Spider Veins, in medical lingo termed “telangiectasias”, like varicose veins, is an inherited trait. The causative vein system that malfunctions is termed the “Reticular Vein” system. Reticular veins are one layer above the main superficial draining system that can lead to major superficial symptomatic venous insufficiency and varicose veins.
A person can inherit the trait for spider veins, varicose veins, or both. In other words, a person can inherit the trait for one or both layers of the superficial veins in the legs to fail.
Other reasons that spider veins tend to be more prevalent over time include hormonal factors in women, prolonged standing and sitting occupations, advancing age with skin thinning, and on occasion a slightly deeper offending problem (termed corona phlebectasia and explained below).
When segments of reticular veins fail with excessive back flow pressure, spider veins result in these same areas. Spider veins look like red, purple, or bluish colored sunbursts or web patterns. They usually pose no health hazard but may produce a dull aching, stinging, or burning in the legs after prolonged standing.
Unlike varicose veins where laser has become preferred primary treatment for most patients, the best treatment for the majority of spider veins remains injections—termed “Surface Sclerotherapy.” Vein specialists use a variety of effective time-proven injection agents (“sclerosants”) to choose from to treat spider veins. Every patient varies in the success of a sclerosing session, but the vein specialist’s experience usually will guide better results based on the patient’s skin type and size/location of the spider veins. Most patients will require two or three treatments spaced several weeks apart to get satisfactory results. Unlike hypertonic saline (that most modern vein specialists do NOT use), the other effective sclerosants do not cause severe pain/stinging and have a very low incidence of side effects.
A tip-off that both superficial vein layers are likely diseased, even with no visible varicose veins, is a suspicious pattern of spider veins termed corona phlebectasia (as illustrated in photo to right). Corona phlebectasia is a very prominent deep purple/blue or even blackish discoloration around the feet/ankles due to very longstanding back flow pressure in the main mid-level superficial vein system that has eluded diagnosis for years, and is now causing severe back flow and literal blowout in to the most superficial reticular vein system feet/ankles.
In the case of the subset of patients with true corona phlebectasia (confirmed by vein ultrasound), if the major diseased trunk vein system is not eradicated first, the corona phlebectasia has no chance of going away and will become even worse in appearance over time. Once the offending diseased trunk vein system is eradicated, the corona phlebectasia typically fades significantly over a few weeks-months. If it doesn’t fade enough to suit the patient, then simple surface sclerotherapy can be performed to usually fade it at least 80%. Such affected ladies with severe corona phlebectasia that is successfully treated, are the ones that typically drain their savings account buying new sandals/open footwear that they haven’t worn for years.
Insurance companies do not cover the cost of spider vein treatment.
Spider Vein Injection Illustrations: