Spider veins
Information relating to spider veins
Spider veins are tiny varicose veins. In Germany, approximately 60% of the adult population* has spider veins, and most of these people consider them to be unsightly. We will explain the symptoms, causes, treatment options and preventative measures – ensuring Freedom in Motion.
* E. Rabe, et al.: Bonn Vein Study conducted by the German Society of Phlebology. In: Phlebologie. (Phlebology) Volume 32, 2003, pp. 1-14.
What are spider veins?
Spider veins are tiny veins that are situated in the epidermis and are clearly visible. Typical symptoms include a light red to dark blue colouring. Spider veins are usually limited to a small area (of a few centimetres) around the feet and legs, more frequently around the ankles, on the outside of the thigh and at the back of the knee, and occasionally around the ribs or in the chest area. Their name comes from the fact that they have an appearance similar to a spiderweb. In a medical context, spider veins are a type of varicose veins. They are therefore also known as spider varicose veins.
Spider veins are caused by venous micro-valves that no longer close properly. Although they can sometimes be a first sign of another venous disorder, they are not regarded as a disease in the medical sense if they are not accompanied by another underlying condition of the venous system in the legs. Spider veins usually do not cause pain or other serious symptoms. However, those affected are often troubled by them for aesthetic reasons.
How do spider veins develop?
Spider veins are visible dilations of thin veins caused by the connective tissue of the vascular wall expanding. This dilation can have many causes. Genetics can play a part, but there are also other preventable risk factors caused by lifestyle.
Causes of spider veins
Congenital weakness of the veins and connective tissue
Congenital weakness of the veins and connective tissue
Increasing age
Increasing age
High blood pressure
High blood pressure
Nicotine and alcohol consumption
Nicotine and alcohol consumption
Lack of exercise (e.g. work mainly involving standing or sitting)
Lack of exercise (e.g. work mainly involving standing or sitting)
Being overweight
Being overweight
Hormonal changes during pregnancy or the menopause
Hormonal changes during pregnancy or the menopause
Taking hormone products (e.g. contraceptive pill)
Taking hormone products (e.g. contraceptive pill)
Constricting clothing
Constricting clothing
Shoes with high heels
Shoes with high heels
Extreme heat
Extreme heat
How are spider veins diagnosed?
Spider veins are visible to the naked eye. In addition to a medical history being taken and existing risk factors being determined, a physical examination performed by a specialist is sufficient to diagnose spider veins. The doctor will mainly observe, listen and palpate. Duplex sonography can help to rule out conditions of the deeper venous system.
How can I prevent spider veins?
Although spider veins are often genetic, there are some things you can do to treat them. You can prevent spider veins altogether, or at least stop them from spreading, by improving the elasticity of the venous walls and promoting unobstructed blood flow.
Preventative measures
- Everyday activities (e.g. climbing the stairs, going for a walk, lifting the toes and heels when sitting)
- Exercise (in particular swimming, cycling, hiking)
- Vein exercises
- A healthy diet (balanced diet high in fibre and omega-3 fatty acids)
- Maintaining adequate hydration
- Avoiding being overweight
- Suitable clothing (avoiding constriction, wearing flat shoes with a soft sole, sometimes going barefoot)
- Contrast baths
- Treating high blood pressure
- Elevating the legs
- Compression stockings for people susceptible to spider veins
- Avoiding prolonged sun exposure
How do compression stockings help in cases of spider veins?
The gentle pressure from the outside counteracts the internal pressure exerted on the vascular walls. This reduces the risk of the vein expanding. Compression stockings provide the vessels with support from the outside. In addition, circulation in the leg veins is improved, preventing congestion and localised accumulation of blood. Although existing spider veins cannot be reduced by compression therapy, this treatment can often prevent the condition deteriorating. Consistent compression therapy is essential in all more advanced stages of this condition.
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What can be done about spider veins?
If these fine varicose veins are not an indication of problems in the deeper venous system but are perceived as a nuisance for cosmetic reasons, there are two methods for removing spider veins.
Sclerotherapy
Sclerotherapy
Sclerotherapy is suitable for all types of spider veins, including extensive and deeper veins. Using a very fine needle, a liquid sclerotisation agent (polidocanol) is injected directly into the damaged vessel. This damages the interior venous wall which reacts with an inflammatory process, causing the vein to stick together and seal. The spider vein is turned into a strand of connective tissue over time, which is known as sclerosis. After that, the new tissue is broken down. Treatment success is therefore only fully visible after a few weeks. This treatment usually takes a few minutes and is almost completely painless. The body will break down the sclerotisation agent within 48 hours and excrete it. Side effects include temporary brown colouring or re-development of small vessels in the treated varicose veins, but these are rare. Consistent compression therapy for up to four weeks after the procedure can optimise the outcome. Several treatment sessions are usually required in order for the spider veins to disappear completely. The amount of sclerotisation agent used during each session is restricted for medical reasons.
Please note: Sclerosing micro foam is only used for the treatment of larger varicose veins.
Laser therapy
Laser therapy
Superficial individual spider veins can be treated with a laser.
This method is completely non-invasive and is particularly suitable for very fine vessels. The infrared energy of the laser heats the vascular walls so they contract. The fine veins will then become increasingly lighter in colour over the next few weeks. Most people do not experience any discomfort with laser treatment, but there may be mild reddening or itching. The risk of local infection is slightly increased during the first few weeks. In rare cases, there can be a loss of pigmentation along the vein. Again, several treatment sessions are required to achieve an ideal result. Compared with sclerotherapy, laser treatment is significantly more expensive. Subsequent compression treatment is optional.
Less common methods
Less common methods
Less common methods where the effectiveness has not been fully substantiated include IPL light therapy, radio wave therapy, electrocauterisation and sclerotisation using a saline solution.
What do I need to bear in mind after spider vein removal?
The spider veins have finally gone – now there are a few things to keep in mind to ensure an ideal outcome.
- Avoid intense light and heat
After laser treatment or sclerotherapy, the skin will initially be quite sensitive, especially to light. Avoid direct sunlight in the first 4-6 weeks. Hot baths or going to a sauna are not recommended in the first few days either. - Compression
After sclerotherapy of spider veins in particular, the use of compression products is highly recommended for up to four weeks. Pressure promotes the adhesion of the vascular walls and the break-down of tissue strands that are no longer used. - Gentle exercise
Strenuous exercise should be avoided in the first few days because of the increasing pressure in the blood vessels. Going for a walk, however, is explicitly recommended. - Elevate your legs
During the first few days, you should elevate your legs frequently to relieve them.
Even if you follow all the advice, there is no guarantee that the spider veins won’t return – especially if you have a genetic predisposition or the feeder veins have not been treated.
Home remedies for spider veins
In addition to removing spider veins, home remedies are also used, but the effectiveness of these has not been proven scientifically. Creams, gels, apple cider vinegar, carrots, garlic or rosemary offer at best only minor relief. Exercise and contrast showers also cannot remove existing spider veins, but they can prevent them from developing. People wanting to occasionally hide their spider veins can use waterproof concealers and make-up.
