Spider veins

Leading Medicine Guide Editors
Leading Medicine Guide Editors

Spider veins, also known as telangiectasias, angioectasias or thread veins, are small, dilated blood vessels close to the surface of the skin. They typically measure between 0.5 and 1 millimetre in diameter. Though they can appear anywhere on the body, they are most commonly found on the face, around the nose, cheeks and chin areas.

ICD codes for this diseases: I83.9

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Article overview

A smaller and milder form of varicose veins, spider veins present as thin, red and blue lines or web-like networks of blood vessels. They can also occur on the legs, although here they may be an indication of an underlying varicose vein. When spider veins are present in the legs, they are usually localised around the upper thigh and below the knee joint, as well as on the ankle.

Spider veins are very common, particularly among those aged 50 and upwards. These abnormal vein formations cause no symptoms, though they may sometimes cause some swelling or throbbing, and restless legs. Occasionally, they may become painful and perhaps even result in skin sores or blood clots.

Symptoms of spider veins

Easily recognisable due to their web-like appearance on the surface of the skin, spider veins may be red, blue, or even purple in colour. Some typical further symptoms include:

  • a feeling of discomfort in the legs
  • swelling
  • throbbing, cramps or aches 
  • a rash
  • skin ulcers
  • restless legs
  • itchy skin around the veins

You should consult your doctor if:

  • your veins become tender and warm to the touch
  • your veins become painful
  • sores, rashes or ulcers begin to appear on your skin
  • the skin on your calf or ankle seems to be growing thicker or changing colour
  • you experience any bleeding from spider veins
spider veins

Causes of spider veins

Spider veins occur because of weakened or damaged valves inside your veins. As a consequence, blood that would normally flow on through the vein then pools, causing the vein to swell. A number of hereditary and acquired factors increase your risk of developing this condition.

These can include:

  • the ageing process
  • family medical history
  • any history of blood clotting
  • oral contraceptives (birth-control pills)
  • hormonal changes at puberty or during the menopause
  • hormone replacement therapy (HRT)
  • pregnancy
  • sitting or standing for long periods
  • wearing any garments that are too tight
  • obesity
  • constipation
  • exposure to sun (light-skinned people)

Diagnosis of spider veins

A physical examination will soon reveal the presence of spider veins. In addition, your doctor may wish to examine your legs while you sit and stand. Further diagnostic tests may be used to monitor your blood flow and/or to check whether you have any blood clots. Such tests will typically include:

  • ultrasound (uses sound waves to project images of your internal blood flow and vascular structures)
  • venogram (uses a coloured dye, tracked via X-rays, to create images of your vein pathway)

Treatment of spider veins

In the absence of pain or other symptoms, there is no medical reason why spider and varicose veins should require treatment. If you are experiencing symptoms or would prefer to have your spider veins removed, the common treatment options include:

  • Compression stockings: These special elasticated stockings apply pressure to your veins, which helps to reduce discomfort.
  • Sclerotherapy: This is a common procedure used to treat both spider veins and varicose veins. The technique involves injecting a chemical into your veins, which causes them to harden and seal. Once the internal blood flow has been stopped, the vein is reduced to scar tissue, which then gradually disappears. The procedure has to be repeated every month to six weeks.
  • Laser therapy: This technique sends a laser light beam through your skin layer and into the vein. This procedure makes the target vein dissolve.
  • Surgery: Different surgical techniques can also be employed, but these are usually reserved for larger and more prominent veins.

Chances of recovery from spider veins

Spider veins will not usually become a severe health issue, and the treatment options are usually straightforward and highly effective. However, new veins may develop as you grow older.

Prevention of spider veins

Those who already have spider veins can minimize the risk of developing more by:

  • wearing support stockings to compress your veins
  • keeping your legs raised for 30 minutes, several times each day

Other actions that will help prevent spider and varicose veins are as follows:

  • Never cross your legs when you sit down.
  • Avoid sitting or standing in one fixed position for long periods.
  • Take regular exercise.
  • Make sure you maintain a healthy weight.
  • Don’t wear high heels.
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