Wrinkles are bad enough, but there’s nothing like ugly red or purple spider veins to remind you you’re aging (which weakens veins) and send you to the store for longer shorts or, for women, bathing suit cover-ups.

If you want to get rid of spider veins, you have two choices: sclerotherapy and laser therapy. Both have advantage and disadvantages, and one is probably more appropriate than the other depending on where the veins are located.

Before you rush in, learn the risks. You might just decide that covering up is the best option after all.

Why do I have spider veins?

These tiny, enlarged veins that crop up just below the skin are caused by a backup of blood in the veins. You may be genetically prone to developing them (thank weak vein valves). Prolonged sitting and standing, pregnancy, weight gain and even excessive sun exposure can increase the chance you’ll get them. So can taking birth control pills and other medicines that contain estrogen and progesterone. Do you favor high heels? Those extra inches can spike your risk, too.

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Sclerotherapy: the “gold standard”for spider veins on the legs

Usually the choice for spider veins on the legs, sclerotherapy works by closing off blood vessels. A liquid or foam is injected into visible veins using a hair-thin needle, causing irritation that makes the vessel collapse. Blood flow stops, and the vein slowly fades from sight over several weeks.. You won’t need general anesthesia for this doctor’s office procedure, which takes about 15 minutes. But multiple treatments are sometimes necessary.

The risks: Bruising may last for a few days or weeks, and the injection area may also hurt for a few days.

A minority of people end up with brownish, discolored spots or lines on skin in the treated area. This hyperpigmentation almost always goes away, but for some people that can take weeks or months. Only about one percent of people treated report discoloration a year after treatment.

About 10 percent of people develop “telangiectatic matting,” a network of tiny new spider veins in the area of the injection. It usually fades away in three to 12 months, but in some cases it can be permanent.Rare side effects include persistent pain, an allergic reaction or small skin ulcers.

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Laser therapy: top choice for spider veins on the face

Spider veins on the face are usually too small and too close to the skin’s surface for sclerotherapy. Instead dermatologists use a variety of laser therapies to pinpoint and destroy these veins, which slowly shrink and fade away, according to the American Society for Dermatologic Surgery.

The type of laser the doctor uses will vary based on the size of the blood vessels, the overall size of the treatment area and its location. For example, spider veins in the folds of skin around the nose often resist laser treatment and may need a more powerful laser. Spider veins on the neck or chest, where thinner skin is prone to scarring, may need a milder treatment, according an article published in the journal Seminars in Plastic Surgery.

The risks: Short-term side effects include bruising, inflammation, swelling and stinging that can last for hours or days.

Patches of brownish, discolored skin, are common especially in people with darker skin tones. These usually fade over several weeks or months, though the risk for permanent discoloration is higher if you have dark skin.

Laser treatments that penetrate more deeply into the skin carry a higher risk for scarring. “Even an experienced practitioner may inadvertently cause painful skin burns" that can lead to permanent dark or light spots or patches of skin, notes a 2014 review on the medical website Medscape by a team of dermatologists from leading universities.

Thinking twice about laser therapy? Cosmetics can often disguise spider veins on the face completely, and that's enough for many people.

If you’re considering sclerotherapy or laser therapy, look for a board-certified dermatologist — a doctor who treats skin conditions — who is also a dermatologic surgeon.

Spider veins or varicose veins?

Varicose veins are like spider veins on steroids. These enlarged veins look like thin cords bulging on the surface of the skin. Large varicose veins are sometimes treated with surgery, which involves more serious health risks than either laser treatment or sclerotherapy.

Varicose veins sometimes signal a problem in the circulatory system, particularly if they are accompanied by cramping, throbbing and pain that's exacerbated by prolonged sitting or standing. In rare cases, they may lead to leg ulcers or blood clots, which require emergency treatment.

Spider veins are rarely hazardous, but in very rare cases, they may be signs of a more serious circulatory problem as well. If you have spider veins on your legs and you experience ongoing cramping or throbbing leg pain, talk to your doctor. 

Sari Harrar is an award-winning health, medicine and science journalist whose work appears in Dr. Oz The Good Life magazine, Good Housekeeping, O--Oprah Magazine, Organic Gardening and other publications.