Spider Veins: Causes and Treatments

If you have noticed small purple veins on your face, calves, thighs or ankles, you are not alone. It's estimated that at least one-third of the adult female population has spider veins, which can also affect men.

People often seek spider vein removals merely out of cosmetic concerns. However, spider veins can occasionally cause symptoms like swelling, itching, night cramps, fatigue, aching and/or burning.

A variety of safe, minimally-invasive procedures are available to effectively remove or reduce the appearance of spider veins. So what are spider veins, anyway? How do you get them? And how do you have them removed? Read on.

What are spider veins?

Spider veins, also known medically as telangiectasia or venulectasias, are tiny purple veins near the surface of the skin that appear perpetually dilated and visible. The small capillaries commonly appear on the surface of the thighs, calves and ankles.

Spider veins may take several forms. 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

How do you get spider veins?

Spider veins are typically caused by abnormal blood flow and weakening of the blood vessel wall. Any condition or activity that places pressure on the veins can contribute to their development, as can other factors including heredity, pregnancy, hormone changes, weight gain, activities that require prolonged sitting or standing (such as a desk job or a nursing job) and trauma.

The likelihood of developing spider veins increases with age, and there may be a genetic predisposition towards spider veins, as spider veins tend to run in families. Getting spider veins during and after pregnancy is quite common and has been associated with an increase in estrogen, the female sex hormone. Estrogen has been known to weaken vein walls and may contribute to the development of spider veins. Spider veins may develop during pregnancy, especially as an enlarged uterus and baby put greater pressure on the veins. The good news is that spider veins which result from pregnancy often improve within three months of delivery.

Spider vein removal

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 spider vein 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. IPL uses concentrated pulses of light which selectively damages and destroys abnormal veins, including small spider veins and small vascular birthmarks. Intense light therapy is best suited for vascular lesions located slightly deeper in the skin than those treated with other procedures. This treatment may be recommended when sclerotherapy or laser therapy does not effectively treat the superficial vein.

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.

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.

Reviewed February 8, 2017