Spider veins are small superficial blood vessels that appear red or purple in the skin. They commonly occur on the legs and may worsen with age. These dilated blood vessels may be short, unconnected lines, each about the size of a large hair, or connected in a pattern looking like a spider web or a tree with branches. Spider veins can occur in a small area where they are not very noticeable, or they can cover a large area of skin and be very unattractive. Larger dilated blood vessels called varicose veins may be raised above the skin surface. They may occur with spider veins.
If spider veins are bothersome, they can be treated by injection of a special solution that can destroy them. They can disappear or become much smaller resulting in a greatly improved appearance. Some lasers may help as well, but injections are still considered "the gold standard".
The cause of spider veins is not completely known. They seem to run in families. Identical twins can be affected in the same area of the body and to the same extent. The condition rarely occurs as part of an internal disease. Spider veins appear in both men and women, but more frequently in women. Female hormones may play a role in their development. Puberty, birth control pills, pregnancy, or hormone replacement therapy may contribute to them. They may also appear after an injury. Spider veins on the nose or the cheeks of fair-skinned people may be related to sun exposure.
Spider veins cannot always be prevented. Wearing support hose may minimize unwanted blood vessels from developing. Keeping one¹s weight at a normal level and exercising regularly may be helpful, as well as eating a high-fiber diet and wearing low-heeled shoes. Sun protection is important to limit spider veins on the face. Despite all efforts, spider veins may continue to progress in some people.
The injection method is a procedure called sclerotherapy. This procedure has been used for spider veins since the 1930¹s. One of several kinds of solutions is injected directly into the blood vessel with a very fine needle. The solution irritates the lining of the vessel causing it to swell, stick together, and the blood to clot. Over a period of weeks, the vessel turns into scar tissue that fades, eventually becoming barely noticeable. A number of vessels can be injected in any one-treatment session.
The injection solutions available are slightly different, and the choice of which to use depends on several factors including the size of the vessel. Your dermatologist will choose a solution that is best for your particular case. After several treatments, most patients can expect a 70-90 percent improvement. Fading will gradually occur over months. Although disappearance of treated spider veins is usually achieved, similar veins may appear in the same general area.
Lasers have been used for more than twenty years. Wavelengths of light are absorbed by the hemoglobin in the blood vessels to destroy them. Many types of lasers, pulsed dye, long-pulsed, variable-pulsed Nd-YAG, and Alexandrite may be used, as well as a non-laser intense pulsed light technique. Your dermatologist will recommend the best type of laser for you if it is indicated.
There are some possible side effects. They include:
Red, raised areas at the sites of injection. These are similar to hives and the response should disappear within a day or so.
Brown lines or spots on the skin at the sites of treated blood vessels.
Darkened areas may result when blood escapes from treated veins. These dark areas occur more often in patients who have larger veins treated or those patients that tan easily. In most cases, they disappear within a year, but they may last longer.
Development of groups of fine red blood vessels near the sites of injection of larger vessels. Some patients develop groups of tiny vessels especially on the thighs as a response to treatment. Most disappear by themselves, but some need additional injection treatments or laser therapy.
Small, painful ulcers at treatment sites either immediately or within a few days of injection. These occur when some of the solution escapes into the surrounding skin. It is important to inform your dermatologist immediately so that the ulcer can be treated appropriately.
Temporary bruises. Bruises usually occur after laser treatments and are probably related to the thinness of blood vessel walls. They usually disappear in a few weeks.
Allergic reactions to sclerosing solutions. Although such reactions are uncommon, they can be treated, so inform your dermatologist immediately.
Inflammation of treated blood vessels. This is very unusual but when it occurs, it is treated with medications such as aspirin, compression, antibiotics, or heat.
Lumps in injected vessels. This is coagulated blood and is not dangerous. The dermatologist may drain the blood from these areas a few weeks after injection. The treatment of spider and varicose veins can be very successful. Treatment methods vary depending on the size and location of the abnormal veins. The injection method is presently the method which yields the most consistent good results but great advances have been made recently in other techniques such as lasers. Ask your dermatologist what is best for you.
