Spider Veins

Assessment determines whether treatment should target only the visible veins or also a deeper source of venous pressure.

Spider veins may occur on their own or alongside larger reticular veins, varicose veins and underlying venous reflux. Contributing factors include genetics, age, pregnancy and hormonal changes, prolonged standing, previous injury to the area and chronic venous disease. They commonly cluster around the ankles, thighs, knees or calves and can slowly increase in number over time.

Most spider veins cause no medical problems. Some people report localised aching, itching, burning or tenderness, particularly after long periods of standing.

Bleeding is uncommon but can occur if a fragile surface vessel is knocked or scratched; firm pressure usually controls it, and persistent or recurrent bleeding warrants review.

Not every small cosmetic vein needs a scan. Duplex ultrasound is recommended when spider veins occur with varicose veins, leg swelling, skin changes, a history of deep vein thrombosis or symptoms suggesting underlying reflux. This matters because injecting surface veins while leaving an untreated deeper source of pressure leads to early recurrence.

For referrers, examination distinguishes isolated telangiectasia from patterns suggesting saphenous or reticular reflux, and duplex is arranged selectively on that basis. The consultation also covers medical history, medications and any previous vein procedures.

Microsclerotherapy

Microsclerotherapy is the most common treatment for leg spider veins. A fine needle injects a solution that irritates the vessel lining, causing it to close and gradually fade. Several sessions are often needed, because veins respond unevenly and new vessels can appear over time.

Surface laser treatment

Very fine vessels that are difficult to inject may suit surface laser treatment. Suitability depends on vein size, depth and skin type, and is assessed individually.

Compression may be recommended for a short period after treatment. Temporary redness, bruising, pigmentation, small areas of trapped blood and local tenderness are relatively common and usually settle. Improvement develops gradually over weeks to months as treated vessels fade, and complete clearance of every visible vessel cannot be guaranteed.

Less frequent complications include skin injury, small ulcers at injection sites, vein matting (a blush of fine new vessels), allergic reaction and, rarely, thrombosis.

A spider vein consultation should establish whether the visible vessels are isolated or are being supplied by larger reticular veins or underlying venous reflux. Ultrasound is not necessary for every patient, but it may be recommended when there are varicose veins, swelling, skin changes, previous thrombosis or symptoms that suggest a deeper venous problem.

Treatment is usually gradual rather than immediate. Microsclerotherapy and surface laser can improve the appearance of suitable vessels, but the likely response depends on vessel size, distribution, skin type and whether an underlying source of pressure has been addressed.

It is helpful to discuss what the legs may look like during recovery, including temporary bruising, trapped blood, pigmentation or fine new vessels known as matting. New spider veins can appear with time even after successful treatment. Your clinician can explain the expected number and spacing of sessions, the role of compression and any factors that may increase the risk of pigmentation or recurrence.

Spider vein treatment at Yarra Vascular Surgeons starts with an honest assessment of whether a deeper venous problem is present, then a realistic, staged plan using microsclerotherapy or laser where appropriate. Expectations about fading, sessions and recurrence are discussed openly before treatment begins.

Spider veins are often cosmetic, but they can coexist with larger varicose veins or underlying venous reflux. Yarra Vascular Surgeons provides careful assessment to determine whether ultrasound is needed and whether treatment should address only the visible vessels or a deeper venous problem. Microsclerotherapy and other options can then be planned with realistic expectations regarding response, recurrence and staged treatment.