needle to minimize pain and discomfort with traditional sclerotherapy.  Compared to traditional saline or salt-water spider vein injections, microsclerotherapy is relatively painless and has a higher safety profile.  Microsclerotherapy was developed in response to patients who have a needle phobia who still require injection treatment.  Rather than the traditional methods of spider vein injection, microsclerotherapy uses a tiny needle in order to treat superficial spider veins and subdermal reticular veins.  Treatments take approximately twenty to thirty minutes to perform and patients are allowed to return to normal, non-strenuous activities after spider vein treatment. The benefits of microsclerotherapy include its high efficacy with superficial spider veins in the absence of venous insufficiency, no incisions and minimal risk of scarring, outpatient procedure with minimal downtime, low risk profile, and less pain compared to traditional saline or salt-water spider vein injections. 



During the treatment, the Palomar system will be directed towards the spider veins and the pulsing of the laser will heat up and destroy the spider veins altogether.  Most patients will see immediate improvement, although this does depend on the type of vein treated.


With the Palomar Spider Vein Treatment, the surrounding skin may turn pink or red for up to 24 hours, followed by some itching and mild tingling of the skin.  Dr. Karamanoukian advises patients to apply Scleroquin cream on the treated areas to minimize the risk of hyperpigmentation and to use compression stockings to reduce the recurrence of spider veins.




Asclera is an FDA approved medicine that was recently approved to treat spider veins and small varicose veins. If you are in the Los Angeles area, Dr. Raffy Karamanoukian can provide you with a comprehensive evaluation of your veins and recommend whether Asclera or sclerotherapy is the right option for you vs. laser spider vein removal.  Dr. Karamanoukian is one of the top vein specialists in the Los Angeles, Santa Monica, and Beverly Hills areas. Patient satisfaction with Polidocanol Asclera injections is very high, with 86% of patients being satisfied or very satisfied with their Asclera treatment. 

Asclera is a prescription medication that is used to treat the following types of veins:

  1. Uncomplicated spider veins (very small veins less than 1 mm in diameter).
  2. Uncomplicated small varicose veins (1 to 3 mm in diameter) that are also known as reticular veins.  

Asclera and other detergent type sclerotherapy agents work to damage the inner endothelium of an unwanted vein once the medicine is injected into the vein.  Once damaged, the veins no longer are active and are eventually absorbed by the body.  Each sclerotherapy session with Dr. Karamanoukian in Los Angeles is about 15 to 45 minutes long and is performed as an outpatient vein treatment.  Patients are able to drive home immediately after injection with sclerotherapy.  Other options for vein treatment include laser vein removal, endovenous ablation, and surgery.  Dr. Raffy Karamanoukian will discuss these alternatives with you during your vein consultation.


Asclera has a high treatment success rate according to research studies evaluated by Dr. Raffy Karamanoukian.  In one study, Asclera showed good or complete treatment success in 95% of patients as rated by physicians.  Asclera treatment showed statistically signficant benefits when compared to placebo for the primary efficacy criterion "improvement of veins."


Polidocanol is an FDA approved medicine for sclerotherapy.  There are different brands of polidocanol including Asclera, available in the United States.  Polidocanol is a safe sclerotherapy agent that is injected small caliber veins during sclerotherapy.  The mechanism of action of polidocanol is to damage the endothelium or inner cell lining of an unwanted spider or varicose vein.  Once the endothelium is damaged the body begins the process of collapsing the unwanted spider vein or varicose vein.  Over time the collapsed vein would be replaced with normal tissue.

Spider vein injections are relatively painless and require minimal downtime after the procedure.  Unwanted spider and varicose veins can be treated with sclerotherapy, wherein small spider veins are injected with an FDA approved medicine to collapse the vessel.  A typical sclerotherapy session last approximately 15 to 45 minutes, depending on the severity of the spider and varicose veins and the complexity of the spider vein or varicose vein network.  One injection of sclerotherapy is usually administered about every inch of a spider vein or varicose veins.  Treatments require minimal recovery and patients are able to return to normal, non-strenuous activities, after the procedure. Cost of spider vein removal.


Asclera is classified as a sclerosant by the FDA because it can effectively eliminate spider veins and thread veins underneath the skin.  Clinical studies have shown that this class of sclerotherapy agents are safe.  Other medicines in the class of 'chemical detergent' sclerotherapy include sodium morrhuate, polidocanol, and STS sclerosants.  The mechanism of action for this type of scerotherapy is protein denaturation.


Sclerotherapy and microsclerotherapy treatments are designed to be outpatient procedures with minimal downtime.  Patients who undergo sclerotherapy or laser spider vein treatments are encouraged to resume their normal activities, barring strenuous exercise for one week. Ambulation and aerobic exercise helps speed recovery and minimizes the risk of blood clots in the veins.  Our office encourages normal activity, ambulation, and a quick return to work and home activities. You will also be scheduled for a one month follow-up appointment after your sclerotherapy session.  In addition, routine use of Scleroquin will help promote a normal recovery and minimize the risk for hyperpigmentation of the skin. Scleroquin works at the level of the enzyme tyrosinase in order to decrease the deposition of melanin by inflamed melanocytes within the skin.  


Dr. Karamanoukian is a Los Angeles and Beverly Hills spider vein specialist, and also performs treatments for varicose veins in Los Angeles.  Contact our office for Los Angeles EVLT, Beverly Hills EVLT, and Santa Monica EVLT.  Laser spider vein and laser varicose vein procedures performed in Los Angeles, Beverly Hills, and Santa Monica. Thank you for visiting ; Schedule a consultation by calling our office at (310) 998-5533. 




  1. What is the recovery like after sclerotherapy? Recovery after sclerotherapy is relatively quick as you may resume normal, non-strenuous activities immediately after the procedure.  You may develop some minor bruising and redness on the sclerotherapy site but that will resolve relatively quickly.  Depending on the size of the blood vessels being treated, you may need to wear compression stockings for a few days to one week.  Bruises will soon disappear by the end of the first week and there may be some left over veins that will take some time to be resorbed by the body.  
  2. What are some conservative alternatives to sclerotherapy? The most common conservative treatments for spider veins in the the legs include EXERCISE, STOCKINGS, AND ELEVATION.  Aerobic activity, compression therapy, and elevation of the legs at night can all help improve the quality of the veins. 
  3. How much does spider vein removal cost with laser in Los Angeles?
  4. Board certified vein specialist in Los Angeles-Choosing an expert in spider vein treatment: It is sometime difficult to choose an expert for varicose vein treatment, as the available treatments have changed dramatically over the last decade.  The American Board of Phlebology (vein surgery) now provides board certification to physicians who have demonstrated expertise in vein disease.  Dr. Raffy Karamanoukian, a board certified surgeon is a diplomate of the American Board of Phlebology and the American Board of Plastic Surgery.  He is the surgical director of the Santa Monica Vein Center and has specific expertise in the management of varicose veins, spider veins, bulging varicose veins, and venous insufficiency.  He has been featured on popular television shows including The Doctors and Fox Television, demonstrating his method of varicose vein and spider vein treatment.  The available treatment at the Santa Monica Vein Center includes injection sclerotherapy, spider vein removal with pulsed dye laser, V Beam laser spider vein removal, EVLT, and VNUS treatment.  Dr. Karamanoukian will evaluate your specific concerns and recommend a noninvasive treatment for your varicose or spider veins in his Los Angeles office.  If you have specific questions about varicose vein treatment or spider vein treatment, including insurance coverage or cost of varicose vein treatment, please call our Los Angeles patient care coordinator at 310-998-5533.  Schedule an appointment today for vein treatment.
  5. Can exercise prevent varicose vein from getting worse? Los Angeles vein doctor. Spider and varicose veins can occur as a result of genetics, family history, activity level, and hormonal influences.  It has been found that women have a higher rate of varicose veins and spider vein development, largely as a result of genetic factors and hormonal load during pregnancy and childbirth.  Activity levels and level of exercise can also determine how quickly one will develop varicose veins.  A decrease in ankle flexion and overall reduction in aerobic exercise can lead to a steady progression in preexisting varicose veins.  Problems of venous insufficiency can be exacerbated by decrease exercise regimen.  Some patients, however, can minimize their genetic predisposition to varicose veins by following a regimented aerobic exercise program.  The progression of varicose veins and venous disease can go unnoticed for years or decades, but can be improved with a combination of a healthy exercise regimen and preventative measures.  Dr. Raffy Karamanoukian is an expert varicose vein surgeon practicing in Los Angeles.  He is a surgical director of the Santa Monica Vein Center and can provide you with specific options for both varicose vein prevention as well as varicose vein treatment.  He performs injection sclerotherapy, laser based spider and varicose vein removal, and endovenous EVLT and VNUS treatment.  Please call our Los Angeles Plastic Surgery office at 310-998-5533
  6. Who are the best patients for laser spider vein removal? Laser treatment of spider veins is most effective for small thread like blue or red veins that appear underneath the skin on the legs and thighs.  These small and superficial spider veins are often termed thread veins in different parts of the country.  The gold standard for treatment for small spider veins are a set of high-tech lasers that can effectively eliminate and collapse small veins underneath the skin.  Patients who are ideal candidate for laser vein treatment include those that have purely cosmetic vein concerns, a fear of needles and injection sclerotherapy, and those with who have successfully been evaluated for deeper vein problems such as venous reflux and venous insufficiency.  Laser therapy is very effective in small spider veins or blood vessels known as telangiectasias, which are small blood vessels less than 0.5 mm in diameter.  Larger spider veins and reticular veins are less commonly treated with lasers, but Dr. Raffy Karamanoukian at the Santa Monica Vein Center can help you evaluate and treat larger varicose veins and reticular veins.  Varicose veins and reticular veins are often treated with several different modalities including sclerotherapy, micro phlebectomy, and endovenous ablation.  The treatment of small spider veins with laser is very targeted and is appealing for those patients who have facial spider veins, rosacea, nasal spider veins, and spider veins on their legs and thighs.  If you have questions about laser spider vein removal, and wish to contact our Los Angles vein clinic, please call our office at 310-998-5535 and speak to our vein treatment patient care coordinators to schedule a consultation.
  7. How does laser spider vein therapy work?  The Santa Monica Vein Center is one of the premier clinics for spider vein treatment in the Los Angeles area.  The treatment of spider veins and small thread like veins underneath the skin begins with careful evaluation to determine whether there is a cosmetic vein problem versus an underlying problem with the vein valves in your deeper veins.  If during your spider vein consultation with board certified vein surgeon Dr. Raffy Karamanoukian it is determined that you have a cosmetic spider vein issue, a laser therapy will be recommended in which the spider veins are eradicated and eliminated underneath the skin.  Laser vein treatment uses a technique known as selective photothermolysis in which high-energy light is directed onto the spider vein in order to heat up the veins and collapse them within the skin.  Spider vein treatment is usually a longterm solution for patients and is effective as a long term strategy in people with isolated cosmetic spider vein issues.  If you have questions about spider vein treatments and wish to discuss your options for laser spider vein removal verus injection sclerotherapy, please call our Los Angeles plastic surgery office at 310-998-5535.
  8. What are the top three causes of spider and varicose veins? Finding a varicose vein doctor in Los Angeles. Spider veins and varicose veins vary in terms of size and prominence under the skin.  Thread like spider veins are barely noticeable in some patients while larger bulging varicose veins can appear prominent under the skin.  The presence of spider or veins on the legs and thighs can be accompanied by symptoms such as pain, itching, and burning.  Most common causes of spider and varicose veins in the general population include family history, genetic influences, occupation and activity level, and a previous history of trauma.  Dr. Raffy Karamanoukian is a board certified vein specialist and can provide you with specific options for diagnosis and treatment of varicose veins and vein problems.  Please call our office at 310-998-5533. 




The latest techniques in varicose veins and spider vein treatment allow for less invasive procedures when compared to old fashioned vein stripping and vein surgery.  The introduction of EVLT endovenous laser treatment, ultrasound guided sclerotherapy, VNUS closure, endovenous vein treatment, sclerotherapy, and microphlebectomy all allow for minimally invasive approaches to cosmetic vein and medical vein procedures.


Choosing a vein center is an important part of your overall treatment plan.  The Santa Monica Vein Center is a comprehensive vein clinic located in the Los Angeles area that uses state of the art equipment and the most high tech approaches to the management of spider veins, thread veins, facial veins, under eye veins, and medical bulging varicose veins.  Our center specializes in the treatment of venous insufficiency, vein disease, venous reflux, bulging varicose veins, and cosmetic facial and legs veins.  One of the main reasons to choose Dr. Raffy Karamanoukian, a board certified vein surgeon, is his expertise in the management of complex vein disorders and his emphasis on noninvasive vein treatment.  He utilizes ultrasound therapy, laser therapy, RF therapy, and microsurgery in the management of vein problems.  Dr. Karamanoukian is a diplomate of The American Board of Phlebology (Vein Surgery), a Fellow of The American College of Surgeons, and an Active Member of The American College of Phlebology.  He provides expertise in the management of vein disease and has performed thousands of vein procedures in the last seven years.


Dr. Karamanoukian has been featured on popular television shows including Fox T.V., KTLA, Good Day L.A., and the popular medical television show The Doctors, demonstrating his unique approach to vein problems.  He uses the most advanced laser system to treat facial spider veins, facial veins, legs veins, and bulging varicose veins.


Our center is accredited by the AAAHC and our facility is equipped with the highest standards of safety for ambulatory surgical centers.


Dr. Karamanoukian is an avid lecturer and scientific author.  He has lectured on the management of varicose veins and spider veins to an international group of physicians and has lectured at national meetings regarding vein care.  He has been featured in multiple scientific journals demonstrating his unique approach to minimally invasive surgery.


The Santa Monica Vein Center is committed to the most advanced therapies for varicose veins and spider veins.  Our office provides laser treatment, ultrasound treatment, radiofrequency treatment, and microsurgery treatment of varicose veins and spider veins.  If you have cosmetic spider vein issues, our knowledgeable staff and surgeon can help you address these problems with a cosmetic prospective.  Dr. Karamanoukian is board certified by The American Board of Plastic and Reconstructive Surgery and spends a good percentage of his time devoted to cosmetic and aesthetic surgery.  Our office accepts most major forms of health insurance and the staff at the Santa Monica Vein Center can help you navigate through the process of obtaining insurance authorization for your procedure.


If you are considering treatment for varicose veins, the Santa Monica Vein Center serves the Greater Los Angeles area including the Westside, Santa Monica, Marina Del Rey, Beverly Hills, Brentwood, Hollywood, Studio City, Sherman Oaks, Encino, Tarzana, Thousand Oaks, Agoura Hills, Northridge, Chatsworth, and Simi Valley.  There is absolutely no reason to forego treatment for varicose veins as newer treatments are less invasive with quicker recovery times and a quick return to normal activities.


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