Spider veins are smaller diseased veins. Phlebologists (vein specialists) categorize abnormal veins by their diameter: spider veins< 1mm, reticular veins > 1-3 mm, and varicose veins > 3mm.
The medical term for spider veins is TELANGIECTASIA. At the base of the dermis (skin) is a microscopic venous plexus. The venous plexus drains into small dermal veins called venules, which in turn drain into subdermal veins called reticular veins. When blood backs up in these microscopic venules, they become enlarged and filled with stagnant blood, making them visible to the eye. This is a spider vein.
Spider veins can be an isolated cosmetic issue, or they can be the “tip of the iceberg”, indicating deeper, significant venous disorders such as chronic venous insufficiency. There are two basic causes of spider veins. The female hormones estrogen and progesterone can cause the tiny veins to dilate and become visible. Also, chronic venous insufficiency (venous reflux) of the superficial venous system can cause increased venous pressure in the leg which can cause blood to back up in the small veins.
At VEINatlanta, evaluation of spider veins includes a venous duplex ultrasound to check for chronic venous insufficiency. If reflux of the deeper veins is present, they may need to be treated first to ensure successful treatment of the spider veins.
Spider veins are like weeds in a lawn; if you just cut off the top of the weed, it is not visible for a while, but it will grow back. The root of the weed must be killed to permanently get rid of the weed. Such is the case with spider veins. If the root cause of the spider veins is chronic venous insufficiency of deeper veins, these deeper veins must be ablated.
Many spider veins are asymptomatic, but not always. Spider veins can cause itching, burning, areas of warmer skin, tingling, bleeding, dry skin, and an urge to rub the area. In addition to treating any underlying venous reflux, at VEINatlanta spider veins are treated with a combination sclerotherapy and surface laser therapy. Compression stockings are usually worn after treatment for 3 to 7 days.