Do you see small, dark-coloured veins on the skin of your legs that look like branches or a spider web? On the thighs, these so-called spider veins are often mainly a cosmetic concern and can, in many cases, be treated with certain endovenous procedures.

Spider veins develop when the valves in the superficial veins do not function properly, causing blood to flow backward and pool in the veins. Like heavy legs and leg pain, spider veins can be early signs of vein disease, which may progress to more serious venous insufficiency.

What Are Spider Veins?

Spider veins, also known as telangiectasias, are small, visible superficial veins under the skin with a diameter of less than 1 mm. They should not be confused with normal visible veins in people with thin or translucent skin.

Spider veins can appear in different areas of the legs and sometimes on the arms and face. They form a network under the skin that can look like small branches or a spider web. Small spider veins are usually a fairly bright red colour. Larger dilated veins, with a diameter of 1 mm to less than 3 mm, are called reticular veins and often have a bluish colour.

When spider veins appear around the ankle, they are called corona phlebectatica. This can be the first visible sign of developing serious venous insufficiency.

Please consult your doctor or a vein specialist. They can confirm the diagnosis and help choose the treatment that is best suited to your needs.

What Causes Spider Veins?

Spider veins are enlarged veins in which the vein valves no longer close properly. Instead of flowing back toward the heart, blood flows back toward the feet and pools in the veins. This increases pressure in the affected vessels, which can weaken the vein walls over time and cause further dilation.

Spider veins are not only a sign of aging. Younger people with a genetic predisposition can develop them as well.

During maternity, or when additional risk factors are present, such as a job that involves long periods of standing or sitting, or excess weight, the likelihood of developing spider veins may increase.

What Can I Do About Spider Veins?

In many cases, spider veins are harmless and mainly a cosmetic concern. However, they can also be early signs of vein disease or, when they appear around the ankle as corona phlebectatica, a sign of more serious venous insufficiency.

Compression May Help

If you are diagnosed with spider veins, your doctor may prescribe medical compression socks that apply controlled pressure to your legs. Compression socks gently support the vein walls, with the strongest compression at the ankle and gradually decreasing pressure up the leg. This helps support blood flow back toward the heart, reduce venous pressure and improve overall circulation.

Medical compression socks and stockings may help prevent new spider veins from forming. They may also help relieve related symptoms, such as leg swelling. In addition, wearing compression socks may help reduce the progression of an underlying vein disease and lower the risk of developing a blood clot.

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Are There Other Treatment Options for Spider Veins?

When spider veins are removed for cosmetic reasons, a doctor closes the visible veins using an endovascular procedure. This is called sclerotherapy, an ultrasound-guided treatment in which a foam or sclerosing agent is injected into the vein to close it. Ideally, the collapsed vein is then reabsorbed into the surrounding tissue and fades over time.

After treatment, wearing compression socks is recommended to help achieve the best possible result.

Summary

Any feeling of discomfort in the legs or visible signs of enlarged veins on the skin, known as spider veins, may be early signs of vein disease.

Understanding Vein Disease

  • The term chronic vein disease describes a long-term condition in which venous return is impaired.

  • When vein valves do not close properly, reflux occurs: blood flows downward and pools in the vein, leading to venous hypertension. This condition is known as chronic venous insufficiency, or CVI, and can lead to edema, skin changes and, in some cases, ulcer formation.

  • If left untreated, chronic venous insufficiency can lead to serious complications, including phlebitis and pulmonary embolism. The CEAP classification system is used to distinguish between the different stages and forms of chronic vein disease.

  • Acute vein diseases usually occur without pre-existing conditions, but they can also be triggered by chronic vein disease. In any case, prompt medical attention is required. Acute vein diseases include superficial vein inflammation, deep vein thrombosis, pulmonary embolism, post-thrombotic syndrome and bleeding varicose veins.

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