Spider Veins (Telangiectasias)

Spider veins (telangiectasias) are smaller than varicose veins. They look like thin blue or red squiggles, and for that reason they're sometimes nicknamed "roadmap veins," though they're more often likened to spider webs. They are small red, blue, or purple veins that commonly appear on the surface of the face (mainly the nose and cheeks), the legs (mainly the thighs, calves, and ankles), and occasionally elsewhere.

It's a common problem — more than half of all adults have at least one on the leg. People often seek treatment for spider veins merely out of cosmetic concerns. However, spider veins can occasionally cause symptoms like swelling, itching, or night cramps, fatigue, and aching or burning.

What spider veins look like

There are typically three spider-vein patterns:

  • A spiderweb shape, where veins radiate out from a central hub
  • An "arborizing" pattern that resembles branches on a tree
  • Thin, separate lines

The appearance of the spider veins can, in some cases, help your doctor determine whether they are part of an underlying disease.

Factors that contribute to the development of spider veins include:

  • Genetics
  • Prolonged standing or sitting
  • Blunt trauma
  • Sun damage
  • Pregnancy
  • Hormonal factors
  • Weight loss, surprisingly (It can thin the skin, making it more transparent.)
  • Exposure to certain chemicals radiation
  • Autoimmune disorders such as lupus

Diagnosing spider veins: looking for underlying problems

Because spider veins may indicate an underlying medical problem, it is important to get them diagnosed. Your vein specialist will examine you and ask questions like whether the veins bleed easily and without any apparent reason. In some cases, the doctor will order blood tests and/or imaging studies to help identify any underlying health problems.

One circulatory problem that can underlie spider veins and varicose veins is venous insufficiency, a condition where the flow of blood from the legs back to the heart through the veins is impaired.

Treatments for spider veins

Typically spider veins don't go away on their own but require treatment to get rid of them.

If the underlying cause is a disease or other health problem, the doctor will need to address and treat that problem before treating the cosmetic aspect of spider veins.

There are two kinds of treatments available for spider veins — using light and using injections — but they're both aimed at the same thing: shrinking the veins so that they eventually fade away and disappear.

Light treatment for spider veins

In laser treatment, a high-intensity beam of light is pointed at the spider veins, heating them up and destroying them, eventually causing them to disappear. Laser treatment is considered the optimal treatment for spider veins on the face and can be used on other parts of the body, but it's rarely used on the legs. It takes a few treatments to be fully effective. Intense pulsed light (IPL) treatment is much like laser treatment, but it's not as precisely focused.

Both laser and IPL treatments may be an option for some patients who are unable to undergo sclerotherapy, such as pregnant and breastfeeding women.

Sclerotherapy treatment for spider veins

Sclerotherapy is the most common treatment for spider veins. The doctor injects a saline (salt-water) or chemical solution into the veins with a very fine needle, causing them to eventually shrink and disappear. As with laser and IPL therapy, you might need a few sessions for it to be fully effective.

About 10 percent of patients just don't respond to sclerotherapy at all. For them, laser treatment may be a more effective option.

Results of spider vein treatments

With either kind of treatment, it can take several weeks to see the results. And not all the veins may disappear completely after a single treatment, which is why a series of treatments may be needed.

Your vein specialist may recommend that you wear compression stockings for several weeks after the procedure, and may tell you to elevate your legs for periods of time and walk or run. All these things can help alleviate other symptoms, such as aching or swelling, and can help prevent new spider veins from forming. Maintaining a healthy weight helps, too.

Updated: October 1, 2014


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