Spider Veins

What are spider veins?

Spider veins technically known as telangiectasias, are tiny 1-2 mm dilated capillary veins that can be red, blue or purplish in color and sometimes give a spidery appearance. Commonly patients will be asked if they have bruised their legs. Spider veins can occur anywhere on the legs but commonly occur along the lateral thigh and medial knee. Risk factors for spider veins include genetics, obesity, pregnancy, increased age, sitting or standing for long periods of time, prior blood clots and just being female.

Are spider veins a sign of vein disease?

Spider veins can initially start as just a cosmetic problem with a worrisome appearance. Spider veins can be associated with varicose veins and most patients with varicose veins will also have spider veins. Spider veins will not disappear without treatment and will normally progress and worsen over years. If you have spider veins and also have leg symptoms including pain, aching, heaviness, tiredness, fatigue, cramping, throbbing, itching, burning, warmth, restless or swelling, you will likely need a diagnostic ultrasound to evaluate for vein disease. Our veins have tiny valves that keep the blood flowing in one direction up towards our heart. These valves may become damaged over time. Diagnostic ultrasound can evaluate these valves and the direction of flow in our veins. As these valves become damaged you will start to notice visible increase in spider and varicose veins.

How are spider veins treated?

Spider veins can be treated with sclerotherapy or laser treatment. Sclerotherapy is a treatment that is performed by injecting a sclerosant into the veins. The sclerosant will cause the vein to collapse and eventually the body will resorb the vein and it will disappear over the following weeks. The needle used for injection is tiny and thus there is minimal discomfort during the injections. New sclerosants are very safe and have minimal side effects. There will usually be some mild bruising after treatment which resolves over the following week. It's important to inform Dr. Madan if you are on blood thinners, which would increase your risk of bruising. Hyperpigmentation at the sites of injection may also occur. This is darkening of the skin overlying the treated veins. Hyperpigmentation more commonly occurs over larger varicose veins and is less of a concern over spider veins. Hyperpigmentation is more frequent in darker skin tone patients and slowly resolves over the following weeks and months. Some patients may notice itching or a small rash over the area of treatment but severe allergic reactions are very rare.