Spider veins are a common cosmetic problem that occurs in men and women, but are most often seen in women. Hereditary factors, pregnancy, hormones and injury are the primary contributing factors in their development. Although these veins carry blood, they are not a necessary component of normal circulation and therefore can be treated.    Before and After Sclerotherapy Sclerotherapy is a technique that has been around for decades to treat spider veins and in some instances small and medium-sized varicose veins. This procedure involves the injection of a sclerosing solution directly into the small veins. As the solution comes into contact with the blood vessel, it produces a local irritation of the blood vessel causing it to seal off so that blood can no longer pass through the vein. After several weeks, many of the treated vessels will visibly disappear. In our office, we most commonly use a medication called Sotradechol, which is FDA-approved for the treatment. The procedure causes minimal discomfort and patients can return to their normal activities immediately. The only activity we limit is heavy pounding exercises and/or weight lifting for at least 48 hours after the treatment. It should be noted that multiple treatment sessions may be required to achieve the desired result, and in rare instances some vessels may not respond. Common side effects include mild bruising immediately after the treatment and a transient brown discoloration of the treated area for several weeks following the procedure. For these reasons, the fall and winter months are good times to work on this problem.