Varicose veins and spider veins (or telangiectasias) are symptoms of blood circulation disorders. When the deep veins do not perform their functions well, small vessels closer to the surface of the skin take over. They dilate and become more visible until they form a network around the ankles and calves: they are spider veins. What to do ?

Telangiectasias or spider veins are very small venules measuring less than 1mm in diameter, close to the skin unlike deep networks, which are red, blue or purple in color. They are mainly present in the lower limbs. Spider veins can sometimes be found in other locations: face, neck, lower back. They are more present in women than in men before the age of 50; after 60 years, nearly 80% of people are carriers of telangiectasias, and this, in an equivalent way in women and men.

Spider veins are mostly unsightly. Their participation in venous symptoms (pain, heaviness in the leg) has not been established. However, some patients may be relieved after treatment for their telangiectasias. They develop in isolation, or are grouped together in bundles and, in this case, often supplied by a more dilated and slightly less superficial vein, called “reticular vein”.

Varicosities can also be in a context of more advanced venous disease, with varicose veins (permanent dilation of a vein) more or less important. Finally, they can be favored by capillary fragility, or even occur after even minimal skin trauma.

For information, our body is made up of a complex venous system which is divided into 2 categories:

• the deep venous system which carries about 90% of the blood through the body;
• the superficial venous system which carries only 10% of the blood. This system is the site of the appearance of varicose veins and spider veins.

When the blood stagnates in the legs, the veins dilate and reveal sinuous, bluish or purplish traces. The veins have valves that allow them to be irrigated in one direction. Varicose veins appear when the valves lose their tone and insulating power. The blood stagnates and causes varicose veins.

There are several causes for the appearance of varicose veins on the lower limbs

• the effects of aging and natural aging;
• standing or sitting for a long time, compression of the venous system caused by crossing the legs;
• during a significant hormonal change, especially in women during pregnancy or at the time of menopause;
• during significant weight gain, cellulite makes lymphatic and venous circulation more difficult;
• during a significant exposure to the sun or to strong heat, the veins tend to dilate.

In order to explore the affected area but also all the veins of the lower limbs, a Doppler ultrasound will be performed by a vascular doctor. This painless examination will make it possible to establish a map (drawing) of the venous network.

To avoid traffic problems, the first thing to do is… get moving! Physical activity such as cycling, walking, swimming have beneficial effects on the blood system.

Avoid staying in a static position for too long and be sure to take a few steps and stretch throughout the day. Cold water is also a good way to stimulate circulation. Avoid sauna, hammam and other hot baths, and end the shower with a jet of cold water on the legs. Also wear loose clothing, which does not compress the legs.

The care provided by the phlebologist varies according to the severity of the condition, the profile and the age of the patient. If the telangiectasias are isolated, not supplied by a nourishing vein, they can be treated immediately.

Among the treatments:

• sclerotherapy. It is the most efficient and complete technique. It consists of injecting a sclerosing foam into the small visible vessels to cause them to close. The blood therefore flows back to other healthier veins;
• the laser;
• external radio frequency.

All these treatments are carried out in the doctor’s office. The consultation lasts 15 to 30 minutes. It is possible to have a normal activity after the session. For optimal results, several sessions are necessary (each spaced 1 to 3 months).

If the telangiectasias depend on nourishing veins or a larger and slightly less superficial supply network, it will first be necessary to treat these before injecting the spider veins. Once the veins which supply the spider veins are treated, we can then “attack” the latter by the techniques mentioned above. The risk of ignoring a feeding vein is to be ineffective.

Is it absolutely necessary to treat spider veins? There is no risk to your health. This is mostly an aesthetic problem. However, if you wait to treat them, they may develop more and more over time and their treatment may take longer. Even after treatment, other telangiectasias can appear over time, because patients with telangiectasias generally have a predisposed terrain. Regular maintenance is therefore necessary to maintain an optimal aesthetic result.