Spider veins (telangiectasias) are small, thin blood vessels visible beneath the skin. They usually develop on the face or legs, and may look like a series of thin tree branches or strands of a spider web. Although most spider veins are only a cosmetic issue, for some people they can cause uncomfortable symptoms such as aching, burning, swelling and leg-cramping.
Spider veins are extremely common, affecting nearly half of the adult population of the United States. Many patients are bothered when spider veins develop on prominent areas such as the legs or face, and seek treatment to eliminate them. Many spider-vein treatments are highly effective and minimally invasive, offering aesthetically pleasing results without painful or lengthy downtime.
Causes Of And Risk Factors For Spider Veins
Spider veins develop from a backflow of blood in the veins. This condition, which results from damaged valves in the veins, is called “venous reflux.” As blood collects in these veins, their walls distend. This increases the size of the veins, and makes them visible under the surface of the skin. Risk factors for developing spider veins include the following:
- Increasing age
- Hormonal changes
- Lack of exercise
- Sun exposure
Having a family history of spider veins is also a risk factor for developing them.
Diagnosis And Treatment Of Spider Veins
Spider veins, which are diagnosed through a physical examination of the patient, an analysis of symptoms and, sometimes, diagnostic ultrasound, can be treated in a number of ways, all of which are minimally invasive.
The simplest solution for treating spider veins is for the patient to wear compression stockings, which put pressure on the affected veins and promote blood flow back to the heart. This method is designed to control the symptoms of spider veins, not remove them.
Sclerotherapy involves injecting a sclerosant, a solution designed to collapse them, into the veins. This procedure is performed in a doctor’s office. Each treatment takes approximately one hour, and a typical patient requires two to four treatments.
Endovenous Laser Treatment
Endovenous laser treatment (EVLT), which is also called “laser ablation,” consists of inserting a catheter with a laser probe attached to it directly into the vein. The laser heat seals off the damaged vein, and diverts blood flow to healthier vessels.
Nd:YAG is a crystal that is used as a lasing medium for solid state lasers. The deeply penetrating Nd:YAG 1064 nm laser has significantly less haemoglobin absorption than the wavelengths of the PDL or KTP laser. However, its absorption by epidermal melanin is also very limited, and this property enhances its safety profile in patients with darker phototypes. This laser can also be used to treat deeper vascular lesions and spider veins up to 3 mm in size , but due to a poor coefficient of absorption by haemoglobin requires much higher fluences. Combined with the longer pulse widths required for this wavelength this significantly narrows the window of safety, with increased potential for volumetric heating and collateral damage. Cooling is therefore critical for epidermal protection and pain control, as well as to reduce the risk of scarring from non‐specific thermal injury.
The above treatments have fewer side effects, cause less pain and have shorter recovery times than traditional surgical-vein-removal procedures.
Prevention Of Spider Veins
Although there is no sure way to prevent spider veins, making certain lifestyle changes may reduce the risk of developing them. Lifestyle changes include losing weight, exercising regularly, and wearing support stockings and comfortable, flat shoes. It is also important to move the legs frequently, especially during long periods of sitting or standing in one place.