Drs. Anderson and Rahman consider sclerotherapy the best treatment for spider veins. In fact, a recent article in the New York Times stated that sclerotherapy is the “gold standard” of treatment for spider veins. During the sclerotherapy procedure, a tiny needle is used to inject a saline solution into the vein, causing it to shrink. Laser treatment is generally felt to be less effective than sclerotherapy. Topical treatments have never been shown to be of benefit.