Spider Veins


Spider veins or telangiectasia are dilatations of small superficial blood vessels. Classically, spider veins are usually less than 2 mm in diameter. They can be red, purple or blue and can present as linear streaks, star burst patterns, or arborizing patterns. They are most frequently found on the thighs, legs and ankles. Millions and millions of men and women are bothered by spider veins. The cause of spider veins is unknown, but some families seem to have a greater tendency to get them. Birth control pills and pregnancy may contribute to spider veins. It is also felt that long periods of sitting or standing may result in worsening of existing spider veins or formation of new ones. Although spider veins may at times be painful, they are not dangerous.

Spider veins should not be confused with varicose veins which are usually a dark blue, 4 to 5 mm in diameter and often bulging. Varicose veins are more often painful, and may be related to more serious vein disorders. In many cases spider veins that appear during pregnancy and breast feeding will disappear on their own. The treatment of spider veins is for cosmetic purposes.

Laser treatment of spider veins involves a process of selective photothermolysis. The laser energy is absorbed by the hemoglobin in the blood vessels resulting in obliteration of the blood vessel. Because the laser is selective it avoids injury to the overlying skin. The use of the laser is indicated for spider veins up to 1 mm in size.

The procedure is usually performed in the doctor’s office, and no anesthetic is required.

Alternative Treatment

Because spider veins are not dangerous they do not have to be treated. Treatment of spider veins is for cosmetic purposes.

Sclerotherapy involves the injection of sclerosing agents into the vein. The sclerosing agent is a chemical irritant and causes the vein to seal off.

Veins stripping is a surgical procedure that is reserved for the treatment of varicose veins.

Risks of the Procedure: The following is a list of the more common potential complications of laser treatment of spider veins.

Discomfort: There is mild discomfort associated with the procedure.

Skin discoloration: The skin may become reddish after the procedure, but usually fades after a few days. Some individuals may experience hyperpigmentation that may take weeks to months to resolve. In a small percentage of people there may be some permanent hyperpigmentation (darkening of the skin) or hypopigmentation (lightening of the skin). The laser is not generally recommended for individuals with darker skin.

Skin Necrosis: There is a chance for skin necrosis and delayed healing and even scarring in a small percentage of patients.

Persistent Spider Veins: To eliminate the spider veins usually requires two to three treatment sessions. In some cases the laser may fail to completely eradicate the spider veins. The laser does not prevent the development of new spider veins.

Post-operative Care

Immediately following treatment, avoid vigorous activity such as jogging or aerobics for 24 hours. Apply polysporin to any crusting or scabbing areas. Avoid direct sun exposure to the affected areas for several weeks.