What Causes Spider Veins, and What You Can Do About Them

At some point, most of us are bound to notice a patch of spider veins on our thigh. They’re those twisting, faint blue lines that seem to suddenly appear out of nowhere. Turn to Google and you’ll begin to see just how widespread they are because you’ll come up with pages of home remedies.

I hate to be the bearer of disappointment, but those DIY treatments don’t work. That doesn’t mean you’re stuck with your spider veins, though. More on that in a moment. First, let me explain what spider veins are, because they’re confused a lot with varicose veins.

Spider veins and varicose veins

There are two types of visible veins, spider and varicose, and spider is the most common. Basically, they’re just small, superficial veins that exist in the outer layer of the skin between the dermis and epidermis. Varicose veins are larger and they run deeper in the body.

Where spider veins generally get noticed initially because of their faint blue color, you won’t see a discoloration with varicose veins. Rather, they become noticeable once they get stretched to the point that they begin to bulge.

To understand why they occur, let’s recap a lesson you probably learned in middle-school biology. Blood circulates outward from the heart to the extremities through arteries and back inward to the heart through veins. When everything goes according to plan, the blood shoots up the vein and a valve closes behind it. When it doesn’t, the blood falls back down and gets backed up in the veins of the legs.

Spider veins are typically hereditary, but they can also be a sign of deeper trouble. In about 60 percent of people, there’s an underlying venous insufficiency behind their spider veins. The causes of those issues vary from irreversible, as in the case of chronic venous insufficiency, to reversible (pregnancy), to entirely preventable (having a desk job where you sit all day, obesity).

Treating spider veins

The creams, ointments, and massages that so many bloggers say resolved their spider veins? They may feel good, but they’re not going to make spider veins go away. Only a dermatologist or a vein surgeon can help with that.

Sclerotherapy is one of the most popular options. A medication is injected into the problematic vein, irritating the walls of the blood vessel, which causes scar tissue to form and, eventually, the vein to close. (It’s a superficial vein, so other healthy veins will just take over.)

There’s also laser ablation, where the same handheld device that’s used for laser hair removal heats the vein, causing it to contract and scar over.

Both treatments are done with small micropunctures, so you can head into work right after your appointment. There is some small risk of pigmenting on darker skin tones, especially with the laser treatment. It typically lasts for a couple of months.

It’s also important to note that, effective as these treatments are, they’re only a temporary solution. Spider veins (and varicose veins) can return in other veins once the original veins are closed off. But, that essentially means a touch-up every year or two. Without treatment, they’ll multiply.