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Spider Veins

(Idiopathic Telangiectasias)

by James D. Douketis, MD

Spider veins (idiopathic telangiectasias) are small, enlarged veins that are visible under the skin.

Many people with or without varicose veins may have spider veins, which are enlarged capillaries. Spider veins may be caused by the pressure from blood in varicose veins, but the cause is generally thought to be hormonal factors that are not yet understood. A hormonal cause would explain why spider veins most commonly occur in women, particularly during pregnancy.

Spider veins usually cause no symptoms. Some people do have pain or burning. Many people consider spider veins unsightly.

Spider veins can usually be eliminated by sclerotherapy similar to that done for varicose veins (see Injection therapy (sclerotherapy)). Large areas of spider veins (multiple telangiectasias) may require several treatments. The skin may darken, but this discoloration usually subsides, often completely. Laser treatment is also effective, but large areas require several treatments. Intense pulsed light therapy can be used to treat small spider veins. This therapy is similar to laser therapy except that the light is applied in short bursts. Small spider veins may persist or recur after initial treatment.

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