The following information does not replace a physician’s diagnosis and advice under any circumstances whatsoever.

Spider veins (starburst varices)

Spider veins: what’s that?

Highly fine, extended and gyrose veins in the uppermost skin layers are described as spider veins (starburst varices). These birch broom-like branched out vessels have a primarily cosmetic significance. Spider veins arise mostly on the legs, often initially in the ankle region. They also occur frequently in the hollows of the knee and the outer side of the thighs. Women are affected three times more frequently than men. Spider veins can indicate venous disorder.

Symptoms of spider veins

The starburst varices are small skin veins which become apparent due to an expansion of their diameter (up to 1 mm) and their reddish-blue gyrose, mesh-like structure. They normally cause no complaints and are not necessarily an indication of an impaired venous function. However, they can also arise as a consequence of changes to the deep vein system, e.g. if the venous valves no longer function optimally. If you squeeze the spider veins, they empty, but they fill again fast after the pressure effect is no longer given. Complaints such as a feeling of congestion or pain do not normally exist. If they do exist, they draw attention to participation of the deep venous system.

Causes of spider veins

Spider veins arise due to a weakness in the wall of the small skin veins which results in their expansion due to the effect of the pressure in the vessels. Vein congestion facilitates their formation. Spider veins are often incurred in conjunction with varicose veins (varices). The factors which may contribute to the formation of spider veins are:

  • Tissue weakness (often hereditary)
  • Hormone changes (pregnancy, menopause)
  • Medication (the pill, antihypertensives)
  • Excess weight
  • Lack of exercise
  • Long standing and sitting for work

Diagnosis of spider veins

Spider veins can already be diagnosed visually (visual diagnosis). However, the patient history (case history) is also interesting: for example how long the spider veins exist and whether they cause complaints. The case history questions also include familial predisposition, risk factors as well as dietary and lifestyle habits.

As spider veins may be an initial indicator of chronic venous weakness (chronic venous insufficiency CVI), examination of the entire surface and deep venous system is necessary prior to treatment. They are diagnosed using ultrasound or duplex sonography.

How can spider veins be prevented?

The most effective prevention of spider veins is keeping the risk factors described as low as possible. We recommend:

  • Exercising as often as possible, frequently changing your position, propping your legs up
  • Sports and gymnastics, also vein gymnastics to activate the calf muscle pump
  • Reduction of overweightness and healthy nutrition
  • Comfortable, flat shoes to support the calf muscle pump
  • Frequent contrast showering or “Kneipp pours” for the legs

What therapy options are available for spider veins?

From a medical viewpoint, it is not necessary to remove spider veins. Currently, various procedures are applied for the removal of spider veins.
One of these methods is sclerotherapy (atrophy) with alcohol. Here, the atrophic agent is injected into the vessels. The atrophic agent triggers a swelling/irritation of the venous wall, which in-turn causes the venous walls to stick together. The body destroys these changed veins gradually. The number of therapeutic sessions depends on the degree of severity. Slight bruises or venous inflammation may be caused as side effects. Brownish discolouration around the injection site is not dangerous and disappears again. Normally, several therapy sessions are required. After the treatment, medical compression stockings such as BORT AktiVen® should be worn.
Very small vessels can be atrophied using laser treatment. For this method, a laser is placed on the areas affected, thus achieving the occlusion of the vessels by heating the venous tissue. Depending on the depth of the spider veins, several sessions are needed to reach the desired result. The procedure is more gentle than sclerotherapy. Side effects include redness of the skin, which disappears after a certain period.

Status: August 12, 2022