Telangiectasias, or spider veins, are small enlarged blood vessels near the surface of the skin.
Eis experienced spider veins during her first pregnancy, and they mostly corrected themselves with time. But now they’ve returned with a vengeance. “My OB/GYN said it’s due to the increased blood flow caused by my body working to create another person, and she recommended that I wear those … compression stockings, which are neither comfortable in the summer heat nor remotely fashionable – a sacrifice I seem unwilling to make,” Eis says.
Eis saw a circulatory specialist who recommended massage and elevating her feet above her heart for part of the day. “It’s the only thing that brings any relief at all … but it’s also nearly impossible as it’s not a widely accepted position from which to conduct my work at the office,” she says. “I’m desperate to find some relief, or if nothing else, to at least recover some self-esteem.”
What Are Spider Veins?
As the director of the Science + Beauty Medical Spa in New York City, Jessica Plotnick has treated thousands of women who suffer from spider veins. And now that she’s expecting, Plotnick has some firsthand experience with this unsightly annoyance.
“Telangiectasias, or spider veins, are small enlarged blood vessels near the surface of the skin,” Plotnick says. “These veins usually measure a few millimeters, are often purple, blue and/or red in color and can develop anywhere on the body. They most commonly appear anywhere on the legs and face. However, I often see and treat them on the feet, ankles, buttocks, around the bra-strap area and on the waist.”
Plotnick says that many women either initially develop the veins during pregnancy or find that existing spots worsen. “As the uterus grows, it puts pressure on the inferior vena cava, which in turn increases pressure in the leg veins,” she says. “Additionally, the amount of blood in the body increases when you’re pregnant, adding to the burden on the veins. However, just as significant as the growing uterus is the change in hormones that occur. During pregnancy, estrogen and progesterone levels rise, causing the walls of the blood vessels to relax and expand.”
Since spider veins are extra tiny blood vessels, they aren’t needed for normal circulation, says Dr. Kristin Walker, a dermatologist in private practice in Orinda, Calif.
“Pregnancy also causes spider veins because of the increased pressure on the legs because of weight gain,” Dr. Walker says. “Other causes of leg veins can be from occupations that require a lot of prolonged standing or pressure on the legs. I’ve seen it in younger people as well, especially track athletes because of the constant pressure exerted on their legs.”
But without question, genetics remains the No. 1 factor for determining whether you’ll end up with spider veins or not, Plotnick says. “I would say at least 80 to 90 percent of all women who have spider veins have a parent who has them, too,” she says. “And once you have them, they tend to get worse with each successive pregnancy.”
Prevention and Treatment
But there are some things that may help prevent the spider veins from getting worse. “Wearing graduated medical compression stockings are very helpful,” Plotnick says. “It’s also important to remain active, try to keep your legs elevated as much as possible and avoid sitting or standing for long periods of time.”
“As far as treatment, one can do nothing or undergo sclerotherapy, laser treatment or vascular surgery/vein stripping,” Dr. Walker says. “But the gold standard for spider veins is still sclerotherapy. I use hypertonic saline, which irritates the lining of the blood vessels and causes them to shut down, which is fine since these aren’t needed for normal circulation. The saline is directly injected into the spider veins, with multiple injections into the legs over one session. Then, over the next two to four weeks, you’ll see the vessels disappear. After about four to five weeks, you see your final results, though many people will need touchups every year or so since the constant pressure on the legs from everyday activities can lead to more spider veins.”
Dr. Walker reports that the side effects are minor, and can include bruising, hyperpigmentation at some of the injection sites, matting (more production of vessels at the site of treatment, which can be subsequently treated again) and mosquito-bite-looking areas for a few days. “No support hose are needed after treatment and you can walk as normal after the treatment with no down time,” Dr. Walker says.
Plotnick agrees that sclerotherapy is by far the No. 1 treatment option. “This procedure has been used to treat spider veins since the 1930s and before that for larger vessels,” she says.
Many women also turn to laser treatments, but Plotnick doesn’t recommend this to her patients because it often causes scarring as well as hyper- and hypopigmention. It’s best to wait and undergo sclerotherapy after delivery – six to 12 weeks post-delivery or whenever nursing is finished – but Plotnick does recommend treating any problem veins before pregnancy so they won’t get worse.
“After my delivery I will wait a few months to see how my spider veins look,” Plotnick says. “Often veins get somewhat better after the weight diminishes and the hormones subside. However, I will be having sclerotherapy treatments to treat whatever remains.”