Before treating surface spider veins, any underlying vein disease must be evaluated and treated first. Sclerotherapy is used to treat spider veins. This involves using a tiny needle to inject a small quantity of a solution that will shut down the vein. It is nearly painless, and even patients who are afraid of needles do very well with treatment. First, larger varicose veins are treated. Second, medium size surface feeder veins (called reticular veins) which are connected to spider veins are treated. Lastly, spider veins are treated within a few weeks. After treatment sessions, a compression stocking is worn for four weeks during the day. Injection sites may initially appear bruised or red. Within a few weeks, once the healing process in complete, most spider veins look better, although, continued improvement usually occurs over many months. Depending on the size and surface area of spider veins, multiple treatment sessions may be necessary.