Spider Veins

The causes of spider veins are unclear, but they are often associated with varicose veins. There are usually deeper veins feeding the patch of spider veins so they are probably associated with increased pressure in the venous system. The increased pressure is due to valves not functioning properly. Some authors suggest that spider veins are associated with hormonal changes. They become more extensive with age.

If the spider veins are associated with varicose veins, the varicose veins will need to be treated first. If there are no varicose veins, then one may choose not to do any investigations. The issue will then be whether there are underlying large veins which one cannot see. The choice will then be up to the individual client. If one wants the best and most long-lasting result from treatment, then investigation is recommended. Spider veins are investigated by ultrasound so that the causes of the spider veins can be determined, and a discussion about which treatment is most suitable can be had with your doctor. 

If there are varicose veins, there will need to be treated first (please refer to varicose vein treatment page). Spider veins along are treated with sclerotherapy: 

• Ultrasound guided sclerotherapy: sclerotherapy involves injecting a solution into the spider veins. The injection is done under ultrasound guidance so that the injection is highly accurate and the solution is injected into the correct spot. The aim is to find the feeding vin and treat it first. 
• Direct vision sclerotherapy: this involves injecting a similar solution directly into the spider veins. It is done using magnification with a special polarized light which makes them easier to see and inject. 

Spider veins and varicose veins are different forms of a medical condition called venous insufficiency. Both conditions result from having weakened or damaged valves in the veins in the legs. However, the two issues have different symptoms.

Spider veins are typically small, thin lines that may be flat or slightly raised. They are often blue, red, or purple. Although they can cause some discomfort, they are painless most of the time. On the other hand, varicose veins are larger and deeper than spider veins and they appear lumpy or twisted.

Successful treatment of spider veins can achieve an even appearance where most of the spider veins have faded significantly. It is unlikely that all the spider veins will disappear completely (unless there are very few and they are very small), and injecting spider veins does not prevent new ones from growing. Further treatments are required if new spider veins started to develop. 

While many people have probably heard of varicose veins and spider veins, fewer may be familiar with reticular veins. They are the middle child of chronic venous insufficiency (CVI). They are smaller than varicose veins—roughly 2mm in diameter. They also do not protrude above the skin like varicose veins.

Reticular and varicose veins do look similar in color—blue or purple. They also appear in many of the same areas of the body. The inner and back of the thigh are common spots, as well as the lower leg and ankle. Reticular veins will sometimes feed into spider veins. This is why they’re also called feeder veins. When they do this, they serve as a source of excess blood for the spider veins. In cases like this, removing the reticular veins can help eliminate the spider veins as well.

Factors that can increase a person’s risk of developing spider veins include:

• Genetics: People with spider veins have a family history of them.
• Pregnancy: An increase in blood flow and the extra weight of the fetus on leg veins during pregnancy may cause spider veins.
• Sex: Spider veins tend to affect females almost twice as much as males.
• Age: The valves in veins tend to get weaker over time. The calf muscles, which help support the veins in the legs and enable them to pump blood upward, may also lose some of their strength as a person ages.
• Being overweight: Extra body weight can place added pressure on leg veins.
• Hormones: Hormonal birth control and hormonal treatments for menopause may increase the risk of spider veins. This is because estrogen can weaken vein valves.
• Sitting or standing for extended periods: Veins in the legs must work harder to pump blood up toward the heart when a person remains in the same position for more than 4 hours
• Past blood clots or vein damage: This can damage the valves and make them unable to work correctly.
• Excess pressure in the face: This can be due to forceful coughing, sneezing, or vomiting. Some people may get spider veins on their face after pushing during childbirth.

Spider veins on the legs are harmless but can cause symptoms such as aching or itching. Very occasionally they can bleed, especially if they are being fed by large reticular or varicosed veins. Bleeding can happen if the spider veins have been bumped. Often the bleeding is worse if the trauma occurs in the shower because the heat opens up the veins so that the pressure is higher. Bleeding spider veins is an absolute indication for treatment though most of the time they are a cosmetic issue.

Very rarely, spider veins may fade on their own without any intervention. But in most cases, once you’ve developed them, they will need to be removed by a medical professional if you want them gone permanently. 

Keep in mind that although you may find them unattractive, spider veins are not harmful. You can try to live with them or cover them up with concealer if they really bother you. If you notice your veins getting worse, there is any pan, or you experience leg aches, it’s a good idea to have them examined by a vein doctor or Phlebologist.