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Home Conditions Spider veins

Spider veinsSmall, visible, and treatable.

The fine red, blue or purple clusters on the legs and ankles. Often cosmetic, sometimes painful, and occasionally a clue to something deeper.

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The pattern

Symptoms and risk factors

What people notice, and what makes it more likely.

Symptoms

  • Fine red, blue or purple clusters
  • Web-like patterns on the legs or ankles
  • Aching or burning over the area
  • Itching
  • Veins that look worse by evening

Risk factors

  • Family history
  • Pregnancy and hormonal changes
  • Weight gain
  • Prolonged standing
  • Certain injuries

Telling them apart

Spider veins or varicose veins?

Spider veins, technically telangiectasias, are very small, flat red-to-purple vessels that may form a fine web-like pattern. Reticular veins are usually somewhat larger, flat blue-green vessels sitting beneath the skin. Varicose veins are the large, raised, twisted ones you can feel as well as see.

Around half of adults get spider veins at some point. Family history, pregnancy and hormonal changes, weight gain, prolonged standing and certain injuries all contribute.

They are different in size, but not always different in cause. Spider veins can exist on their own, or they can be the surface sign of reflux in a larger vein underneath.

Which one yours are

Cosmetic, or medical?

For many people spider veins are purely cosmetic and treating them is a choice, not a necessity. But any of these veins can be painful, even the little ones, and some people find small spider veins genuinely sore while someone else has large varicosities and no symptoms at all.

The question worth answering before treatment is whether anything is feeding them. Treating the surface while a refluxing vein underneath keeps pressure on it tends to disappoint, and the vessels come back. A duplex ultrasound answers that, and it is the reason we assess before we treat.

Larger, bulging, symptomatic, feeder or recurrent veins are not appropriate for cosmetic laser treatment and should be medically assessed first.

Timing

Winter is a good time to treat

After sclerotherapy you wear compression stockings for fourteen days, and that is part of what makes the treatment work rather than an optional extra.

Compression stockings are more comfortable and more easily concealed in cooler weather, so many patients start their treatment then. If you want your legs sorted for summer, the winter before is the time to begin.

Worth an appointment

When to see someone

Any one of these is reason enough to have your legs looked at.

  • The veins ache, burn or itch.
  • They are spreading, or new clusters keep appearing.
  • You also have aching, heaviness or swelling in the same leg.
  • There is a larger bulging vein nearby.
  • You simply want them gone and want to know what is involved.

What an assessment involves

A painless scan maps the veins in your legs, your vascular surgeon reads it with you in the same visit, and you leave with a plan. Plenty of people leave with nothing that needs treating.

About the ultrasound assessment

What can be done

Treatment options

Which one applies to you depends on the scan, not on how your legs look.

A liquid agent is injected into the vein through a fine needle, making it shrink and disappear over the weeks that follow.

Combined radio frequency and light energy heats fine surface veins through the skin, so the vessels the needle cannot reach can still be treated.

All vein treatments

Prevention and self-care

Looking after your legs

None of this replaces an assessment, and all of it helps.

Keep moving

Walking activates the calf muscle pump, which is what helps push blood back up out of your legs. A manageable walk you repeat beats an ambitious one you do once.

Interrupt long sitting or standing

The pump is idle when you are still. Break up a long stretch at a desk or on your feet rather than waiting for the end of the day.

Elevate when you rest

Giving your legs a lift helps ease symptoms at the end of the day.

Wear compression if it is recommended

Graduated compression supports the pump from the outside. It is measured and fitted in clinic: see compression and bracing for the fitting detail, or compression therapy for how it works.

Look after your skin

Moisturise dry skin and report new changes rather than watching them.

The vein clinic difference

One visit. Not two years.

Vein patients used to wait more than two years and make several trips before seeing a specialist. Integrating ultrasound testing with the surgeon consultation turned that into a single appointment.

  1. Step 1

    Ultrasound

    A certified ultrasonographer maps your veins and circulation prior to your consultation.

  2. Step 2

    Surgeon consult

    Your vascular surgeon reviews the results with you and explains what they mean.

  3. Step 3

    Your plan

    Treatment, compression therapy or prevention advice, based on your results.

In more depth

Further reading

Written by the team who treat it.

Spider veins, answered

Questions

The questions patients ask us most often.

What is the difference between a spider vein and a reticular vein?

Spider veins are very small, flat red-to-purple vessels that may form a fine web-like pattern. Reticular veins are usually somewhat larger, flat blue-green vessels beneath the skin.

Which treatment is better, sclerotherapy or laser?

Neither, in the abstract. Sclerotherapy injects an agent through a needle, so it needs a vessel big enough for the needle and works best on medium to larger veins. elōs™ laser works through the skin and reaches the very fine veins a needle cannot. The size, depth and distribution of your veins decide it, and many patients do best with a combination.

How many sessions will I need?

With sclerotherapy, each session typically produces about a 50% improvement, so plan for more than one. With elōs™ laser, improvement can show after a single session and most people have one to three.

Will I need compression stockings?

After sclerotherapy, yes: fourteen days. After elōs™ laser, no.

Will they come back?

Treated vessels are gone, but neither treatment stops new ones forming. That is why the assessment matters: if something underneath is driving them, treating that changes the outcome.

Does treatment hurt?

Sclerotherapy is a brief sting as the agent goes in. With the laser you may feel brief warmth, a pinch or an electric-like snap while contact cooling is applied.

Can I have treatment in summer?

You can. The practical issue is compression after sclerotherapy, which is less comfortable in heat, and sun exposure after laser treatment, which needs avoiding.

Is spider vein treatment covered?

There are both private and public payment options depending on your situation. It is worth raising at your consultation rather than assuming either way.

Find out where you stand.

One visit: a scan, a vascular surgeon who reads it with you, and a plan you understand.

Call 902-678-2121 Book a consultation

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