Spider veins, also know by the medical term telangiectasias, are tiny abnormal blood vessels that reside close to the surface of the skin. Spider veins are a very common disorder affecting women more often than men and become more prevalent with age. They may have the appearance of a web or branching pattern, thus the name spider veins. They can be red, blue or purplish in color and commonly affect the legs or face. This blog will discuss indicators of chronic venous disease and review their causes, risk factors, symptoms, treatment and complications.
Spider veins are caused by slow and progressive damage to the valves along the vein walls. The valves in our veins work to keep our blood flowing in one direction towards the heart. The blood in the veins is pushed up to the heart by the muscle contractions of our legs. The muscle contractions squeeze the veins and push the blood forward. The blood is not allowed to return back towards the legs by these one way valves. As these valves become damaged over time, the pressure increases within the veins, leading to pooling of blood within the veins. This increased pressure is called venous hypertension. With pooling of blood in the veins, the walls of the veins become dilated, resulting in spider veins. As the disease progresses over time, varicose veins are developed. If these veins go untreated, it is possible for complications to arise in the future.
There are some well known risk factors to the development of spider and varicose veins. The most common risk factor is genetics and family history. If one or both of you parents have spider veins, your risk varies from a 46% to 94% chance of developing them yourself. Unfortunately, even people who are very healthy and exercise regularly may still develop spider and varicose veins. Additional risk factors include being a female and pregnancy. Spider veins and varicose veins affect women more often than men. Pregnancy is a significant risk factor for developing spider and varicose veins. This is related to changes in hormones during pregnancy, as well as weight gain and increased pressure on the pelvic and leg veins by an enlarging uterus. These veins may improve after delivery, but there is usually progression of spider and varicose veins with every following pregnancy. Hormonal therapy for menopause and hormonal birth control will also increase the risk of spider veins. Other risk factors include increased age and careers that require people to stand for long periods of time. Cashiers, waiters, chefs, teachers, and nurses are some careers that may have an increased risk of developing spider veins. Weight also plays a role in the development of spider and varicose veins. Sedentary life styles and obesity increase pressure on the leg veins and propensity to develop spider veins. Additional risk factors include blood clots and trauma. A previous blood clot in the legs may damage the deep and superficial vein valves and increase the risk of spider vein development. Trauma to the leg and the adjacent valves may also lead to focal areas of spider veins.
Spider veins may initially start as only a cosmetic issue and are unsightly to the patient. Spider veins may however cause symptoms of itching, burning or warmth over the areas of spider veins. Spider veins may progress over time and be an indicator of a larger developing problem. If you have spider veins and no associated symptoms of pain, aching, cramping, throbbing, restlessness, or swelling then you are fortunate and the problem is only cosmetic at this point. These spider veins are easily treatable with sclerotherapy. Sclerotherapy is a medical procedure where a sclerosing solution is injected into the spider veins, which causes them to collapse and disappear over the following few weeks. If however, you do notice pain in your legs that seem to worsen as the day progresses, then you may have the early findings of venous insufficiency. Spider veins can definitely be an early indicator of chronic venous disease. If you notice varicose veins along with your spider veins and swelling of the ankles at the end of the day, then you may be developing venous insufficiency. Venous insufficiency arises from progressive damage to the valves within the veins, leading to pain in our legs that usually progresses over the day, requiring you to take breaks or elevate your legs for relief. If you find relief of your symptoms with the use of compression stockings, then that may also be an indicator of underlying venous disease. If you suspect that you may have venous disease, it can easily be diagnosed with a diagnostic ultrasound of the legs. The ultrasound will be able to determine if the flow is normal within your veins and if you have a valve or clotting problem. If you are concerned that you have a vein problem or are looking to have sclerotherapy for your spider veins, call (203) 529-5521 or visit Dr. Vinay Madan, MD, DABVLM at the Center for Varicose Veins.