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