Broken veins on thighs

What are spider veins?

Spider veins, or thread veins are small burst veins visible on the surface of the skin. The medical term for these veins is telangiectasia. Usually asymptomatic although some people describe itch or discomfort. Symptoms worse or veins appear more prominent after sitting or standing for prolonged periods. The commonest reason for treatment is cosmetic.

Spider veins can occur on their own, commonly on the side of the thigh, but often they are associated with underlying varicose veins and venous insufficiency.

What causes spider veins?

To understand what causes spider veins it is important to understand how blood flows in the legs. Arteries carry blood away from the heart and veins carry blood back to the heart.  

Blood in the legs should flow in one direction- from the feet back up the legs to the heart. The muscles in our legs pump blood back to the heart.

Small valves in the vein wall help the blood flow in this direction. If these valves stop working because they become weak or damaged, then blood will move in the wrong direction – back down the leg. Blood can start to pool in the vein and in time the vein can protrude outward resulting in varicose veins or spider veins.

Leg spider veins and varicose veins result from weakened or damaged valves and are part of an underlying medical condition termed venous insufficiency. Although both problems result from the same underlying condition, they often have different signs and symptoms.

Spider veins are small superficial veins that appear as flat or slightly raised lines on the leg. They can be blue, purple or red. They are usually painless but can be associated with discomfort or itch.

Varicose veins are veins that are larger than 3mm and lie deeper in the legs than spider veins. They are baggy distended often torturous and twisted veins that can be felt through the skin and are usually flesh coloured although can be bluey-green.

Varicose veins can cause a variety of symptoms including:

• an achy or heavy feeling in the legs
• restless legs or leg cramps
• pain
• itching
• bleeding
• swelling of the legs or ankles
• thrombophlebitis (clots within a varicose vein)
• eczema and skin changes

Varicose veins may also increase a person’s risk of a blood clot, known as Deep Vein Thrombosis (DVT).

Risk factors

The commonest cause of varicose veins and spider veins is a family history. Over 90% of people with spider veins or varicose veins have a family history. Other Risk factors for spider veins include:

• Advancing age: The valves in the vein walls get weaker over time. The leg muscles, which support the veins and pump blood upward, also weaken with age.
• Pregnancy: The increase in blood volume combined with the extra weight of the growing foetus places more pressure on leg veins during pregnancy.
• Female sex: Spider veins affect more women than men.
• Obesity: Body weight places pressure on leg veins. The heavier you are, the greater the pressure.
• Hormones: Hormonal treatments for contraception and menopause has been associated with spider veins as oestrogen can weaken vein valves.
• Sitting or standing for extended periods: Veins in the legs have to work harder to pump blood upwards if a person remains in the same position for long periods of time.
• Trauma. A previous blood clot or vein damage can weaken the valves making them unable to function correctly.

What are the treatments for Spider veins?

Treatment options are aimed at improving appearance or removing the problem veins completely. It is best to seek medical advice from a qualified practitioner on the best treatment choice for you.

Treatment should begin with an assessment of the leg veins to check for any underlying problems. If an underlying vein issue is suspected, then a duplex ultrasound is performed.

It is important to treat any underlying varicose veins before addressing surface spider veins to achieve optimal results and prevent unwanted side effects.

The commonest treatments for spider veins are sclerotherapy and laser therapy.

Sclerotherapy

Using an ultra fine needle a liquid called sclerosant is injected into the vein. The sclerosant removes the lining of the vein causing the walls of the vein to stick together and scar is formed. This process takes up to several weeks and often 2 or 3 sessions are required with an interval of at least 6 weeks.  Studies show that this is the best treatment for spider veins on the leg.

After undergoing sclerotherapy you will be asked to wear compression stockings for at least a week and to walk regularly.

Laser

Transcutaneous laser treatment can improve appearance of broken veins on thighs and legs. Veins that are less than 2mm in size and close to the vein surface are suitable for laser treatment. Laser treatment involves damaging the vein wall by heat which produces a scar.

Unlike sclerotherapy, Laser treatment does not involve injections.

At Palm Clinic we use the Exotherme laser which is a 980nm diode laser specifically designed for the treatment for veins measuring 0.2-2mm in size. This is a different laser treatment to the hair removal laser and the laser for thread veins on the face.

Glue closure system

This is a treatment for large varicose veins. Similar to sclerotherapy, a glue closure treatment involves injecting a sticky substance into the affected veins. This substance closes damages the vein wall which closes the vein off from blood flow, causing the vein to fade or disappear with time.

Glue therapy is a relatively new treatment in varicose vein disease and not performed widely in New Zeland.

Endovenous thermal techniques

The preferred treatment for varicose veins is Endovenous thermal ablation. These treatments literally mean “heating the vein from inside”. This includes Radiofrequency Ablation (RFA) and Endovenous Laser Ablation (EVLA). At Palm Clinic we use Radiofrequency ablation as the primary treatment for varicose veins. 

Surgery

Surgery is on longer considered first line treatment for varicose veins. For spider veins less invasive treatment such as sclerotherapy and laser therapy are preferred.

Compression socks

Wearing compression stockings can relieve the symptoms of achy legs but will not stop vein disease progression.

Side effects of treatment

Like all medical treatments there are side effects which are usually very minor and self-limiting. These include bruising, swelling and brown staining.

Serious complications are very rare following varicose vein or spider vein treatment. These include blood clot.Wearing compression socks and walking regularly after treatment decreases your risk of blood clots.

Prevention of SVs

Certain lifestyle changes can affect spider veins. These include:

• Maintaining a healthy weight. This helps reduce pressure on the veins.
• Wearing compression stockings. If spider veins or varicose veins are a concern or there is family history, then consider wearing compression socks.
• Staying fit and active. Avoid sitting or standing for long periods of time without taking a break. Get up and walk around every 20-30 minutes. Physical activity improves overall circulation and can prevent blood from pooling in the lower extremities.
• Avoiding tight clothing. Ensure clothing around the waist and legs is not too tight. Wearing clothes that restrict blood flow may increase the risk of spider veins.
• Avoiding excessive heat. Hot tubs and saunas use cause veins to dilate, increasing the risk of spider veins in the legs.
• Elevating the legs. Raising the legs when sitting or lying down can help prevent blood from pooling in the legs. Try not to sit with your legs extended straight out in front of you as this can cause knee problems. Use a rolled up towel, cushion or pillow under your knees for support.
• Using cover-up products. Self-tanning and leg concealer products can temporarily minimise the appearance of spider veins on the legs.