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Spider Veins or Telangiectasias

Spider veins (Telangiectasias) are thin purple or red superficial veins commonly appearing as on the thighs, legs, ankles, and occasionally on the face.

Spider veins usually take on one of three basic patterns. They may appear in a true spider shape with a group of thin broken and curved veins converging into a central point (A). Occasionally, they may take branch-like shapes (B); or they may be linear, appearing as separate thin lines (C). Linear spider veins commonly occur on the inner knee, whereas the branched-like ones often appear on the outer thigh in a sunburst pattern.

Spider veins occur in the general population much more commonly than varicose veins. In fact, most people who have spider veins do not have varicose veins. However, once venous reflux occurs and varicose (bulging) veins form, the pressure in these veins leads to accelerated and often uncontrolled growth of spider vein clusters.

In the absence of venous reflux, spider veins occur spontaneously and independently. This happens due to the inherent weakness of the one-way valve system of the smaller veins of the legs. These veins subsequently dilate, expand and recruit smaller networks of thinner veins that are visible to the naked eye.


Forms of spider veins

Causes for the Appearance of Spider Veins

While it is true that there are some conditions like pregnancy, obesity, sedentary lifestyle, localized trauma or general aging that may hasten the appearance of spider veins. Most patients have a genetic predisposition to develop them.

Chest and Facial spider veins, on the other hand, usually appear due to sun damage.

Interestingly, most of the patients that seek spider vein removal are otherwise healthy. In general, they are fit, physically active, and relatively young, in the 30-55 age range.

Pregnancy is the most common precipitating event for the appearance of spider and blue veins in the child-bearing age female population. Wearing high compression stocking in the third trimester may have some preventative benefits in these patients. Other preventative measures may include being physically active, avoiding prolonged periods of standing, and keeping your weight in check.

Wearing high compression stockings consistently may have theoretical preventative benefits, but is unacceptable to most patients.

Treatment of Spider Veins

Spider veins and their feeder vein counterparts are often perceived as a cosmetic problem. In some patients, however, they could be associated with disproportionately severe symptoms similar to those occurring with varicose veins. Treating these spider veins can often dramatically reduce these symptoms.

Please go to spider vein treatment or vein sclerotherapy to read about the treatment of these unsightly veins, or click non-surgical vein treatments to read about the many minimally invasive vein treatment techniques currently offered by advanced vein centers and clinics, including our vein center, Nu Vela.


How Common Are Spider Veins? 

Spider veins are a common occurrence, affecting a significant portion of the population. They are observed in over 50% of women and individuals assigned female at birth. Moreover, their prevalence tends to increase notably in individuals 80 years of age and older. 

Can Spider Veins Appear Anywhere on the Body? 

Spider veins can develop anywhere on the body, they most commonly appear on the face, legs, chest and ankles.  

Can Spider Veins Become Varicose Veins? 

No, spider veins do not typically become varicose veins. Spider veins and varicose veins are different conditions, although they both involve issues with blood vessels in the legs. The development of spider veins can be caused by varicose veins under the surface. 

When Should I be Worried About Spider Veins? 

Pain or Discomfort: If you experience pain, aching, throbbing, or discomfort in the area where you have spider veins, it’s a reason for concern. These symptoms can indicate an underlying issue with your venous system, and a healthcare professional can determine the cause and recommend appropriate treatment. 

Swelling: If the affected area becomes swollen, especially in the lower legs or ankles, it’s essential to seek medical attention. Swelling can be a sign of venous insufficiency or other vascular problems. 

Skin Changes: Skin changes, such as redness, inflammation, or the development of ulcers (open sores) near the spider veins, should be taken seriously. These changes can indicate a more advanced venous condition, and prompt medical care is necessary. 

Bleeding or Open Sores: If your spider veins are prone to bleeding or if you develop open sores in the affected area, it’s a cause for concern. These issues can result from the fragility of the veins and should be evaluated by a healthcare professional. 

Increased Size: If your spider veins are rapidly increasing in size or number, it may be a sign of an underlying issue, and a medical evaluation is warranted. 

Skin Discoloration: If the skin overlying the spider veins develops dark pigmentation or changes in color, it may indicate a vascular problem that requires attention. 

Family History: If you have a family history of venous disorders, such as deep vein thrombosis (DVT) or venous insufficiency, it’s wise to be vigilant about the development of spider veins and seek professional evaluation. 

Cosmetic Concerns: While spider veins are primarily a cosmetic concern, if their appearance significantly impacts your self-esteem and quality of life, consulting with a healthcare professional or a vein specialist about treatment options can be beneficial. 

What Are the Risk Factors for Spider Veins? 

Genetics and Age: Family history plays a significant role. If your parents or grandparents had spider veins, you’re more likely to develop them. Spider veins become more prevalent as you get older. 

Gender and Hormones: Spider veins are more common in women and individuals assigned female at birth. Hormonal changes during pregnancy, menopause, and the use of birth control can contribute. 

Occupation and Lifestyle: Jobs that require prolonged periods of standing or sitting can contribute to spider veins. Lack of physical activity can weaken muscles that support blood flow in your legs. 

Trauma and Blood Clots: Past injuries causing vein trauma or blood clots can increase the risk of spider veins. 

Sun Exposure: Spider veins of the face are often caused by sun exposure. Skin cells that make collagen (fibroblasts) produce less collagen when sun damaged and skin becomes thinner and more transparent. 

Smoking: Smoking can negatively affect blood circulation, increasing the risk of spider veins. 


What Are the Non-Surgical Treatments for Spider Veins? 

Sclerotherapy: While it involves an injection, sclerotherapy is a non-surgical procedure. A solution is injected directly into the spider veins, causing them to collapse and gradually fade. It is particularly effective for smaller to medium-sized spider veins. 

Laser Therapy: Laser treatments, such as intense pulsed light (IPL) therapy and pulsed dye laser therapy, use concentrated light energy to target and fade spider veins. Laser therapy is often used for spider veins on the face but can also be effective for those on the legs. 

Endovenous Laser Therapy (EVLT): EVLT is a minimally invasive procedure that uses laser energy to treat larger veins that are the source of spider veins. It is typically performed under local anesthesia and requires only a small incision. 

Venefit™ is a minimally invasive procedure that uses radiofrequency (RF) Energy to treat vein health issues. 

Foam Sclerotherapy: This variation of traditional sclerotherapy involves injecting a foam solution into the veins, which can be effective for larger spider veins or veins that are deeper below the surface. 

Microphlebectomy (Ambulatory Phlebectomy): This non-surgical procedure is used for the removal of larger surface veins. It involves tiny incisions and the physical removal of the veins. 

Compression Stockings: While not a treatment to eliminate spider veins, wearing compression stockings can help manage symptoms and improve blood circulation. They are often recommended after treatment to support the healing process and prevent the development of new spider veins. 


Do I Need a Vascular Surgeon for Vein Treatments? 

While many vascular surgeons continue to practice traditional vein stripping and ligation, the field of Phlebology, dedicated to vein care, has undergone a remarkable transformation driven by technological advancements. 

In the present day, phlebologists hail from diverse medical backgrounds, including radiology and anesthesiology, specialties that encompass expertise in needle-based vascular access. 

As defined by the American College of Phlebology, a phlebologist is a physician who specializes in diagnosing and treating vein disorders. Notably, in 2005, the American Medical Association (AMA) acknowledged phlebology as a distinct, self-designated specialty, placing it on par with recognized specialties like dermatology and vascular surgery. 

Dr. R. Dishakjian, a board-certified anesthesiologist and accomplished phlebologist, possesses extensive experience in surgical operating rooms. Furthermore, Dr. Dishakjian is a cosmetic surgeon and a proficient expert in cosmetic lasers. 

Hence, beyond benefiting from the care of an adept phlebologist, patients at our vein clinic can be confident in achieving the best possible cosmetic results. We invite you to peruse the online reviews shared by our patients and reach out to us to arrange a consultation with Dr. Dishakjian. 

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