What are spider veins?

Spider veins are small veins in the skin in which blood has pooled, causing the veins to dilate and become visible. Spider veins, also called telangiectasia, appear as thin red, purple or dark blue lines, frequently in clusters.

Spider vein can develop anywhere on the body, but are very common on the thighs, calves and ankles, particularly in women.

What are symptoms of spider veins?

Spider veins usually do not cause any symptoms and are purely a cosmetic concern. Spider veins can occasionally cause symptoms such as:

  • Itching
  • Burning
  • Bleeding

In some cases, spider veins can signify the presence of chronic venous insufficiency in deeper leg veins.

What causes spider veins?

Gravity, stagnant blood, and poorly functioning one way valves in the veins causes spider veins.

Normal veins in the skin are too small for the eye to see. If the tiny one way valves in the skin veins stop working properly, then blood backs up and pools in these veins, causing them to dilate and become visible as spider veins.

What are reticular veins?

Spider veins drain blood into slightly larger veins called reticular veins, which can become dilated and appear as slightly larger bluish veins. Spider veins and reticular veins are frequently found together on the legs. Abnormal reticular veins can act as “feeder” veins for the spider veins. In this case, it is important to treat the feeder veins as well as the spider veins.

Spider veins are less that one millimeter in diameter, reticular veins are 1 to 3 millimeters in diameter, and varicose veins are greater than three millimeters in diameter.

What are the risk factors for developing spider vein?

The risk factors for developing spider veins are:

  1. Chronic venous insufficiency. When blood pools in the deeper leg veins, such as the saphenous veins, the increased venous pressure can lead to spider veins.
  2. Hereditary. Like many disorders, if you have a parent or other close relative that has spider veins, you are more likely to get them.
  3. Gender. Women develop spider veins more commonly and at a younger age than men due to female hormones. Estrogen and progesterone can cause veins to dilate and weaken the one-way valves leading to the pooling of blood.
  4. Age. The older we get, the more time for the one-way valves to wear out and spider veins develop.
  5. Standing for long periods of time. For those people that stand for long periods of time, such as teachers, retail sales, food industry, hair stylists, etc., gravity tends to pull blood towards the ankles. Gravity plus improperly functioning vein valves leads to blood pooling and dilated veins.

Spider Vein Treatments

Once you get spider veins, they will not go away unless you get them treated.

There are two general methods of spider vein treatment:

  1. Sclerotherapy. Sclerotherapy is when a medication is injected into the spider veins. The medication (the sclerosing agent) causes the vein to close down and over time the vein is absorbed by the body and fades away. Sclerotherapy is a slow process. It can take many months and a number of treatment sessions to get spider veins to disappear.
  2. Laser treatment. Surface laser therapy can also be used to zap spider veins. The laser energy is absorbed by the blood in the spider veins, which causes the vein to close down and be absorbed by the body. Spider veins can be resistant to treatment, so as with sclerotherapy, more than one laser session is frequently needed to get satisfactory results.

What are saline injections?

One type of sclerosing agent is hypertonic saline. This solution is 25 times more concentrated than normal saline and is effective at treating spider veins. However, it is it is can be painful when injected. And it can cause skin ulcers and other complications if some of the solution extravagates into surrounding tissue. At VEINatlanta we do not use hypertonic saline for these reasons. We use Asclera, which is an FDA approved brand of the sclerosing agent polidocanol.

Do spider veins come back?

If spider veins are treated thoroughly, they are absorbed by the body so they do not come back. However, in cases of partial treatment, the vein may the vein can heal itself and re-appear. Also, over time, new spider veins can develop near the previous ones. Patients may think the same spider veins came back, but they are actually different veins. If someone is prone to spider veins, they may develop new ones over the years.

If you have a lot of spider veins, they can be difficult to treat. You may require multiple treatment sessions to fully remove them
Although both laser and sclerotherapy are effective treatments for spider veins, in some cases, they do not work. It is important to talk to your doctor about what you can expect before your first procedure.

How can I prevent spider veins?

It is difficult to prevent spider veins, especially if you have a predisposition to developing them (see risk factors). Regular use of compression stockings over many years is the best prevention.

Food supplements such as diosmin (a bioflavonoid derived from citrus fruit) and horse chestnut extract, have been shown to help with reduction of spider veins. For this to be effective, these supplements need to be taken daily for life.

People with significant, symptomatic chronic venous insufficiency, should seek treatment for this condition before treating spider veins.