Spider veins / broken capillaries (telangiectasia) overview

Spider veins are harmless and generally cause no pain or discomfort as opposed to varicose veins (large enlarged veins), which may be symptomatic. Their main impact is unsightly appearance.

What causes spider veins?

Enlarged veins in the legs, both spider veins and varicose veins, are generally a result of venous insufficiency, a condition where blood pools in the veins due to excessive pressure and impaired drainage. In turn, venous insufficiency is caused by the damage to the vein valves that normally prevent the backflow of blood. The valves can typically get damaged for two reasons: excessive pressure and weakness of vessel walls. Thus, whatever increases pressure and impairs blood drainage from leg veins tends to contribute to the development of spider and/or varicose veins.

Facial spider veins are slightly different. They tend to be smaller and are generally not caused by excess pressure or vein valve damage. They are typically caused by the damage resulting from sun exposure or inflammatory conditions (such as acne rosacea). A combination of direct damage to vessel walls and excessive and prolonged dilation (e.g. due to chronic inflammation or irritation) often leads to facial spider veins / broken capillaries.

A number of factors are associated with the development of spider veins:

• Increasing age
• Family history of vein problems (spider or varicose viens)
• Hormonal changes, such as those during pregnancy or menopause. Sometimes hormonal contraceptives may cause or worsen spider veins. (This factor is more relevant for spider veins on the legs.)
• Pregnancy. In addition to hormonal changes, pregnancy causes increase in blood pressure and volume, which can lead to spider veins on the legs.
• Various factors increasing blood volume and pressure in the legs (obesity, leg injury, prolonged standing, heavy lifting, etc.).
• Sun exposure, inflammatory skin diseases, such as rosacea, chronic skin irritation/inflammation. (This factor is more relevant for spider veins on the face.)

Prevention

As with many other conditions, spider veins are easier to prevent than to treat. If you have family history of spider and/or varicose veins and/or have noticed early signs, you may want to minimize the risk of progression. Of course, some of the risk factors (such as age, heredity, hormonal lifecycle phases) you can do nothing about. If you can, try to reduce strain on your legs veins by avoiding prolonged standing and excessive heavy lifting. To prevent facial spider veins, protect your face from sun exposure, avoid skin irritation and treat facial skin inflammation (if any) promptly. Some plant-derived substances have been shown in clinical studies to reduce venous insufficiency by strengthening vessel walls. Since venous insufficiency is related to spider and varicose veins (at least in the legs), it is possible that vessel wall strengthening agents may prevent the progression or even reduce the appearance of spider veins. The examples of such agents include rutin, proanthocyanins (from grape seed extract), gotu kola and others.

Treatments

Unfortunately, once spider veins have developed, conservative treatments, such as topical and oral medications or supplements, seem to be only modestly effective at best. More aggressive alternatives include lasers, intense pulsed light and sclerotherapy. See Spider Vein Treatments.