Spider Veins and Telangiectasias

Spider veins are tiny, dilated blood vessels that appear close to the surface of the skin. They often resemble thin red, blue, or purple lines or webs, which is how they earned their name. Telangiectasia is the medical term for these visible, broken blood vessels. They can occur anywhere on the body but are most common on the face, legs, and chest. When they occur on the legs they may be called reticular veins. Spider veins are very common, increase with age, and affect about 41% of women.

The primary symptom of spider veins and telangiectasias is their visible appearance. They may look like:

• Fine red, blue, or purple lines
• Web-like or branch-like patterns
• Starburst clusters, especially on the legs or around the nose and cheeks

Some individuals may also experience:

• Mild itching or burning around the veins
• A feeling of heaviness or fatigue in the legs, especially at the end of the day
• Swelling, cramping, or aching in more severe cases

For most people, these conditions are a cosmetic concern. However, they may occasionally indicate underlying vein issues or be associated with other medical conditions.

The cause can be multifactorial depending on the presentation of the veins. Spider veins and telangiectasias develop when tiny blood vessels near the skin’s surface dilate or break. This can happen due to a number of risk factors, including:

• Gender: Women are more likely than men to develop these visible veins, particularly during hormonal shifts.
• Age: Risk increases with age due to weakening vein valves and vessel walls.
• Family history: Genetics play a significant role.
• Prolonged standing or sitting: People with sedentary or standing occupations are at greater risk.
• Sun exposure: Frequent or intense exposure can lead to facial telangiectasias.
• Pregnancy: Increased blood volume and hormonal changes during pregnancy can contribute to vein changes.
• Medical conditions: Rosacea, liver disease, or connective tissue disorders can cause or worsen telangiectasias.

Dr. Brian Hibler begins with a thorough consultation and skin examination. For most patients, diagnosis is based on a visual assessment. In some cases, he may refer for evaluation of underlying venous insufficiency using non-invasive techniques such as Doppler ultrasound, particularly if there are symptoms like swelling or leg fatigue.

Although not all spider veins can be prevented, certain habits may reduce your risk:

• Wear sunscreen daily to protect facial capillaries
• Avoid prolonged standing or sitting
• Elevate your legs when resting
• Wear compression stockings if recommended
• Maintain a healthy weight to reduce pressure on leg veins
• Avoid hot baths and saunas, which can dilate facial vessels