What are spider veins?
Spider veins are small, thin veins that lie close to the surface of the skin. They are often red, blue, or purple. They look like spider webs or tree branches. They usually occur on the legs, but can also be found on the face.
Spider veins are a mild form of varicose veins. They are not usually a sign of a serious medical condition. However, in some cases, they may indicate underlying venous problems. Spider veins can also cause symptoms like aching, burning, swelling, and night cramps in some people.
What causes spider veins?
Spider veins are caused by a backup of blood, leading to vein swelling and twisting. There are a few factors that contribute to the development of spider veins:
– Genetics – Spider veins often run in families. Having a family member with varicose veins increases your risk.
– Hormones – Puberty, pregnancy, and menopause can increase the risk due to hormone changes that affect vein walls. Using birth control pills also raises risk.
– Increasing age – As you get older, your vein walls weaken and valves become less effective at circulating blood back to the heart from the legs.
– Prolonged standing – Standing still for long periods of time adds pressure on the veins in the legs. This can lead to spider veins over time.
– Obesity or weight gain – Extra weight adds more pressure on the veins, which can stretch them out.
– Prior injuries – Injuries or trauma to a vein can damage the valves, leading to pooling of blood.
– Sun exposure – Years of sun exposure can cause spider veins on the face or chest.
Who is at risk for getting spider veins?
There are certain factors and characteristics that put a person at higher risk for developing spider veins:
Age
– Spider veins usually first appear in adulthood and become more common with older age. Vein walls weaken and valves become less effective over time.
– Women tend to develop spider veins in their 30s-50s while men develop them slightly later in life.
Gender
– Females are about twice as likely as males to get spider veins, likely due to female hormone fluctuations.
– Pregnancy significantly increases risk due to increased blood volume placing pressure on veins.
Genetics
– Having a family member with varicose or spider veins raises your risk. Genetics can make vein walls weaker.
– Family history is one of the biggest risk factors. If your mother had spider veins, your risk is very high.
Weight
– Carrying excess weight puts added pressure on leg veins, increasing risk. Obesity raises chances significantly.
– Even moderate weight gain can increase risk as more fat presses on the veins.
Prolonged standing
– Jobs or activities requiring prolonged standing still are high-risk. Gravity plus standing pressure strains leg veins.
– Nurses, teachers, retail workers, hair stylists, and surgeons have higher rates of spider veins.
Prior injuries/trauma
– Past damage to a vein from surgeries, accidents, or trauma can contribute to spider veins by impacting valve function.
– Even minor injuries that cause bleeding under the skin can increase risk.
Sun exposure
– Years of sun exposure can cause spider veins, especially on the chest, face, and arms. UV radiation damages vein walls.
– Fair skin is especially vulnerable to sun-induced spider veins. Always wear sunscreen!
Lifestyle factors
– Lack of exercise/sedentary lifestyle leads to sluggish circulation and higher risk.
– Smoking cigarettes causes vein damage.
– Chronic constipation adds pressure to leg veins.
Medical conditions
– Chronic venous insufficiency, a condition where leg veins have difficulty sending blood back to the heart
– Obesity
– Multiple pregnancies
– History of blood clots
– Vein inflammation (phlebitis)
Are specific groups more likely to get spider veins?
Yes, spider veins are more common among:
Women
Around 55% of adult females have some visible spider veins, compared to 45% of men. Hormones, pregnancy, and a higher percentage of body fat all raise risk.
Caucasians
Paler skin shows spider veins more readily. People with darker skin tones have lower rates of noticeable spider veins.
People over age 30
Few people develop spider veins before age 30. Risk increases steadily through adulthood, with highest rates among seniors.
Those who are obese
Excess body weight strains the veins. Obese individuals have a spider vein rate 2-3 times higher than average weight people.
People with venous insufficiency
Chronic venous insufficiency weakens leg veins and valves, leading to very high spider vein risk.
Pregnant women
Blood volume expands during pregnancy, placing extra pressure on veins. Spider veins frequently emerge during pregnancy and post-partum.
Those with a family history
If your mother or other close relative has prominent varicose or spider veins, your risk is exponentially higher.
Diagnosing spider veins
Spider veins can be easily diagnosed just by examination during an office visit. Your doctor will visually inspect the veins in your legs and anywhere else you are concerned about.
In questionable cases, they may use additional methods:
– Duplex ultrasound – Uses soundwaves to evaluate vein structure, valves, and blood flow. Helpful in assessing if underlying venous issues are causing spider veins.
– Venous Doppler ultrasound – Measures speed and direction of blood flow in a vein. Can confirm venous reflux or leakage.
– Angiography – Dye is injected into veins, then x-rays visualize vein structure. Helps find the source of spider veins.
– CT or MRI scans – Advanced imaging provides detailed views of underlying veins if needed.
Preventing and treating spider veins
While spider veins cannot always be prevented, you can lower your risk by:
– Maintaining a healthy weight
– Exercising regularly
– Avoiding prolonged standing or sitting
– Raising legs when possible
– Avoiding tight clothing around legs and waist
– Moisturizing skin daily
– Wearing sunscreen on legs
– Elevating legs during sleep
Treatment options include:
– Sclerotherapy – The most common treatment. A solution is injected into the vein, causing it to scar and fade. Multiple treatments are usually needed.
– Laser therapy – Pulses of light are applied to the veins. The heat damages the veins so they eventually fade.
– Radiofrequency ablation – Uses radiofrequency energy to heat and collapse spider veins.
– Ambulatory phlebectomy – Tiny incisions are made to remove clusters of spider veins.
– Endovenous thermal ablation – Heat from a laser or radiofrequency is used inside the vein wall to seal it shut.
– Compression stockings – Graduated pressure socks and hose can help relieve achiness and swelling.
When to see a doctor
You should make an appointment with your doctor if:
– Painful symptoms like throbbing, cramping, itching or burning develop
– Spider veins bleed or become warm to the touch
– Lower legs are swollen or discolored
– Veins appear dark purple or bulging
– New spider veins appear rapidly or keep worsening
– Legs feel tired, heavy or achy frequently
– Varicose veins are present
Sudden onset of spider veins or progression over a few weeks warrants urgent evaluation to identify any underlying condition requiring treatment. Make an appointment as soon as any worrisome symptoms appear.
The takeaway
Spider veins are common, especially among women and those over 30. While annoying, they are rarely serious. Still, worsening or symptomatic veins should be evaluated. Support stockings, elevating your legs, and maintaining proper weight can provide relief in many cases. For significant spider veins, minimally invasive treatments like sclerotherapy offer great cosmetic improvement.