Spider veins
Telangiectasias: small vessels visible on the skin
Spider veins (telangiectasias) are small blood vessels visible on the skin, frequent on the legs and face. Learn their causes, how to prevent them and the most effective treatments to remove them, such as sclerotherapy and vascular laser.
What are spider veins?
Spider veins, also called telangiectasias, are small superficial blood vessels that dilate and become visible through the skin. They can be red, blue or purplish in colour. Their appearance resembles a network or the legs of a spider, hence their name.
Although they usually represent a mainly aesthetic problem, in some people they can be associated with an underlying venous insufficiency or produce mild discomfort. The most frequent locations are the legs, the thighs, the ankles and the face (cheeks and nose).
Why do they appear?
Telangiectasias can develop due to multiple factors. The most important are:
- Genetic predisposition.
- Age.
- Female sex.
- Pregnancy.
- Hormonal changes.
- Venous insufficiency.
- Sun exposure (especially on the face).
- Rosacea.
- Treatments with topical corticosteroids for long periods.
- Repeated trauma.
- Standing for many hours.
In many people they appear due to the combination of several factors.
What are the symptoms?
Most do not produce symptoms. However, some people may notice:
- Sensation of heaviness.
- Mild burning.
- Itching.
- Discomfort at the end of the day.
- Significant aesthetic sensitivity.
When they affect the face, the main reason for consultation is usually the cosmetic impact.
How is the diagnosis made?
The diagnosis is usually clinical. During the examination the doctor will assess the distribution of the vessels, the colour, the size, the presence of venous insufficiency and the existence of rosacea or other skin diseases.
Doppler ultrasound. When there are numerous telangiectasias on the legs or symptoms of venous insufficiency, it may be advisable to perform a Doppler ultrasound, since treating an insufficient vein before the spider veins improves the results and decreases recurrences.
What treatments exist?
Treatment depends on the location and the type of vessel.
Sclerotherapy. It is the reference treatment for most spider veins of the legs. It consists of injecting a sclerosing substance inside the vessel to close it progressively. Several sessions are generally necessary.
Vascular laser. The vascular laser is especially useful for facial spider veins, very fine vessels and patients in whom sclerotherapy is not indicated. Among the most used devices are the pulsed dye laser (PDL), the long-pulse Nd:YAG, the KTP and intense pulsed light (IPL) in selected cases.
Combined treatment. In some patients, the combination of sclerotherapy and laser offers better results.
Do they disappear forever?
Treated spider veins are usually eliminated definitively. However, the predisposition to develop new telangiectasias remains. Therefore new vessels can appear over the years, especially if there are risk factors.
What can you do in your daily life?
Maintain a healthy weight, walk daily, avoid remaining immobile for many hours, use sun protection on the face, control rosacea if you have it, wear compression stockings when indicated and avoid prolonged intense heat.
When should you consult?
Request an evaluation if the spider veins increase rapidly, if they appear associated with significant pain, if there is swelling of the legs, if you present symptoms of venous insufficiency, if they bleed easily or if you wish to improve your aesthetic appearance.
Myths and facts
- Myth: Spider veins are small varicose veins. Fact: Not exactly. They are different superficial vessels, although they can sometimes coexist with varicose veins.
- Myth: Creams eliminate spider veins. Fact: Currently no cream manages to make telangiectasias disappear.
- Myth: The laser works for all spider veins. Fact: It depends on the calibre, the depth and the location of the vessel. On the legs, sclerotherapy is usually more effective.
- Myth: Spider veins appear only due to age. Fact: Genetics, hormones, pregnancy and venous insufficiency play a very important role.
- Myth: After treatment they never reappear. Fact: Those treated disappear, but new telangiectasias can develop over time.
The essential points to remember
- Spider veins are small dilated superficial vessels.
- They are usually an aesthetic problem, although they can be associated with venous insufficiency.
- Sclerotherapy is the reference treatment on the legs.
- The vascular laser is usually the best option for facial telangiectasias.
- Sun protection and treatment of venous insufficiency help to prevent new lesions.
- Current treatments allow very satisfactory results to be obtained.
Frequently asked questions
Are spider veins dangerous?
Generally not. In most cases they represent an aesthetic problem.
Can they hurt?
Yes, although they normally produce mild discomfort or none.
What is the best treatment?
It depends on the location. On the legs it is usually sclerotherapy; on the face, the vascular laser.
How many sessions do I need?
It depends on the number and size of the vessels. Several sessions are frequently necessary.
Does the treatment leave scars?
Performed correctly, the risk of scars is very low.
Can I lead a normal life afterwards?
Yes. You can usually resume your activities immediately, following the specialist's recommendations.
Is it advisable to sunbathe after the treatment?
It is preferable to avoid sun exposure until the skin has healed to reduce the risk of spots.
Do compression stockings help?
Yes, especially after sclerotherapy and in patients with venous insufficiency.
Can they appear during pregnancy?
Yes. It is a very frequent situation due to hormonal changes and the increase in venous pressure.
Do they have a good prognosis?
Yes. Current treatments offer excellent aesthetic results when they are correctly indicated.
Need personalised guidance?
This guide is for information only and does not replace a medical consultation. For an assessment tailored to your case, you may request a consultation.
Request a consultation
