By Lance Barazani
Over time, what may have started out as an “itsy bitsy” spider vein can become a real concern. We call them “spider veins” because of their web-like appearance, but really they’re broken blood vessels: veins that are not properly returning blood to our heart. They can be unsightly and—in some cases—indicate a medical problem.
Age is one risk factor for spider veins, which are sometimes referred to as “telangiectasias.” As we get older, so do our veins, which are the tubes that bring blood back to our heart for a refill of oxygen to be delivered to the rest of our body. Our veins have valves to make sure that blood continues to flow to the heart. If those valves don’t work well, blood backs up, causing spider veins and, in more severe cases, varicose veins.
Genetics, injury and disease, sun exposure, hormones, diet, and prolonged sitting or standing can also contribute to spider veins. As a result, the American Society for Dermatologic Surgery reports that most of us will see some level of vein breakdown during our lifetimes. Women are more susceptible due to hormones: Regardless of age, forty percent experience vein issues, with four out of five women having problems by age 80.
Spider veins usually appear on patients’ legs and faces, which can cause significant cosmetic concerns. In addition, though infrequent, spider veins can be a sign of circulatory problems that require medical treatment. With this in mind, try these tips to address spider veins:
Start with a thorough medical examination
Especially for treating leg veins, it’s important that patients are carefully evaluated to make sure that the appearance of spider veins is not related to an underlying circulatory problem. The doctor needs a comprehensive understanding of the nature and extent of the vein damage so that a tailored, effective approach can be used.
Legs or face? Location matters
The type of procedure that is used depends in part on where the veins are. In general, laser and light-based treatments are used for the face, where spider veins may appear as the result of conditions such as rosacea. For the legs, chemical injections—called sclerotherapy—are often used. Another more recent approach for spider veins on the legs is endovenous laser therapy (EVLT).
Choose your doctor carefully
Spider-vein procedures are generally minimally-invasive outpatient treatments and the patient can usually expect to be back to their normal routine by the next day. That said, these procedures are surgeries, and the doctor’s knowledge and expertise are important for the best outcome.
Manage your expectations
Whether chemical or laser, spider-vein treatments work by disrupting the problem veins so that they eventually dissolve and disappear, with blood flow rerouted to fully functioning veins. But this takes time, usually at least three to six weeks. Also, it’s important that patients realize that more than one treatment may be needed to address the appearance of spider veins.
Take preventative steps after the procedure
Part of managing expectations is understanding that treating spider veins will not prevent new ones. Patients should be aware of the steps they can take to support healthy veins: staying active, watching their weight, limiting sun exposure, avoiding hot baths, refraining from prolonged sitting or standing, wearing comfortable, non-restrictive clothes and, when possible, using compression hose.
Above all, it’s helpful for patients to know that while spider veins are inevitable for many of us, if they become disruptive, there are effective treatment options.
Lance Barazani, M.D., F.A.A.D., is board-certified in dermatology and specializes in all areas of medical dermatology for adults and children, the prevention and treatment of skin cancer, cosmetic dermatology and laser surgery. Dr. Barazani was recognized on New York Magazine’s list of top doctors for 2016 and has also received recognition as a Castle Connolly Top Doctor and a NY Top Doctor.
