Spider Veins
What Are Spider Veins?
Spider veins are small, dilated superficial blood vessels visible just beneath the skin. They appear as fine red, blue, or purple lines, often in a web-like pattern. Medically, they are telangiectasias.
Core characteristics:
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Diameter typically less than 1 mm
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Located in the dermis (more superficial than varicose veins)
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Common on legs and face
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Usually cosmetic, not dangerous
Causes and Development:
They result from dilation of superficial venules due to loss of vessel wall tone and valve dysfunction in the microcirculation.
Contributing factors include:
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Genetic predisposition
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Hormonal influences (pregnancy, oral contraceptives)
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Prolonged standing
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Age-related connective tissue weakening
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Sun damage (facial spider veins)
Symptoms:
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Most are asymptomatic
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Some patients report mild burning or aching in the surrounding skin
Clinical Significance:
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Typically a cosmetic issue
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Occasionally a surface marker of underlying venous reflux, particularly in the legs, so duplex ultrasound may be indicated if larger veins or symptoms coexist
Spider Veins Treatment Options:
Microsclerotherapy:
Microsclerotherapy is the gold-standard treatment for lower-limb spider veins (telangiectasia). It is a minimally invasive outpatient procedure designed to permanently close superficial dilated micro-veins.
Procedure overview:
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A very fine needle is used to inject a sclerosant solution (commonly polidocanol or sodium tetradecyl sulfate) directly into spider veins
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The sclerosant damages the vein lining, causing controlled fibrosis
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The treated vein collapses and is gradually reabsorbed by the body
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No incisions, no anaesthetic required, typically 30 minutes per session
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If you have a lot of veins several sessions can be necessary
Indications
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Cosmetic clearance of leg spider veins
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Residual telangiectasia after treatment of larger varicose veins
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Symptomatic small surface veins causing local burning or aching
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Post-treatment protocol
Immediate ambulation encouraged
Avoid strenuous exercise, hot baths, and sun exposure for several days
Expected outcomes
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70–90% clearance per treatment course
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Multiple sessions often required for full clearance
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Mild bruising or redness common and temporary
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The veins tend to look worse for a few weeks before improvement
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It can take several weeks before the final result is evident
Risks and complications:
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Temporary hyperpigmentation
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Matting (fine new vessels)
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Local inflammation
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Rare: ulceration or allergic reaction
Additional treatment considerations:
If duplex ultrasound shows saphenous or perforator incompetence:
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Endovenous thermal ablation (radiofrequency)
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Foam sclerotherapy of refluxing trunks. Addressing venous reflux improves durability of spider vein clearance.
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Compression hosiery may help reduce progression.
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Lifestyle modification such as weight control, activity, and avoiding prolonged standing may also be beneficial.
Spider Vein Treatment Pathway.
1.
Consultation .
At the initial consultation you will be asked questions about your symptoms and any previous treatment for spider veins or varicose veins.
You will also be asked if you have any history of deep venous thrombosis and about your medical history in general.
It is also important to know if you are on any medications particularly blood thinners and if you have any allergies.
2.
Examination & Ultrasound.
Your legs will then be examined to look at the distribution of your veins and if you have any skin changes or ulcers.
It is a good idea to wear loose fitting clothing and even bring a pair of shorts with you.
You will then have a duplex ultrasound which is a very simple painless procedure where we can look in detail at the veins in your legs and determine how best to treat them.
3.
Treatment Discussion.
We will then discuss in detail with you the various treatment options outlining the advantages and disadvantages of all.
You will be provided with an information leaflet for the treatments suitable for you.
At this stage we can either book you in for a suitable date for your treatment or you can contact us again via phone or email if you would like treatment to be arranged.