Some people may think that spider veins are dead or defunct veins, but that’s not true. They are in fact patent working veins. Spider veins can be described as small abnormally dilated blood vessels.

To test whether a vein is ‘dead’ or not, gently push on it. It should blanch (whiten) and then return to normal color as it refills with blood. This illustrates that the vein is still transporting blood. Your spider veins should blanch.

Varicose veins and spider veins aren’t the same thing.

Spider veins are:  small, thin, reddish-purple blood vessels that can be seen under the skin’s surface.  They are usually harmless and they can be a symptom of poor circulation and varicose vein formation.

Varicose veins are: stretched out veins where blood has pooled.  They have a thick, “ropey” appearance and protrude out of the legs.  They occur when one-way valvues don’t work properly.

Spider veins are smaller versions of varicose veins that are closer to the surface, more visible, less likely to cause symptoms, and usually mostly a cosmetic problem. Spider veins can be a sign that there are varicose veins or insufficient circulation issues deeper in the leg. Most venous issues in the legs are due to reverse venous flow or pooling of blood within the vessels. Normally valves inside the veins prevent the blood from flowing backwards.  With prolonged strain the valves become dysfunctional and the blood pools.  The venous system doesn’t have a pump so movement of the blood toward the heart is dependent on contraction of the surrounding leg muscles.

Why do so many of us (upwards of 50% of the population) get spider veins?

The pooling of blood is commonly caused by prolonged standing and/or sitting. Other notable causes are obesity, smoking, lack of exercise and hormonal birth control.

So a systemic approach to improving circulation and venous health is important. One or several of the following may be beneficial: exercise, reduced sitting or standing for prolonged periods of time, horse chestnut (an herbal supplement), witch hazel, compression stockings, an assessment by your physician, elevation of legs, weight loss, etc.

Laser treatment is appropriate for small to medium sized spider veins. Deeper, bluer, larger veins require sclerotherapy (injection into the vein).  Large, ropy, twisting, tender veins known as varicose veins require a medical assessment/examination to determine if sclerotherapy or surgery are indicated.  Varicose veins are not candidates for laser treatment.

Lots of people are confused about the difference.  We will assess you during a free consultation and advise you of the best course of action.  In general spider veins that can be treated with a laser are purple or red (as opposed to blue), have a diameter of less than 3mm, and are easily visible on the surface of the skin.

During laser treatment the laser light will damage the internal lining of the vein causing it to collapse. Over a period of 8-10 weeks the broken down tissue will be resorbed and cleared by the body. At that time the vein may have disappeared or may need a 2nd treatment.  Due to the higher blood pressure in the lower extremities, spider veins in the legs may reappear after a period of time sometimes in a different place as blood flow is redirected.  But in the majority of cases, those vessels will be gone permanently.

Although spider veins are most common on the back of the legs, they also frequently occur on the face and chest.

As you age or as you prepare yourself for the summer season of bare legs, know that improving the appearance of your legs is possible with the convenience and effectiveness of laser treatment.