Spider veins: what are they and how can we prevent them?
Cosmetic leg veins can be classified into two main categories: spider veins and varicose veins. The two conditions often occur in parallel, but they can be distinguished according to their appearance: a varicose vein is an abnormally dilated, tortuous, twisted subcutaneous vein (1), while spider veins occur in the dermis and their diameter varies between 0.1 and 1.0 mm (2).
Spider veins appear when widened venules (tiny blood vessels) cause fine, web-like patterns on the skin. These patterns appear as red or violet areas on the skin that form gradually in different parts of the body - often on the legs and around the ankles. The medical term for this condition is Telangiectasia, commonly referred to as "spider veins", "star bursts", "thread veins", or "matted veins" (1) due to their appearance. Associated symptoms are itching skin, tingling, threadlike marks and patterns on the skin, pain connected to pressure on venules (3).
A study of people aged 35 to 70 conducted in London in 1992 revealed that over 80% of the total population has reticular varicosities or telangiectasia. (1) Researches believe several causes can contribute to the formation of spider veins, including genetic and environmental factors like sunlight exposure. Pregnancy, increasing age, occupations that require a lot of standing, habitual corticosteroid use and alcoholism can also contribute to the appearance of Telangiectases as they cause a weakening of blood vessels. Certain skin conditions (such as rosacea, scleroderma, dermatomyositis and systemic lupus erythematosus) (3) also appear to be related to spider veins as they increase skin sensitivity and cause irritation. Spider veins are usually benign, but they may be associated with an underlying psychologic discomfort (4) as they can be perceived as a cosmetic concern by those affected by this condition, considering spider veins aesthetically unpleasant.
A variety of treatments are available for varicosities and spider veins, and they vary according to the size, location and incidence of associated symptoms (5). Treatment are generally not necessary when they primarily are a cosmetic problem, but following some basic rules can help in slowing down their progression or preventing their appearance:
1.Regular exercise can help strenghtening the heart and blood vessels, improving blood flow and boosting circulation. Periodic leg elevation, avoidance of prolonged standing, and weight control can also be beneficial, while, when spending long periods of time seated, it is important to maintain a good posture and take regular walks to stretch the legs
2. Tight clothing can restrict the circulation which can contribute to the appearance of spider-veins. Wearing comfortable clothing and elastic support hose may help reduce their incidence
3. Excessive sun exposure can cause a breakage of the collagen beneath the skin, causing the appearance or worsening of the appearance of spider veins. Taking precautions during sun exposure by applying sunscreen with an adequate SPF factor prevents sunburns, which can instigate an inflammatory immune response
4.A correct diet can also be a prevention factor: foods high in fibers, fruits and vegetables rich in bioflavonoids can contribute to the overall vein health. Many fruit and vegetables have natural anti-oxidant and anti-inflammatory properties, which can help diminish swelling and strengthen the collagen within the vein walls. Some examples are cherries, watermelon, berries, grapes, tomatoes, broccoli, bell peppers, leafy greens.
(1) London, N. J. M., Nash, R. (2000). "Varicose veins", BMJ: British Medical Journal, 320(7246), pp. 1391–1394
(2) Thibault, P et al. (July 1990). "Cosmetic Leg Veins: Evaluation Using Duplex Venous Imaging", J Dermatol Surg Oncol, vol. 16, n.7
(3) Healthline Editorial Team, Cobb, C. (November 29, 2017), "Telangiectasia (Spider Veins)". Web resource: https://www.healthline.com/health/telangiectasia
(4) Gloviczki, P. et al. (May 2011). "The care of patients with varicose veins and associated chronic venous diseases: Clinical practice guidelines of the Society for Vascular Surgery and the American Venous Forum", vol. 53, n. 5, Supplement, pp. 2–48
(5) Cole, G. W., Nabili, S. N., Doerr, S., Conrad Stöppler, M. (2016), "Varicose Veins and Spider Veins". Web resource: https://www.medicinenet.com/varicose_veins/article.htm