Spider veins, also known as telangiectasias (tel-AN-juh-ek-TA-ze-uhs), are small thin blood vessels that lie close to the surface of the skin. Spider veins usually appear on the legs, face, or chest—but can occur in other locations. They’re red or blue and usually look like a spider web or tree branch. Spider veins can be purely a cosmetic concern or may indicate an underlying condition.

Causes

Their presence may be indicate with an underlying problem not visible to the naked eye. Often, there are ‘feeder veins’ or reticular veins, which are the source of the problem.  This ‘feeder vein’ can be identified by special light sources which use infrared technology to identify the underlying veins.  Underlying feeder veins, also known as reticular veins, must be identified and treated for effective results.

Signs and Symptoms

Spider veins can cause symptoms such as leg aching, heaviness, fatigue, burning, and throbbing.

Complications

In some cases, these small veins may rupture and cause spontaneous bleeding (hemorrhage). These hemorrhages occur at sites where particularly delicate thin skin covers the spiders; this usually happens in the ankle or foot.

Cosmetically, the appearance of spider veins tend to worsen over time. Symptoms can gradually worsen over time as well if left untreated.

Diagnosis

For most people, varicose veins can be diagnosed by an experienced physician during a routine physical exam. However, underlying vein problems may be present that are not visible to the naked eye.

As a result, physical examination by a doctor is important when considering treatment for spider veins. Some patients with seemingly simple spider veins may require further evaluation with duplex ultrasonography.  Patients who have severe symptoms associated with their spider veins, or clusters of spider veins in certain anatomical locations like the inner ankles or inner thighs, may have underlying venous insufficiency that should be identified prior to starting treatment.

As a result, the exam is coupled with a Duplex Ultrasound scan.

This scan is a noninvasive and painless test that is used to better evaluate the superficial and deep venous system. It is necessary to make an accurate assessment of the extent of the varicose veins, as well as to create the best treatment plan. This outpatient test can be performed in a medical office or a vascular laboratory.

Treatment Options

Spider veins like varicose veins may be treated with lifestyle changes and medical procedures. The goals of treatment are to relieve symptoms, prevent complications, and for some, to improve appearance.

Lifestyle Changes

These changes are often the first treatment for varicose veins. Lifestyle changes can significantly reduce symptoms. These changes include:

  • Avoid standing or sitting for long periods of time
  • Exercise
  • Weight Loss
  • Leg elevation

Compression Stockings

Compression stockings reduce symptoms but do not prevent new spider veins from appearing.

Vein Procedures

Spider veins and reticular veins of the legs can be treated with sclerotherapy. Sclerotherapy involves an injection of a sclerosant medication into the vein.  This procedure has been used to treat spider veins for decades, but new painless solutions such as Asclera allow for spider veins to be treated with minimal discomfort and immediate return to activities. The procedure is performed in the office and takes approximately 30 minutes. The specially trained professional uses a very fine needle to inject a safe sclerosing agent directly into the blood vessel. The sclerosant solution displaces the blood in the vein, causing it to immediately appear lighter in color and sometimes vanish. Next, the solution irritates the vein lining, causing it to collapse, thus blocking it from getting more blood. The vein is then absorbed by the body and disappears over several weeks. Healthier vessels nearby absorb the blood flow of the collapsed veins. Sclerotherapy is preferred over laser treatment for leg veins, because there is often an underlying vein that ‘feeds’ the surface spider veins. These may be too deep beneath the skin for lasers to penetrate.

Many people will require more than one treatment session for optimal results.