What are Spider Veins?

Spider veins, also known medically as telangiectasia or venulectasias, are the mildest manifestation of venous insufficiency, similar to varicose veins but smaller. They are small, often tangled groups of tiny blood vessels just under the skin surface that frequently resemble spider webs or tree branches. They are generally red, blue or purple and are clearly visible, usually on the thighs, lower legs and face. Spider veins can sometimes cover large areas of skin, but they are a cosmetic problem only, rarely causing physical symptoms. At least a third of all women and a smaller percentage of men are believed to display the condition.

Spider veins are capillaries, thin vessels directly connected with the larger venous system, and like varicose veins they are caused by venous reflux. Spider veins may be isolated or associated with "feeder" veins or with larger underlying varicose veins, but they are not varicose veins – they do not bulge above the skin surface and do not require medical treatment.

Spider veins can be diagnosed merely by sight. They tend to take on one of three characteristic patterns – a "sunburst" or spider-web pattern radiating outward from a central point, a "tree-branch" pattern, or a "matting" or linear pattern that may be nothing more than a set of thin lines. Even in the absence of physical discomfort, some physicians observing spider veins prefer to conduct ultrasound exams to determine the extent of the problem and the underlying causes of the condition.

Risk factors for spider veins are similar to those for varicose veins – age, heredity, pregnancy, hormonal changes, obesity and extended periods of standing – as well as sun exposure, particularly in fair-skinned people, and injuries to the skin surface. Some physicians believe that exercise, weight loss and the wearing of support hose and flat shoes instead of high heels can reduce the incidence of spider veins.

Spider vein treatments are non-invasive or minimally invasive and include sclerotherapy and laser procedures. They are considered cosmetic procedures and are not covered by health insurance or Medicare unless a more serious underlying condition is diagnosed.

Causes & Risk Factors

Spider veins are the mildest manifestation of venous reflux disease. They are small, often tangled groups of blood vessels just under the skin surface that frequently resemble spider webs or tree branches. They are generally purple, blue or red in color and are clearly visible, usually on the legs and face. Spider veins are not varicose veins – they do not bulge above the skin surface like varicose veins and do not require medical treatment except for cosmetic purposes.

Many of the risk factors for spider veins are similar to those for varicose veins – heredity, advancing age, pregnancy, obesity, hormonal changes and occupations requiring extended periods of standing. They can also be triggered by exposure to the ultraviolet rays of the sun, particularly in fair-skinned people, and by certain medications. Spider veins may also develop at the site of an injury to the skin surface, sometimes years after the injury. As with varicose veins, spider veins appear more often in women than in men.

Symptoms

Spider vein treatments are considered cosmetic procedures and are not covered by health insurance or Medicare unless a more serious underlying condition is diagnosed.

Test & Diagnosis

Spider veins are diagnosed visually. The small red and blue vein tangles located just under the skin do not cause physical symptoms, but some physicians observing spider veins prefer to conduct ultrasound exams to determine the extent of the problem and the underlying causes of the condition.

Treatments

Non and minimally invasive treatments for spider veins are frequently and readily available in a doctor’s office. Both kinds of procedures are considered safe and allow the patient to return to normal activity immediately following vein treatment.

Sclerotherapy

Sclerotherapy is performed by injecting an irritant solution, either concentrated saline or a specialized detergent solution, directly into the spider veins themselves. The irritant damages the spider vein walls of the spider veins, causing them to swell, adhere and seal shut. The vein then slowly turns into scar tissue and gradually disappears over a period of weeks. Sclerotherapy ("sclero"), which was first developed in the 1930s, sclerotherapy is generally performed in the doctor’s office in less than 30 minutes and is considered highly effective when properly done, although the same vein may require multiple injections and repeat treatments over time. The treatment can be painful, with a burning or stinging sensation common, but the discomfort usually passes in a few minutes. Side affects are generally mild and temporary, and can include skin sores, superficial phlebitis, bruises and discoloration around the treatment site.

Sclerotherapy

Laser and Intense Pulsed Light

Laser and Intense Pulsed Light devices treat spider veins non-invasively by delivering heat through the surface of the skin to the vein, sealing the vein walls. Laser energy can be directed with a high degree of accuracy to minimize the damage to the tissues adjoining the treated vein. The patient will frequently feel a painful burning sensation during the vein treatment and depending on the severity of the vein condition, two to five treatments lasting 15 to 20 minutes a piece may be required to eliminate spider veins in the legs. Facial vein procedures require less time for treatment. Side effects of laser can include postoperative redness or swelling and discoloration of the skin, which will disappear within days or weeks. Side effects of laser can include postoperative redness or swelling, superficial phlebitis, and discoloration of the skin, which will disappear within days or weeks.

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