What are Spider Veins?
If you sometimes avoid showing your legs because you have spider veins — those small clusters of red, blue or purple veins that appear on the thighs, calves and ankles — you are not alone. It’s estimated that at least half of all women are bothered by this common cosmetic problem.
Spider Veins, also known as telangiectasia, or broken capillaries, form when groups of blood vessels close to the surface of the skin dilate and break. As a result, fine-lined networks of red, blue, or purple veins –each barely more than the width of a hair — appear on the thighs, calves, and ankles. The veins may form patterns resembling a sunburst, a spider web, or a tree with branches, but can also emerge as short, unconnected lines.
Who can get spider veins?
The cause of them is not completely clear there are some risk factors for developing them:
- Heredity (if your mother or sister has them, you likely will too.)
- Hormonal shifts (puberty, birth control pills, pregnancy, hormone replacement therapy.)
- Weight gain
- Occupations or activities that require prolonged sitting or standing
- Injuries (even if it occurs early in life.)
Are spider veins dangerous?
Unlike varicose veins, spider veins do not pose any medical problems, other than a dull ache in the legs after long periods of standing. Usually, women find spider veins unsightly.
How are spider veins treated?
The two major methods utilized to treat spider veins include sclerotherapy and laser treatment. In the legs, sclerotherapy is typically used as a first line treatment with laser treatment reserved for difficult to treat or persistent areas. For facial lesions, the opposite is true and MidAmerica Plastic Surgery typically recommends the laser therapy approach first.
What is sclerotherapy?
Sclerotherapy involves injecting a sclerosing (hardening) solution through a very fine needle directly into the blood vessel cluster at the source of the spider vein. From there, the solution seeps into the spider vein’s branches. The sclerosing solution irritates the vessel, causing it to collapse. The vessel turns into scar tissue and is eventually absorbed by the body. The loss of a few blood vessels is not a problem; blood easily diverts itself into nearby, healthy veins.
What to Expect
When the sclerosing solution is first injected, the spider veins momentarily disappear, but then reappear red and slightly swollen. After the injection, many people feel a minor burning or itching sensation, which should subside after 10-15 minutes. Over weeks the effected will become clear.
Patients should be prepared for the treated area to look and feel worse before it gets better. The injection site may be tender for a few days after treatment. Some people experience cramping, which is more likely if a highly concentrated saline solution is used, or swelling around the ankles. Others develop bruising or yellow-brown staining caused by iron deposits from the blood. Both should eventually fade, although in rare cases, the discoloration can persist for months or years.
- Stop ASA or other blood thinners (if ok with your primary care physician).
- Stop smoking.
These include but are not limited to:
- Unfavorable scarring
- Bleeding (hematoma)
- Poor healing of injection sites
- Change in skin sensation
- Damage to deeper structures — such as nerves, blood vessels and muscles — can occur and may be temporary or permanent
- Allergies to tape, suture materials and glues, blood products, topical preparations or injected agents
- Skin contour irregularities
- Skin discoloration and swelling
- Skin sensitivity
- Pain, which may persist
- Possibility of revision surgery
- Need for further injection therapy
How successful is sclerotherapy?
Sclerotherapy generally requires two to four treatment sessions at intervals of four to six weeks. On average, 50-70% of spider veins disappear after one or two sessions. After three or four visits, 80-90% of the veins start to disappear. It may take up to six months for them to completely go away. Once a vein disappears, it is gone for good. But be aware that new spider veins may develop, particularly if you are predisposed to the condition.
After the vein is injected with the sclerosing solution, compression bandages are wrapped around the affected leg or legs for two to three weeks. You should refrain from high-impact exercise for 48 hours, but may begin walking immediately. Aerobic exercise of this kind helps get blood flowing through other vessels in the treated areas and can be started 48 hours after treatment.
Once spider or varicose veins develop in the legs, they won’t go away without medical treatment. There is no proven method for preventing varicose veins however some things may help:
- Exercise regularly – Activities that keep the calf muscles moving help pump blood back up through the veins, preventing pooling. Walking, jogging, bicycling, and swimming are all good choices.
- Wear support hose or compression socks
- Elevating your legs above your heart a few times a day (for instance, by lying down with your feet on a pillow)
What are varicose veins?
Varicose veins are the larger, deeper, bulgier cousins of spider veins. They are caused by defective valves within blood vessels. These cause blood to back up and damage vessel walls. One of the most important distinctions between varicose veins and spider veins is that in some cases, varicose veins develop into serious medical conditions and are treated in a different manner.
Dr. Ryan Diederich is a board-certified plastic surgeon specializing in a range of aesthetic and reconstructive plastic surgery procedures at Mid-America Institute of Plastic & Cosmetic Surgery in Glen Carbon, IL. If you’re looking for a plastic surgeon east of St. Louis, you can schedule a consultation online schedule a consultation online, or call us at (618) 288-7855 to schedule an appointment.
For more information see the American Society of Plastic Surgery
*This article is intended as a guideline only. This is not intended as medical advice. There are no guarantees written or implied from the information presented here. Only a consultation can provide an appropriate evaluation and discussion regarding any procedure. Refer to your physician for medical decision making and advice.