Written and medically reviewed by Tanya Ross Flohr, MD, on November 27, 2024
Everyone has seen those annoying purple-blue blood vessels just underneath the skin that become more prominent as we age. Nearly half the population over the age of 50 is afflicted by them, and sometimes, they seem to appear overnight. Why do spider veins form, and more importantly, what can we do to make them go away?
Physicians classify abnormal veins based on size with the colloquial term “spider,” including both subcategories of reticular veins (1-3mm in diameter) and telangiectasias (< 1mm in diameter). The larger abnormal varicose veins (> 3mm in diameter) are not considered “spiders” and are often treated differently. However, their cause is often the same as that of spider veins.
The function of veins in the legs is to drain blood upward towards the heart. Smaller veins, including spider veins, normally drain into larger veins that coalesce to form the central venous system in the abdomen and chest. In addition to flowing from the distal limbs towards the heart, blood flow in the veins drains from superficial tissues, such as the skin, towards the deeper tissues.
Because spider veins are so small and visible, their treatment is often considered a cosmetic concern. However, the formation of spider veins can indicate increased pressures within the venous system. Thibault PK et al. determined that at least 23 percent of patients with spider veins have valves in larger veins that do not work properly.
Valvular dysfunction in the venous system can result in sluggish blood return from the lower extremities to the heart. While this dysfunction is not life-threatening, symptoms such as leg swelling, heaviness, and throbbing can occur, not to mention the formation of spider veins. Not surprisingly, valvular dysfunction in veins increases with age.
An increase in spider veins and varicose veins has also been frequently noted in women during and after pregnancy. During pregnancy, the amount of blood and circulating hormones in the body are increased. The growth of the baby and changes the body experiences can put increased pressure on the venous system. This is why it is important to maintain a healthy weight during pregnancy. More abdominal girth experienced during pregnancy, weight gain, or obesity can compress the veins in the upper thighs and groins, resulting in increased venous pressure. This pressure prevents the veins in the legs from draining properly.
Researchers have also found that changes in hormone levels and their corresponding receptors during pregnancy can relax the smooth muscle around blood vessels. When the blood vessels relax, they can accommodate more blood volume, resulting in stretching and dilation. Fluctuations in hormone levels are not only experienced in pregnancy but also commonly occur during puberty, menopause, and obesity.
Like many things, we can often blame our parents for our spider veins. In a recent study by Fukaya E et al. evaluating half a million people, at least 30 regions in the human genome were identified as robustly associated with varicose veins. Inheriting multiple of these genetic regions together in combination likely contributes to the formation of abnormal veins.
Taking into consideration one’s genetic predisposition and individual risk factors (age, hormonal changes, obesity, height, smoking, hypertension, physical inactivity, leg trauma, and history of deep venous thrombosis), it is a wonder that everyone is not afflicted with spider veins!
While their formation might be inevitable with time, there are some steps you can take to minimize their appearance. Methods of prevention include maintaining a healthy weight and avoiding weight fluctuations, not wearing restrictive clothing around the abdomen or groin, regular exercise to promote and improve venous circulation, smoking cessation, compression socks if standing for prolonged periods to minimize lower extremity swelling and taking your medications as directed if diagnosed with a deep venous thrombosis or high blood pressure.
If you have spider veins and are interested in treating them, healthcare specialists such as the physicians at Center for Vein Restoration (CVR) can help you. To ensure the best treatment success, CVR can evaluate your lower extremity deep and superficial veins for dysfunction with a thorough ultrasound of the legs.
Call 240-965-3915 or visit our SCHEDULING PORTAL to book a consultation at a CVR vein clinic near you.
Venous ultrasounds can identify problems, including blockages, otherwise known as venous thrombosis, that impede drainage. They can also identify valvular dysfunction in the veins that can increase the likelihood of forming spider or other abnormal veins. Treatment of larger malfunctioning superficial veins involves removal or closure of the vein.
CVR uses various methods of closure, including radiofrequency or laser ablation, which heat or cauterize the vein, medical devices that function as adhesive sealants for the vein, and chemical foams that irritate and plug up the vein. Curing the underlying superficial venous disease, if present, will increase the likelihood of spider veins responding to treatment.
Finally, the specific treatment of spider veins can be divided into three categories: sclerotherapy, laser therapy, and thermal therapy. Depending on the location and size of the spider veins, your medical history, and your provider’s expertise, one or multiple of these treatment options may be available.
Sclerotherapy, involving the injection of irritating chemicals into the veins directly for closure, is the most widely available therapy. Some of the chemicals used for injection include concentrated saline or dextrose, mild detergents, and glycerin. Injections of these materials are performed with small needles under direct visualization and are generally well-tolerated. Outcomes are excellent but may take time to appreciate. Patients may experience discoloration in injection areas depending on their ethnicity, tendency toward scar formation, treated vessel size, and material used for injection.
Repeat treatments are often required, and compression socks worn over the treated areas improve results.
Laser therapy and thermal therapy are used less frequently because of the special equipment required. There are multiple types of laser therapy. However, the premise of their use revolves around specific wavelength light energy emitted by the laser and absorbed by hemoglobin in blood as heat. The heat, in turn, causes the blood within the vein to clot or thrombose, closing the vessel. Like sclerotherapy, complications associated with laser include discoloration and scarring associated with treatment area thermal injury.
Discomfort with treatment can vary depending on the depth of the vessel treated and the intensity of the energy used. Thermocoagulation is another form of spider vein treatment that uses a special needle to deliver high-frequency energy, causing the vessel to heat up and thrombose. As with the other treatment modalities, thermocoagulation can require multiple treatment sessions, and side effects include discoloration and scarring from thermal injury.
So, to answer the original question, “Do spider veins ever go away?” ...our answer is yes, with treatment.
It is imperative to minimize risk factors and treat the underlying venous insufficiency to achieve great treatment results, but with treatments currently available, spider veins can disappear. Patients undergoing treatment should know that recurrence is common, with 20 to 60 percent of treated patients experiencing the development of other abnormal veins within five years. Therefore, follow-up with the treating physician is often beneficial.
Understanding what spider veins mean for your venous health can help you make decisions that align with your goals and values regarding treatment and overall quality of life.
It’s critical to stay proactive about your venous health — and we’re here to support you through every step of your journey. Ready to take control of your venous health? Call 240-965-3915 to speak to a Patient Services Representative or schedule your consultation online at a Center for Vein Restoration near you.
About Vein Disease
Spider Veins
Varicose Veins
Vein Disease Treatments
Treating Spider Veins
Treating Varicose Veins
About Us
Patient Resources
Physician Resources