Spider veins on legs (telangiectasias) show up as a mesh of tiny veins near the surface of the skin. Spider veins are dilated, or enlarged, but they are normally less than one millimeter in diameter. Many people assume that getting rid of spider veins requires only a cosmetic solution, but sometimes spider veins are symptomatic of a more serious condition in the larger veins.
There are three different dilated vein conditions: spider veins, reticular veins, and varicose veins.
Spider veins on legs form a mesh pattern that often resembles a web, which is how this particular venous disease gets its name. On thighs and knees, spider veins may resemble the branches of a tree or appear as thin, separate lines. Spider veins are less than one millimeter in diameter.
Reticular veins measure between one millimeter and three millimeters in diameter. These bluish veins shouldn’t be confused with the normal bluish veins that can be seen in people with thin, transparent skin.
Varicose veins are dilated veins that are equal to or greater than three millimeters in diameter. Varicose veins are often twisted and bulge on the surface of the skin.
Spider veins are the most frequent feature of venous disease and are the mildest indication of venous reflux, a disorder in which the tiny valves inside veins that control blood flow become damaged (valvular incompetence), allowing blood to flow backwards and pool.
The most frequent cause of varicose veins is likely due to an abnormality in the vein wall, although the cause can also be in conjunction with valvular incompetence
There are several factors that can contribute to venous reflux and valvular incompetence:
Typically, spider veins look unsightly and may itch or burn. Other common symptoms include pain and aching, fatigue, heavy or restless legs, and leg cramps. These symptoms usually indicate another underlying disorder in veins that can’t be seen from the surface of the skin.
In these more serious cases, getting rid of spider veins may be part of a more comprehensive therapy involving those veins that are not visible.
There are several treatments for spider veins, depending on their size.
The symptoms of mild venous disease can sometimes be made less severe with conservative therapy measures including compression stockings, leg elevation, exercise and over-the-counter medications.
More serious venous disease can usually be treated with radiofrequency endovenous ablation therapy, foam sclerotherapy, or ambulatory phlebectomy.
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