SPIDER VEINS – DEFINITION, CAUSES AND TREATMENTS

Spider veins. We’ve all heard the complaints, especially during shorts season.
“My legs look terrible!”
“How did this happen?”
“Am I going to look like this forever?”
The good news is spider veins are not medically dangerous and are easily treatable.

Spider veins: Defined

Spider veins are dilated capillaries, resembling spider legs, brought to the surface of the skin. They appear as tiny webs of red, blue, or purple lines easily visible through the skin. Spider veins are skin-level imperfections. They are cosmetic more than medical, as they are just on the surface. Patients complain they see very thin, erratic blue-purple lines throughout their legs. They are often described as “ugly,” but patients normally don’t experience any symptoms. Spider veins usually don’t hurt; they’re just unsightly.

What are the risk factors for spider veins?

A number of factors increase one’s risk in developing spider veins. These can be simple to complex, including
• aging
• heredity
• a history of blood clots
• taking oral birth control pills
• hormonal changes during puberty or menopause
• hormone replacement therapy
• pregnancy
• standing or sitting for long periods of time
• wearing clothing that is too tight
• obesity
• constipation
• sun exposure
• injury or trauma
• liver disease

How do I know if I have spider veins?

Most patients are unable to “feel” spider veins. They are usually asymptomatic, meaning they are not going to hurt or itch. They will appear in the form of red to purple and small but visible lines in the skin.

What causes spider veins?

Usually, the root cause is a minor blood back up. When the blood is having a tough time traveling through the veins, the veins become a little bit stretched out and distorted. If it occurs near the very top of the skin and becomes noticeable, those are spider veins. If it happens deeper, then it’s more of a varicose vein.

These backups can be a result of several different conditions. Sometimes, pregnancy can trigger it. Other times, injuries, previous surgery or a broken bone can cause spider veins.

In addition, excessive sun exposure or thinning of the skin (atrophy) can cause spider veins to appear. For example, strong topical cortisone or steroid cream on the skin for a very long period of time can thin the skin. This allows the small blood vessels in the skin to become visible. These little spider veins are called telangiectasias.

Occasionally, some conditions can involve broken blood vessels, like Rosacea. In Rosacea, the small blood vessels dilate and constrict, dilate and constrict, dilate and constrict, over and over again. If the opening and closing and stretching and dilating become extremely repetitive the veins become permanently enlarged to a degree, thus becoming much more visible.

Obesity and a history of blood clots also contribute to the development of spider veins.

How are spider veins treated?

Since spider veins cause very little pain and are not harmful so ignoring them is not a problem, though they may increase in number over time. Patients can begin with at-home treatment by wearing tight compression socks and elevating their legs. In terms of compression stocking strength, 20-30mmhg is recommended. They are to be worn as tolerated and for at least a week following a vein treatment. If patients want to pursue cosmetic treatment, there are two ways to do that.

Usually, sclerotherapy is the starting point for treatment. Through this procedure, medicine is injected into the veins causing them to collapse, seal shut and go away. Additionally, a laser can be used to zap the veins from the outside. The laser zaps the blood in the vein, heats it up and seals it shut. This is essentially intentionally damaging the vein and then prompting the body to absorb or take it away. 

These are very low-risk procedures, but patients with poor circulation or other circulatory issues will want to consult their doctor first.

What is the treatment process?

Treatments take 20-30 minutes, depending on how many spider veins are present. For just a handful of spider veins, only 15-20 minutes of injections are required. Extremely tiny needles are utilized in order to be able to accurately puncture small spider veins. Since they are so small, pain is very tolerable. It has been described as feeling like a little pinch. Some patients feel a bit of burning afterward because it is meant to damage the inside of the spider veins in order to trigger the healing process.

It takes about two months to see the results from sclerotherapy. If you are trying to achieve a clean look by summer, start in the late fall or winter and give it time to work. Because it’s not immediate, winter tends to be the most popular treatment time. Once the medicine is injected, the body takes it from there and takes over the healing.

In six to eight weeks progress is evaluated. A second round may be administered in order to combat the remainder of spider veins. Sometimes, depending on the individual, only one treatment may be necessary. Patients do need to plan accordingly, as sclerotherapy is not an overnight success.

Cost is calculated by the milliliter of the medicine used. The first unit costs about $200 and then $100 for each additional unit. The average dose is 3-5 units per treatment session.

How do these treatments affect the function of the body?

Most importantly, blood will still able to be delivered to the same places as before. There are numerous return points for blood, so there is a lot of different ways to get blood back to the heart. Typically, spider veins are extra. Since they are near the surface, they are not performing a substantial function and they can normally be removed without any problem.

Are spider veins related to varicose veins?

Spider veins are smaller, skin-level versions of varicose veins. They also are closer to the surface of the skin than varicose veins. While they have similar root causes, varicose veins often look like cords and appear twisted and bulging. They can be swollen and raised above the surface of the skin. Varicose veins can have deeper medical ramifications, such as blood clots, venous eczema, skin breakdown and ulceration and, rarely, skin cancer.

The effectiveness of spider vein treatments has motivated more and more people to take advantage of the procedures and improve their self-confidence. The results of both options can be accessed easily and for a relatively low cost. Consult with a doctor to diagnose the best action steps.