Spider Veins Treatment

Overview

Spider veins are reddish-purplish to greenish distended veins in the skin of the legs which may appear cosmetically unsightly. These tend to affect women more than men. Spider veins generally do not cause much symptoms other than affecting the appearance of the legs.
Spider Vein Treatment Procedure

Symptoms

Spider veins rarely cause much symptoms. They usually appear unsightly as either prominent reddish-purplish fine veins on the skin or larger greenish veins slightly deeper in the skin layers.

The appearance of the spider veins may worsen over time. This can be aggravated by certain occupations that require the person to stand for long periods of time. People who may be at risk include nurses, teachers, sales assistants and F&B servers and cooks.

Presence of symptoms such as calf heaviness especially after standing for long periods and calf cramps at night may be due to underlying problems in the main veins in the thigh and calf, such as reflux or backflow. In the presence of these symptoms, patients should have a proper workup done to address these underlying health issues before seeking treatments for the spider veins.

When to Seek Treatment

Most people seek treatment to try to reduce the appearance of these unsightly veins especially when they become more prominent over time. The veins are more noticeable in light skinned patients and this can be quite disconcerting.

Women tend to seek treatment when the appearance of the veins prevents them from wearing the clothes they prefer. Presence of veins in the calves may prevent some from wearing skirts and shorts especially if the spider veins are quite florid.

Diagnosis

The presence of spider veins are usually quite visible and no further diagnostic tests are usually needed to confirm the diagnosis. However, in the presence of other symptoms such as leg discomfort, pain, swelling or cramps, further investigations may be required to confirm that there are no other medical problems underlying the spider veins.

One commonly performed test is to do an ultrasound scan of the legs. This allows the doctor to check if there is significant backflow or reflux in the veins in the legs. If there is backflow, then this problem should be addressed before commencing treatment for the spider veins.

Treatment

Injection sclerotherapy is one of the main modalities of treatment for spider veins. This procedure is done in the clinic. Injection sclerotherapy involves injecting the spider veins with a medical grade chemical agent which will cause inflammation of the veins and lead to the veins eventually closing off or sclerosing. The injection is delivered with a fine tipped needle.

Another treatment option is using Laser Sclerotherapy. In this technique, a laser probe is used to fire laser energy onto the skin. This laser energy is then absorbed by the spider veins and this creates heat and eventually inflammation of the spider veins. This technique does carry a risk of causing darkening of the treated skin, a complication known as Post-Inflammatory Hyperpigmentation (PIH)

To treat some of the smaller spider veins, Veingogh may be used. This is a new modality of treatment that delivers a burst of electric current into the spider veins via a fine tipped needle. This will then create heat and cause inflammation of the spider veins.

Most of these treatments will require a few sessions of treatment to be able to see some results. After each session, patients are usually advised to wear compression stockings for the first few days and to avoid sun exposure for at least a week by wearing long pants or applying a high SPF sunscreen.

Causes

Women tend to develop spider veins more often compared to men. This may be due to the fact that more women are involved in occupations that require them to stand for long periods, especially in the healthcare and service industries.

Another reason why women have a propensity for developing spider veins is the fact they wear high heeled shoes. Wearing high heeled shoes places the ankle in a constant state of plantar flexion, where the foot is bent forward when the heel is raised. Walking in this position severely limits the freedom of movement of the ankles and this leads to increased pressure in the veins of the legs.

Risk Factors

  • Female gender
  • Previous childbearing
  • Occupations that require long periods of standing (nurses, teachers, sales assistants, F&B servers and cooks)
  • Wearing high heeled shoes for long periods

Consult Our Doctor

Dr Lee Chee Wei
Vascular & General Surgeon

MBBS (Singapore), FRCS (Edin), FAMS (Surgery)

FAQs

Avoiding standing still for long periods will reduce the pressure in the veins in the legs. For people who need to stand for long periods at work, wearing compression stockings will reduce the pressure build up in the legs.

The ultrasound will be done of the legs from the thigh to the calves. Please wear or bring along a pair of shorts to change into for the scan.

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