What are spider veins?

Photos of patients with different varicose veins, Spider veins and telangiectasias | Mark Medical Care

Spider veins or telangiectasias are small, dilated veins that form on the skin’s surface; they are seen under the skin, but they do not make the skin bulge out as varicose veins do.
The spider veins can emerge from the blood pressure in varicose veins and commonly have no symptoms. Although they are generally located on the lower extremities, especially on the thighs, calves, and around the heels, they could also appear on hands, face, and other body areas.
The spider veins usually appear as thin purple, blue, or red clusters, taking their name from their striking spiderweb shape.
Many people consider the spider veins as an aesthetic problem; however, they could be a visible sign of the beginning of having circulation issues and Venous Insufficiency.

What causes spider veins?
The spider veins appear due to Chronic Venous Insufficiency (CVI). This disease prevents the veins from properly transporting blood from the legs to the heart, causing the blood to return and accumulate in the veins and gradually forming spider and varicose veins.
The normal function of our cardiovascular system consists of the veins moving deoxygenated blood from bodily tissues back to the heart while the arteries deliver oxygenated blood throughout the body.
For this process to happen, veins contain one-way valves that open and close, helping blood flow against gravity towards the heart. If these valves become damaged and do not fully close, they can allow blood to flow with gravity, causing reflux and impairing blood circulation. Obstructed or blocked veins can also impair blood flow back to the heart.
Venous reflux disease (VRD), also known as Chronic Venous Insufficiency (CVI), may concern up to 40% of the US population, and it is more common in women (especially after multiple pregnancies) and in people who are middle-aged or older.
Spider veins are asymptomatic and may appear for various reasons, including genetics or hereditary factors, overweight, hormonal influences, alterations (Puberty, pregnancy, and contraceptive treatments), aging, sedentarism (not exercising), and be sitting or standing for many hours.

Who is at Risk for Spider Veins?
According to the article published by AHA Journals, a medical study suggests approximately 23% of US adults have varicose veins. It is generally being more common in women and older adults. If spider veins and reticular veins are also considered, the prevalence increases to 80% of men and 85% of women. (AHA Journals, Vol. 130, No. 7)
Spider veins may appear for various reasons, including genetics or hereditary factors, overweight/obesity, hormonal influences, alterations (Puberty, pregnancy, and contraceptive treatments), aging, sedentarism (not exercising), and sitting or standing for many hours.
The risk factor categorized under inherited is the single most significant risk factor. It means that if your parents or any family member had varicose veins, including spider veins, there is a 90% risk of developing chronic venous insufficiency.

What are the symptoms of Spider Veins?
Although the aesthetic appearance of spider veins is not ideal, it is even more important to realize they may be a sign of the condition of venous insufficiency and can be prevented by visiting a medical specialist.
Spider veins may be asymptomatic; however, some people may experience minor symptoms, including burning, heaviness, itching, tingling, numbness, or cramping of the legs.

How can spider veins be treated?
Sclerotherapy helps to improve the appearance of those undesirable ‘spider veins.’
The procedure involves injecting a sterile sclerosing solution into the vein using a thin needle. The goal is to close each spider vein and direct the blood to other better functioning veins. The closure is achieved gradually and naturally, and the final results can be seen after 12 weeks.
Sclerotherapy is a non-invasive treatment that can be performed in the comfort of the doctor’s office.

What are varicose veins?
To comprehend the varicose veins, it is important to understand the primary function of our cardiovascular system.
The heart pumps blood to supply oxygen and other nutrients to the entire body. As the heart beats, it pumps blood through a system of blood vessels called the circulatory system. There are three main types of blood vessels: Veins, Arteries, and Capillaries.
The veins carry the used blood or deoxygenated blood back to the heart. At the same time, the arteries deliver oxygenated blood throughout the body.
The veins contain one-way valves that open and close, helping blood flow against gravity towards the heart. However, suppose these valves become damaged and do not fully close. In that case, they are not strong enough to transport blood against gravity and back to the heart. The blood returns and accumulates the veins, developing a medical condition called chronic venous insufficiency (CVI), causing veins to swell and become painful pop out varicose veins.
Varicose veins are bulging, twisted, enlarged blood vessels that protrude beneath the skin and often appear like cords on the legs. They are usually found on the inside of the thigh, calf, or back of the leg. However, they can form anywhere from ankle to groin.
Varicose veins are a progressive medical condition that gets worse over time. The veins slowly spread, and they can stop being just an aesthetic concern to become a health complication that causes hemorrhages, ulcers, or infection.
What Causes Varicose Veins?
Varicose veins are caused to a medical condition named chronic venous insufficiency (CVI).
Chronic venous insufficiency (CVI) is a condition that occurs when the venous wall and valves in the leg veins are not working effectively, making it difficult for blood to return correctly to the heart from the legs.
Any condition that blocks the main leg veins or damages or weakens their valves can cause Venous reflux disease (VRD), better known as chronic venous insufficiency (CVI).
Conditions that can lead to VRD include:
• Deep vein thrombosis (DVT)
• Congenital (from birth) absence of vein valves
• History of blood clots or DVT in the leg damages or weakens vein valves, which causes veins to enlarge to the point where the valves cannot close.
• Tumors or unusual growths.
• Blockages in the veins of the pelvis or groin.
Also, different factors may increase the risk of developing CVI, such as:
• Family history
• Age
• Constipation
• History of DVT (deep vein thrombosis)
• Pregnancy, especially multiple pregnancies
• Injury to a vein
• Recent surgery
• Being overweight/obesity
• Tall height
• Lack of physical activity
• Sitting or standing for long periods
• Hypertension (high blood pressure), High cholesterol, Diabetes.
• Hormonal influences, alterations (Puberty, pregnancy, and contraceptive treatments.

What are the symptoms of varicose veins?
The most visible sign of varicose veins is an enlarged, twisted blue or purple vein just under your skin’s surface. Other symptoms can enclose:

• Spider veins or telangiectasias: small, dilated veins on the skin’s surface.
• Tiredness – Heavy legs: Muscles in your legs may feel sluggish, tired, and heavy, especially after physical activity.
• The area around varicose veins may itch and flake skin.
• Legs may be painful, especially behind your knees. In addition, you might have muscle cramps.
• Legs, ankles, and feet can swell.
• Numbness.
• Skin discolorations and ulcers: Untreated varicose veins can cause skin damage and discoloration if left untreated.
• Venous eczema (stasis dermatitis).

According to the symptoms and appearance o the skin, it is possible to categorize varicose veins in 6 grades or types.

Stage one – spider veins. These small, reddish-purple veins – are visible on the legs and ankles.
Stage two – enlarged, twisted varicose veins. These swollen veins are, in many cases, “stage one” of the disease. It is the stage at which people often first become aware that they have vein disease. The swollen veins may be accompanied by itching, burning, or numbness along the veins themselves and by tired, weak, or achy legs. This is the best stage at which to treat them.
Stage three – edema (swelling), but without skin changes. In this stage, the legs and ankles’ swelling increases because CVI has impaired the circulatory system’s ability to reabsorb fluid. Again, the elevation of the limbs may help but will not cure the disease or reduce the swelling much.
Stage four – skin changes and discoloration. As the disease progresses, venous congestion and poor circulation can lead to skin color and texture changes. For example, the skin on your legs can become reddish-brown or white, and take on a more leathery texture that leaves it brittle and prone to injury.
Stage five – skin changes with healed ulceration. In this stage, scratches or injuries to the toughened skin may heal with treatment, often leaving scars.
Stage six – skin changes with active ulceration. In this final stage of CVI, injuries to the skin and leg ulcers refuse to heal even with treatment and can leave your legs covered with bleeding open sores.

Why do we have Varicose Veins?
Varicose veins are a medical condition that affects 1 out of every five people worldwide and mainly affects women. However, many men suffer from it, although men are more likely to put off seeing a medical specialist until the problem is already very advanced.

Chronic Venous Insufficiency (CVI) is a medical condition that can occur for different reasons:

Inheritance: a person has up to a 50% chance of suffering from varicose veins if one of the parents suffers from the condition.
Age: with age, the valves wear out, and blood accumulates, causing vein dilatation.
Hormonal changes in women: the hormonal changes experienced by women during pregnancy, menstruation, and menopause cause the walls of the veins to relax. Hormone treatments, such as birth control pills, also increase the risk of varicose veins.
Pregnancy: during pregnancy, the volume of blood in a woman’s body increases to promote the growth of the fetus. The pregnancy increases the pressure in the veins of the legs, which causes at least “spider veins” on the legs.
Obesity: Being overweight puts extra pressure on the veins.

How can Varicose veins be treated?
There are different treatments for Varicose Veins that can replace traditional surgery. These options are less invasive, have a lower risk of complications, and patients can return to their daily activities in less time.

Endovenous Laser
Endovenous laser is one of the most modern techniques to treat varicose veins with the same effectiveness traditional surgery provides. It introduces a laser to the affected vein, allowing the thermal energy to heat the vein and seal it permanently. This prevents any more blood from circulating through it, effectively eliminating the vein or reducing its size. After the procedure, the body will direct the blood to other healthy veins.
Once the vein with venous insufficiency has been cauterized, another Phlebectomy procedure is recommended. This procedure entirely removes the inflamed varicose veins that can be seen on the skin’s surface. The extraction of these veins is necessary to release the stagnant blood and decrease the symptoms that affect the patient’s well-being. It also restores the smooth appearance of the skin.
Varithena is a foam medicine approved by the FDA (Food and Drug Administration) to treat venous insufficiency and varicose veins. Varithena contains (Polidocanol) a medication used to treat large varicose veins of up to 12 mm, which usually cause pain. After treatment with Varithena, the varicose veins collapse and diminish in size, eliminating pain and restoring the aesthetic and healthy appearance of the legs.
It is the final step in the treatment of varicose veins. Sclerotherapy helps to improve the appearance of those undesirable ‘spider veins’.
The procedure consists of injecting a sterile sclerosing solution into the vein using a very thin needle. The goal is to close each ‘spider vein’ and direct the blood to other better functioning veins. The closure is achieved gradually and naturally, and the final results can be seen after 12 weeks.

Before choosing a treatment for varicose veins, it is very important to see a specialist get a sonogram. This test allows the medical professional to verify the level of blood reflux (amount of blood returned) and determine the severity of the disease.

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