Spider veins, or thread veins, most commonly appear on the legs and face. They look like red spiderwebs, and they become visible when blood vessels close to the surface of the skin get damaged. While they are usually painless, spider veins can be unsightly. They also serve as a warning sign for more serious chronic venous disorders. At the first sign of spider veins, many doctors recommend compression therapy as a way to keep your vascular system strong.
Differences Between Spider Veins, Reticular Veins, and Varicose Veins
Spider veins describe damaged superficial veins that lie close to the surface of the skin. Although noticeably discolored, spider veins do not appear swollen or bulging. In contrast, varicose veins, even smaller varicose veins, typically protrude from the skin. Varicose veins also tend to be bluer in color, compared to reddish-purple spider veins. Reticular veins are blue or green veins, sized between spider and varicose veins, that do not protrude from the skin.
When a vein suffers from dilation and reflux, it can swell to such a degree that it forms a rope-like bulge. A varicose vein becomes so large that it pushes against the skin, sometimes pushing hard enough to form an ulcer. Varicose veins can develop on the lower pelvic area and buttocks, as well as on the legs. Spider veins and reticular veins mostly appear on the legs and face. When spider veins occur on the face, they're often called "broken capillaries." "Broken capillaries," "burst blood vessels," and "spider veins" all refer to telangiectasias, which is the medical term for small blood vessels (smaller than 1 millimeter in diameter) that have become damaged from too much dilation.
Similarities Between Spider Veins, Reticular Veins and Varicose Veins
Spider, reticular, and varicose veins have a lot in common. They all occur during the early stages of chronic venous insufficiency (CVI). Although spider veins are mainly a cosmetic problem, any visible veins can indicate a vascular system under stress. As CVI worsens, the one-way vein valves stop functioning properly, allowing blood to flow backwards. This reflux causes blood to stagnate, which puts additional pressure on the walls of the vein.
As more pressure builds in the vein, more valves fail, causing "a vicious cycle." Daniela Ligi et al., in an editorial for International Journal of Molecular Sciences, explain, "All these steps lead to the formation of a deleterious network and a vicious cycle...creating an environment that causes remodeling of the vein walls and valves, venous hypertension, formation of varicosities, edema, and leg ulceration." (2) Small varicose veins, reticular veins, and spider veins all act as warning signs for what's to come if CVI progresses: hypertension, worsening varicose veins, swelling, and venous ulcers.
Management of Spider Veins
Most doctors recommend compression socks as the first line of defense against the progression of chronic venous disorders. Luckily, spider veins do not cause any painful symptoms. If you begin wearing compression socks when you first notice spider veins forming on your legs, you may be able to avoid the aches and discomfort of varicose veins, as well as other damaging symptoms of CVI.
Compression socks work by constricting the vein, which forces the blood to circulate at a faster velocity. Think of the different settings on a garden hose nozzle. A narrow spray has more power than a wide spray. Similarly, inside your vein, narrowing the vein circumference improves the velocity of your blood flow. As an added bonus, graduated compression socks apply more pressure towards the ankle and less pressure towards the calf. This effectively pushes your blood against the flow of gravity, preventing venous reflux and stagnation. Graduated compression socks work on the vascular system in two ways: the socks constrict the veins, and they also push deoxygenated blood and waste fluids out of the lower leg.
For patients already suffering from painful varicose veins and swelling, compression socks help to reduce those symptoms. Because they are so effective at preventing venous disorders from worsening, most insurance companies require patients to wear compression socks before they will approve more invasive treatments. The Mayo Clinic confirms that, "Wearing compression stockings all day is often the first approach to try before moving on to other treatments." Whereas compression socks are often covered by insurance, the Mayo Clinic explains, "If done for purely cosmetic reasons, you'll likely have to pay for the treatment of varicose veins yourself."
Treatment of Varicose Veins, Reticular Veins, and Spider Veins
To remove unsightly veins, patients may choose from a number of treatment options. For most vein treatments, the aftercare involves compression therapy.
Sclerotherapy
This procedure involves injecting the vein with a chemical solution that seals it. After the procedure, the blood reroutes to healthier vessels.
Side effects:
- Bruising
- Raised red skin
- Small sores
- Darkened skin
- Tiny red blood vessels
- Inflammation
- Blood clots
- Air bubbles
- Allergic reaction
Aftercare:
- Walking is recommended
- Wear compression socks
- Avoid strenuous exercise
- Avoid sun exposure
Laser Treatments
Subcutaneous laser light can be used to destroy spider and reticular veins. This procedure may require multiple treatments to clear veins, and it only works for veins smaller than 3 millimeters in diameter.
Side effects:
- Burns
- Skin color changes
- Nerve damage
- Blood clots
Aftercare:
- Avoid sun exposure
- Wear compression socks
Endovenous Laser Treatment and Radiofrequency Ablation
Both procedures use heat to treat large varicose veins. The doctor pushes radiofrequency or a laser fiber through the tip of a catheter. When the catheter is removed, the vein collapses and heals shut. More than one treatment may be necessary to close off a larger vein.
Side effects:
- Burns
- Skin color changes
- Nerve damage
- Blood clots
- Superficial thrombophlebitis
- Deep vein thrombosis (DVT)
Aftercare:
- Take paracetamol or ibuprofen
- Wear compression socks
("Going Home")
Vein Ligation and Stripping
Surgical procedures are only used in extreme instances of CVI, superficial venous thrombosis, or phlebitis. Ligation refers to the surgical tying a vein, and stripping refers to vein removal. The surgeries normally take place under general anesthesia and last 2-3 hours.
Side effects:
- Severe pain
- Infection
- Blood clots
- Scarring
Aftercare:
- Limit activity
- Elevate leg
- Wear compression socks
("Venous" , "Varicose..." UCSF)
You Have Spider Veins—Now What?
Spider veins are your body's way of warning you that you should pay closer attention to your blood circulation. If you stand for long periods of time, sit for long periods, are pregnant, or experience frequent swelling in the lower legs, you're at greater risk of developing CVI. Any extra pressure on your veins may set off "the vicious cycle" of venous insufficiency. Luckily, it's easy and inexpensive to wear knee-high compression socks. Not only do they help prevent varicose veins, which can be painful and costly to treat, but they also leave your legs feeling energized.
Spider veins also have a number of other potential causes:
- Rosacea (skin problem that causes the face to turn red)
- Aging
- Problem with genes
- Pregnancy
- Sun exposure
- Overuse of steroid creams
- Trauma to the area
(“Telangiectasia”...Mount Sinai)
Spider veins on the face do not indicate a venous disorder; however, If spider veins appear on your legs, ask your doctor what you can do to promote healthy veins. Be sure to mention any symptoms, such as leg swelling, cramping, or aching. Most doctors will answer questions about venous disorders the same way. They'll tell you that spider veins do not require removal, so treatment to remove them is considered cosmetic. Compression socks work well as a first line of defense against venous disorders, they have few risks, and they offer excellent preventative support for those patients at risk of developing new spider and varicose veins.
According to Cleveland Clinic, in addition to people who currently struggle with CVI, other groups at risk of developing varicose veins include:
- Women
- Elderly people (over 50)
- Anyone undergoing hormone therapy
- Pregnant women
- People with a history of deep vein thrombosis (DVT)
- Anyone with a family history of varicose veins
- Obese people
- Anyone immobile or Inactive
- Smokers
- People who stand or sit for long periods
If you have spider veins on your legs and fit into any of the at-risk categories listed above, you may want to consider our best-selling Companions. These knee-high socks offer more support than the compression socks you'd find in a drug store. Plus, they're available in great patterns and colors, so you never have to sacrifice style to ensure optimal blood flow. These socks have it all—both fashion and function—and that's why we call them socks with benefits. Why wear regular socks? They do nothing to prevent webs of red and purple veins from forming. Only graduated compression socks work on your vascular system in two ways—by squeezing your veins and by preventing fluid from pooling—and prevent new spider veins from forming.
Sources:
“Chronic Venous Insufficiency (CVI): Management and Treatment." Cleveland Clinic, https://my.clevelandclinic.org/health/diseases/16872-chronic-venous-insufficiency-cvi/management-and-treatment
Going Home after Radiofrequency Ablation and Foam Sclerotherapy for Varicose Veins, Leaflet 4294/VER1, Guy’s and St Thomas’ NHS Foundation Trust, August 2016, https://www.guysandstthomas.nhs.uk/resources/patient-information/vascular/Going-home-after-Radiofrequency-Ablation-4294v1.pdf.
“Laser Treatment for Varicose Veins.” Michigan Medicine | University of Michigan, Healthwise, Incorporated, 14 July 2019, www.uofmhealth.org/health-library/tn10097.
“Leg Veins: Why They Appear and How Dermatologists Treat Them.” American Academy of Dermatology, American Academy of Dermatology Association, www.aad.org/public/cosmetic/younger-looking/how-dermatologists-treat-leg-veins.
Ligi, Daniela et al. “Chronic Venous Disorders: The Dangerous, the Good, and the Diverse.” International journal of molecular sciences vol. 19, iss. 9, 2544. 28 Aug. 2018, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6164218/pdf/ijms-19-02544.pdf.
"Sclerotherapy." Mayo Clinic, Mayo Foundation for Medical Education and Research, https://www.mayoclinic.org/tests-procedures/sclerotherapy/about/pac-20384592.
“Telangiectasia and Autoimmune Disease.” HSS, Hospital for Special Surgery, www.hss.edu/conditions_telangiectasia-and-autoimmune-disease.asp.
“Telangiectasia.” Mount Sinai Health System, Icahn School of Medicine at Mount Sinai, www.mountsinai.org/health-library/symptoms/telangiectasia.
"Varicose veins." Mayo Clinic, Mayo Foundation for Medical Education and Research, https://www.mayoclinic.org/diseases-conditions/varicose-veins/diagnosis-treatment/drc-20350649.
“Varicose Veins: Radiofrequency Ablation.” HealthLink BC, Healthwise, Incorporated, 26 Sept. 2018, www.healthlinkbc.ca/health-topics/tx4190.
“Varicose Veins.” UCSF Department of Surgery, The Regents of the University of California, surgery.ucsf.edu/conditions--procedures/varicose-veins.aspx.
“Venous Disease Vein Ligation & Stripping.” Cleveland Clinic, http://my.clevelandclinic.org/health/treatments/17614-venous-disease-vein-ligation--stripping.