Unfortunately, creams and other topical medications tend to offer only mild improvements. You need a combination of Vascular Lasers and Sclerotherapy.
Spider Vein and varicose vein treatment options:
1. Vascular Lasers like Pulsed dye Lasers (eg. V Beam) and Copper bromide Lasers (e.g Dual Yellow/Pro Yellow) emit a specific wavelength of light that is absorbed by Haemoglobin in your blood vessels. This creates heat which causes narrowing and collapse of your prominent blood vessels.
Costs: >$400/area. Usually requires 2-4 sessions.
2. Sclerotherapy
For larger veins or veins that do not have adequate improvement using Vascular lasers, I suggest Sclerotherapy injections.
Cost: >$350/area. Usually requires 1-2 sessions.
Please consult a doctor for more details.