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Spider Veins: Causes, Treatment and Prevention

Spider veins usually develop on the legs and face as a red or blue spiderweb when a small group of blood vessels located just beneath the skin surface dilate and weaken. Spider veins are similar to varicose veins but varicose veins are larger and may become raised above the skin surface. This common and in most cases harmless condition is also known as telangiectasias or sunburst varicosities. Spider veins may cause a dull, aching sensation after prolonged standing. They tend to affect women more than men as more than 40% of women will suffer from abnormal leg veins by the time they are in their 50s.

Causes of Spider Veins

The valves within the veins keep blood moving back toward the heart. When these valves weaken, they allow some of the blood to leak backwards, causing them to become clogged. Because of this congestion, the vein may enlarge into a spider vein. Why this happens is not exactly known but heredity appears to play a strong role.

An increased volume of blood during pregnancy as well as hormonal changes during puberty, pregnancy and menopause can contribute to the development of spider veins. Other factors that may add to the problem include hormone replacement therapies, birth control pills and wearing girdles or hosiery held up with tight elastic bands.

Additional factors that raise the risk of developing spider veins include aging; injuries to the leg that damage the veins; sedentary lifestyle and long periods of sitting or standing which impair good blood circulation and cause blood to pool; excess weight increasing the pressure on the veins; and sun exposure contributing to the formation of spider veins on the nose and cheeks. In rare cases, spider veins may signal more serious medical conditions such as severe venous disease or liver disease.

Symptoms of Spider Veins

The dilated vessels that make up spider veins often resemble a spider web or a tree with branches. They may appear as short, unconnected lines or as groups of veins connected in a “sunburst” pattern.

Spider veins may be sometimes barely noticeable but may also cover a large area of skin. Although they commonly appear on the face (especially in people with light colored skin), spider veins more often develop on the legs because the pressure on the valves within leg veins is greater, causing the veins to work harder to overcome these forces.

This condition is usually considered medically harmless, though some patients may experience a dull, aching sensation after long periods of standing. In some patients, the discomfort associated with spider veins may be more intense, causing a throbbing and burning sensation.

However, in most severe cases, the condition may result in venous insufficiency, in which the veins become so clogged that they obstruct blood returning to the heart. This can lead to developing varicose veins and blot clots.

Diagnosing Spider Veins

A physician will examine the legs or other areas where the spider veins are present. Occasionally, x-ray or ultrasound may be ordered to help assess vein disorders and the severity of the problem.

Treatment of Spider Veins

There are several effective treatment options available to patients with spider veins. The most conservative treatment involves support hosiery, which gently compresses the leg muscles, thus helping the veins to move blood more easily. However, many patients choose sclerotherapy instead of wearing uncomfortable compression stockings. During this procedure, a dermatologic or a vascular surgeon injects a solution into the spider vein. The vein closes up or collapses and turns into scar tissue which is then absorbed by the body over a period of several months. Blood that previously had traveled through the spider veins will shift to other nearby blood vessels. This painless and inexpensive procedure is the most common method used today for the treatment of spider veins. It is usually performed on an outpatient basis, requires no anesthesia and rarely results in scarring.

Up to three sessions, each lasting between 15 and 45 minutes, may be necessary to successfully treat a spider vein. Any larger varicose veins that are attached to spider veins will likely be treated at the same time. Possible side effects, though rare, may include bruising, swelling, redness, itching, soreness, muscle cramps and a stinging sensation at the injection sites.

Other treatment options available to patients with spider veins include:

  • Laser surgery – uses the heat of high-intensity light to destroy abnormal veins.
  • Electrodesiccation – the use of electrical current to seal off veins.
  • Ambulatory phlebectomy – involves the removal of superficial veins through a series of small incisions along the path of an enlarged vein.
  • Surgical removal – the damaged vein is either removed or tied off through an incision in the skin.

If necessary, a combination of these techniques can be used to treat spider veins. Pregnant women are often encouraged to postpone any treatment for spider veins because those spider veins that develop during pregnancy often disappear on their own without treatment.

While surgical forms of treatment for spider veins are usually successful, patients should be aware of the potential risks and side effects associated with these procedures. They include allergic reactions, blood clots, temporary pigmentation changes and, occasionally, also permanent scarring and telangiectatic matting (fine reddish blood vessels appearing near the treated area). Moreover, in rare cases, spider veins may recur after treatment.

Prevention of Spider Veins

People can take several steps to lower their risk of developing spider veins. These include exercising regularly; avoiding long periods of sitting or standing and crossing the legs while sitting; avoiding high-healed shoes and tight clothing; eating a healthy diet high in fiber; maintaining a healthy weight; and elevating their legs above the level of the heart two or more times a day for 30 minutes.