Spider Veins

Spider veins (telangiectasias) are small, thin blood vessels visible beneath the skin. They usually develop on the face or legs, and may look like a series of thin tree branches or strands of a spider web. Although most spider veins are only a cosmetic issue, for some people they can cause uncomfortable symptoms such as aching, burning, swelling and leg-cramping.

Spider veins are extremely common, affecting nearly half of the adult population of the United States. Many patients are bothered when spider veins develop on prominent areas such as the legs or face and seek treatment to eliminate them. Many spider-vein treatments are highly effective and minimally invasive, offering aesthetically pleasing results without painful or lengthy downtime.

Causes of and Risk Factors for Spider Veins

Spider veins develop from a backflow of blood in the veins. This condition, which results from damaged valves in the veins, is called "venous reflux." As blood collects in these veins, their walls distend. This increases the size of the veins, and makes them visible under the surface of the skin. Risk factors for developing spider veins include the following:

  • Increasing age
  • Hormonal changes
  • Pregnancy
  • Obesity
  • Lack of exercise
  • Sun exposure

Having a family history of spider veins is also a risk factor for developing them.

Diagnosis and Treatment of Spider Veins

Spider veins, which are diagnosed through a physical examination of the patient, an analysis of symptoms and, sometimes, diagnostic ultrasound, can be treated in a number of ways, all of which are minimally invasive.

Compression Stockings

The simplest solution for treating spider veins is for the patient to wear compression stockings, which put pressure on the affected veins and promote blood flow back to the heart. This method is designed to control the symptoms of spider veins, not remove them.

Sclerotherapy

Sclerotherapy involves injecting a sclerosant, a solution designed to collapse them, into the veins. This procedure is performed in a doctor's office. Each treatment takes approximately one hour, and a typical patient requires two to four treatments.

Endovenous Laser Treatment

Endovenous laser treatment (EVLT), which is also called "laser ablation," consists of inserting a catheter with a laser probe attached to it directly into the vein. The laser heat seals off the damaged vein and diverts blood flow to healthier vessels.

The above treatments have fewer side effects, cause less pain and have shorter recovery times than traditional surgical-vein-removal procedures.

What Do Spider Veins Look Like?

Spider veins tend to develop on the lower extremities, including the ankles and anywhere on the legs. They may congregate around the knees. Some say that this happens when a person has a habit of sitting with their legs crossed. Regardless of where they occur, spider veins typically accumulate in small groups of red, blue, and purple squiggly lines. They may be very short in length or may spread out several inches from a center point. What gives them their name is the way in which spider veins occur in a web-like pattern. 

Who Gets Spider Veins?

Anyone can get spider veins. They typically occur during adulthood when a person begins to show signs of venous insufficiency. Like varicose veins, spider veins indicate that the blood is not circulating optimally through a few veins. In the case of spider veins, these are the tiniest capillaries that are located just under the skin. There may be a few factors that make a person more susceptible to developing spider veins. These include weight, pregnancy, hormone changes, standing or sitting for prolonged periods, and age. If you are concerned about the sight of spider veins on your legs, we suggest that you implement healthy lifestyle habits now to reduce your risks of developing more in the future. Walking at least 30 minutes a day and elevating your legs in the evenings are two good ways to foster optimal circulation up and out of your legs.

What Causes Spider Veins?

Spider veins become visible because they fill with blood that isn't moving forward as it should. All of the veins in the body, even the smallest capillaries, have valves that open when blood pushes forward and close when it stops. This is intended to naturally prevent blood from pooling anywhere along a vein. For various reasons, from hormone changes to excessive pressure on the low body, some valves may fail to close all the way. This failure to seal off blood results in small amounts sitting in one part of the vein. This makes the vein visible and also can cause it to swell.

Will My Spider Veins Go Away without Treatment?

If you have developed spider veins during pregnancy, there is a chance that they will go away once your weight and hormones return to normal. Otherwise, there is very little chance that your condition will improve on its own. While we recommend leading a more active lifestyle to prevent the worsening of spider veins and the development of new visible veins, walking, exercising, and elevating your legs will not get rid of the spider veins that you already have. The purpose of losing weight and maintaining a healthy weight for your body frame is to alleviate the excess pressure and stress that is on the veins in your legs. This may keep your current condition under control but will not reverse it.

What Treatment Options Are There?

At Vascular Institute of Virginia, we offer two proven treatments to eliminate frustrating spider veins. These include sclerotherapy and endovenous laser treatment.

Sclerotherapy is a longstanding medical treatment for dysfunctional spider veins and varicose veins. Doctors have safely performed this procedure for many decades. Sclerotherapy is performed in the office while you sit or lie down comfortably. Using a very small needle, the doctor injects your spider veins with a special medication. The medication causes the inner lining of the veins to stick together, closing off the vein. With the vein close, blood redirects to nearby capillaries and the once-visible vein disappears.

Endovenous laser treatment (EVLT) ultimately does the same thing as sclerotherapy but uses a different modality. EVLT is also performed in the office. In this procedure, the doctor inserts a tiny laser probe into the spider veins. The probe administers controlled heat to the veins, causing them to close. Blood diverts to nearby vessels, leaving the closed-down veins to gradually fade away.

Prevention of Spider Veins

Although there is no sure way to prevent spider veins, making certain lifestyle changes may reduce the risk of developing them. Lifestyle changes include losing weight, exercising regularly, and wearing support stockings and comfortable, flat shoes. It is also important to move the legs frequently, especially during long periods of sitting or standing in one place.

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