Small blood vessels, sometimes called spider veins or more appropriately telangiectasias, can be an unsightly problem. They can also represent a more serious underlying disease. This primer is aimed at helping patients to understand the causes of spider veins and some of the treatment options.
What are spider veins?
Spider veins also referred to as vascular spider, arterial spider, spider nevus, or spider telangiectasia are small visible blood vessels. They may represent either small arms or veins.
What causes telangiectasias?
Telangiectasias can occur naturally in otherwise healthy patients. They may also represent a more serious medical condition. Those illnesses associated with telangiectasias include:
· Ataxia – telangiectasia
· Bloom syndrome
· Cutis marmorata telangiectatica congenita
· Hereditary hemorrhagic telangiectasia (Osler-Weber-Rendu syndrome)
· Klippel-Trenaunay-Weber syndrome
· Nevus flammeus such as port-wine stain
· Spider angioma
· Sturge-Weber disease
· Xeroderma pigmentosa
· Liver disease
Spider veins or dilated veins in the legs can also represent a more serious blockage of other vessels in the legs. For patients with minimal telangiectasias that present a cosmetic concern, additional workup is not often undertaken. Evaluation by a trained physician before any treatment is undertaken is necessary to ensure that the spider veins do not represent a more serious medical condition.
What are my treatment options?
If the spider veins are caused by a medical condition, the key to treatment is treatment of the underlying medical condition. If the concern is only cosmetics, there are several options depending on the size and location of the vessel. For small vessels on the face, intense pulsed light system or green light lasers such as KTP can be used to treat the lesions. For larger vessels, electrocautery, ligation, endovascular clotting techniques, or sclerotherapy can be used to shut off the blood flow to the vessel and make it disappear.
What is the first step in treatment?
The first step in treatment is consultation with a physician who specializes in treating vascular lesions. A good starting point for lower extremity lesions is a vascular surgeon, preferably one who is versed in treating not only the medical causes of the problem but also versed in the use of lasers and other techniques to address the aesthetic problems associated with them. For facial lesions, a facial plastic surgeon or general plastic surgeon can certainly both diagnose and treat small vascular abnormalities such as telangiectasias.