Spider veins, also called telangiectasias or varicose veins, are dilated capillary vessels belonging to the more superficial venous network immediately beneath the skin. By themselves they do not cause a clinical problem, that is, they do not constitute a disease, although they do cause an aesthetic problem that worsens with the passage of time, since they have a tendency to spread.
Why spider veins are formed
They are generally red or purplish in color and have the shape of a tree, with a main trunk that divides into many branches. They are due to the insufficiency of a microvalve at the level of the main trunk that results in an increase in pressure at the capillary level and this causes them to dilate and, having more blood inside them than normal, they can be seen through the skin.
Spider veins can appear anywhere on the body, such as legs, cheeks or nose, although they are much more frequent on the legs due to the effect of gravity that hinders venous return to the heart compared to other parts of the body.
Risk factors that cause spider veins
In general, there is talk of genetic factors and hormonal factors, estrogens in women. However, there is a widespread belief that they only appear in women, but in clinical practice we see that there are a large number of men with spider veins, even if they are partially concealed by the presence of hair.
There are other factors that can also be the cause of the appearance and extension or worsening of telangiectasias:
- Obesity: hinders venous return due to increased pressure in the abdomen and is a risk factor in the appearance and development of spider veins.
- Postural factors: Standing or sitting for long periods of time is also a determining factor due to overloading the venous system of the lower extremities, which has to work against gravity.
- Lack of exercise: When walking there is a blood “pumping” by the so-called “plantar pump and gemellar pump” that help a lot to venous return. When the person does very little exercise, there is a slowing of venous return in the legs that increases the number of spider veins, as well as the appearance of edema or swelling and even the development of varicose veins.
- Taking contraceptives: The hormonal contribution of this treatment also favors the appearance and development of spider veins.
- Pregnancy: This is a high-risk period for the appearance of these varicose veins because during pregnancy the problem of hormonal overload is combined with the increase in intra-abdominal pressure due to fetal growth.
- Other periods of hormonal involvement: such as puberty and menopause in women, which may contribute to the appearance or worsening of spider veins.
Symptoms of spider veins
As we have already said, it is not a disease but more of an aesthetic problem, but apart from the aesthetic problem they also cause discomfort in the legs that diminish the quality of life. They can produce or add to the so-called Orthostatic Syndrome which consists of a set of symptoms such as heaviness, itching, tingling, heat … etc..
After the elimination of these varicose veins, apart from the aesthetic improvement, there is the sensation of having more rested legs with the consequent improvement in the quality of life.
How to prevent the appearance of spider veins or telangiectasias
Reduction of risk factors, i.e., exercising the legs, fighting obesity and avoiding long periods of standing or sitting.
Use of compression stockings on the legs, especially during work if it requires standing or sitting. Also use them during pregnancy to prevent the appearance of these spider veins and varicose veins.
Treatments for spider veins
There are two types of treatment for telangiectasias that pursue the same goal: the closure of these varicose veins, that is, that blood stops passing through them and then the body will take care of making them disappear when they are no longer useful.
Eliminating spider veins with laser
It consists of making different shots with laser in the path of the varicose veins thereby achieving a photocoagulation of the same and then the body eliminates them. As the shots are made transcutaneously, it is necessary to protect the skin above the varicose veins to avoid injury to it. This is usually done by pre-cooling the skin to avoid micro-burns that could leave it pigmented. One of the drawbacks is that only small areas are treated in each session and the process is time consuming.
Eliminating spider veins with sclerotherapy
Sclerotherapy is the most common treatment and allows treating larger areas of skin in one session, reducing treatment time. It consists of injecting a sclerosing liquid into the spider veins using very fine needles to create an irritation inside the spider veins that will cause them to close. Subsequently, the body will take care of their elimination and disappearance. This treatment allows to make more extensive areas in less time due to the diffusion of the sclerosant inside the spider veins in each injection, so it allows to treat both legs in a single session.
After one or two weeks, it will be necessary to repeat the procedure on the same treated area to achieve the total elimination of the remaining telangiectasias. The number of sessions will depend on the number and extent of spider veins present in each patient.
This treatment is performed in the office without the need for prior anesthesia or medical leave. In fact, the patient can resume personal and work activities immediately. This treatment is very effective if done correctly.