Spider Veins (Telangiectasia)

Patient with spider veins at The Leg Vein Doctor.

Patient with spider veins at The Leg Vein Doctor.

Spider veins or telangiectasia are very small veins which are visible on the surface of the skin. Sometimes they can cause an ache and discomfort in the legs. They are quite common and generally not harmful.  Sometimes spider veins can be very extensive and cause a great deal of distress for patients because of their unsightly appearance particularly in Queensland where we enjoy such warm weather.

At the clinic we often hear these kinds of comments:
"Oh, I can't wear that!"
"I never wear short dresses"
"I never go to the beach" 

There are four different patterns of telangiectasia. 

  1. Simple

  2. Arborized

  3. Spider

  4. Papular

Spider veins arise due to reverse pressure from larger veins downstream called reticular veins which lie slightly deeper under the surface of the skin. Reticular veins tend to have a blue/greenish appearance. They are also called "feeder veins" as they tend to feed into the spider veins.  Successful treatment of spider veins most often depends on effective occlusion of these reticular veins with sclerotherapy.   Poor results and complications such as matting are usually the result of a failure in identifying and treating the relevant reticular vein network which can often be hidden beneath the skin and not immediately obvious.  Their depth, their diameter and their underlying course is highly variable which explains why surface lasers have a limited ability to adequately treat spider veins.

There is almost universal agreement amongst experts in this field that microsclerotherapy is the "Gold standard" for treatment of spider veins. Vascular or surface lasers which are suitable for treatment of spider veins on the face and upper body tend to be ineffective in the treatment of spider veins on the legs.  

Spider veins are frequently (~25%) associated with underlying problems  in the deeper veins under the skin. So this is why at The Leg Vein Doctor we perform a duplex ultrasound scan on your legs to properly image these veins and check their flow direction with Doppler if we suspect a problem.  Failure to detect underlying incompetence of superficial veins or saphenous veins leads to much greater complication rates in the treatment of surface veins and most trained sclerotherapists will not proceed with surface vein treatment until underlying venous incompetence has been treated.