Telangiectasia, commonly called spider veins, are tiny (0.1mm to 1mm) vessels that can appear anywhere on the body. They are most commonly found on the face and lower extremities. Spider veins can occur due to numerous factors including genetics, hormonal influences (estrogen & progesterone), pregnancies, injury and more significantly, an underlying issue with lower extremity superficial vein valve incompetence. Vein disease is extremely common: about half the population has some sort of vein issue during the course of their lifetime.
The role of veins, in general, is to return blood flow back to the heart. In the lower extremities, the challenge is to do so against the force of gravity. Fortunately we have an ingenious system to accomplish this: a calf muscle “pump” that acts as a peripheral heart. The contraction of the calf muscle generates the force to propel blood that is in the leg veins upward. What keeps the blood that has been moved upward from passively pooling back in the legs are one-way valves within lower extremity veins. If the valves malfunction, one-way valves can, unfortunately, become two-way and allow blood to flow downward with gravity.
As blood pools, pressure builds up (venous hypertension). This excessive pressure leads to veins becoming enlarged, tortuous and more apparent at the skin surface. Reticular veins (1mm-3mm) are bluish-appearing veins that are often thought of as “feeder” veins that may underlie and lead to tinier spider veins at the surface. Varicose veins (3-4mm or greater) are those bulging, often twisty veins that grow larger and more tortuous over time.
All of these abnormal veins, including the tiny spider veins, can cause significant symptoms. Symptoms of chronic vein disease include lower extremity heaviness, fatigue, cramping, itching, restless legs and swelling. Venous hypertension, over the course of time, can lead to chronic inflammatory changes in the skin. The skin can become discolored, thicker and even ulcerated.
Varicose veins can also lead to more significant problems such as bleeding episodes (due to the fragility of the thin, enlarged vein bulging at the surface) and superficial & deep blood clots.
The key is to consult with Dr. Rosen to determine the best course of action to take to diagnose and treat your particular vein issues.