Spider veins are tiny dilated blood vessels visible on the skin. They are called spider veins, because they frequently resemble spider webs in their appearance. They range in color from blue to red, tend to pop up around the ankles, and may also be found on the legs, face, and hands.
Spider veins are a result of increased blood pressure in the venous system, which is usually a low pressure system. As the pressure increases in the venous system, the pressure causes veins to dilate, then increase in size. There are valves throughout the veins in the legs that keep the blood flow moving against gravity, towards the heart. As we age, our elastic tissue becomes less elastic, and the increased forces of pressure on the valves overwhelm them, and they become incompetent. When the valves fail, this causes a further increase in pressure and blood pooling in the legs which becomes a vicious cycle of increased pressure and further venous distention.
Studies show that 60-80% of the population has spider veins, and women are slightly more predisposed to having them. Beyond women, individuals in professions that required extended periods of standing or sitting are also at increased risk.
Often times, pregnancy is the first time women will notice their spider veins; the increase in circulating blood volume and venous pressure in the lower extremities that occurs during pregnancy can make spider veins appear for the first time.
Several systemic illnesses are related to spider veins. Most commonly, underlying chronic venous insufficiency is the culprit, but they can also be the result of trauma, chemotherapy, autoimmune disorders, and corticosteroid administration.
The best treatment for spider veins is sclerotherapy, and it usually takes 1-2 months (and several treatments) for the veins to disappear. Other treatments include laser treatment, but sclerotherapy is much more effective and less costly.
In many cases, patients seek out treatment for cosmetic reasons, but because spider veins are often a sign of venous reflux, it’s a surprise to many that the treatment for spider veins can involve procedures to address these underlying veins they were previously unaware of. Spider veins are a lifelong problem, but if we treat the underlying venous disorder that is causing them, it can halt the progression that worsens the severity of the spider veins. We scan every patient that presents to our practice for venous reflux because of this association between spider veins and venous reflux.
Treating the underlying venous will not prevent the spider veins from ever coming back, but it will significantly slow their progression.