When fine veins on the legs are only a cosmetic concern, and when they may indicate deeper changes worth checking with ultrasound.
What causes spider veins?
Small vessels beneath the skin can dilate and become visible because of inherited vessel-wall weakness, hormonal changes, prolonged standing or sitting, or pregnancy. A spider vein is not itself a varicose vein, but it can sometimes be the visible tip of an underlying problem.
When it's just aesthetics
If there are only a few spider veins, they are not increasing and there are no other symptoms, the concern is most likely cosmetic. Treatment may be considered if their appearance bothers you.
When to seek advice
If spider veins appear alongside heaviness, swelling, night cramps or bulging veins, an ultrasound scan can check for underlying venous reflux.
Why diagnosis before treatment is important
If spider veins are treated while an underlying larger vein remains incompetent, they may return quickly. Treatment therefore starts with an examination and, when indicated, ultrasound. Any underlying cause is addressed before the cosmetic surface veins.
How spider veins are treated
The main treatment is sclerotherapy. A fine needle delivers a sclerosant solution into the vessel, causing its walls to close. It then fades gradually. Foam sclerotherapy under ultrasound guidance may be used for small tributary veins. The procedure is outpatient and usually requires no recovery time.
- Without incisions and anaesthesia.
- The treated vessels fade gradually over several weeks.
- Several sessions may be needed, depending on the number of spider veins.
Conclusion
Spider veins are rarely dangerous, but they deserve proper assessment. The right approach is to check that the deeper veins are healthy before treating the visible vessels, which supports a better and longer-lasting result.