Spider veins (telangiectasias) are fine, dilated capillary vessels visible just beneath the skin surface, appearing as red, purple or blue threads, often radiating outwards like a spider's web. Though rarely causing serious medical problems, they are a very common source of cosmetic concern and occasional aching or burning discomfort.

Spider Veins vs Varicose Veins vs Reticular Veins

  • Spider veins (telangiectasias): <1 mm, flat or near-flat, red/blue/purple
  • Reticular veins: 1–3 mm, blue-green, slightly raised — often "feeder" vessels for spider veins
  • Varicose veins: >3 mm, visibly bulging, may cause significant symptoms

Causes and Risk Factors

  • Hereditary predisposition (the most important factor)
  • Hormonal changes — pregnancy, oral contraceptives, HRT
  • Prolonged standing occupations
  • Obesity
  • Sun damage — particularly for facial spider veins
  • Minor trauma and skin pressure

Treatment Options

1. Sclerotherapy (Gold Standard)

Injection of a sclerosant agent (Polidocanol) directly into the vessel using an ultra-fine needle. The solution irritates the vessel wall, causing it to collapse and gradually fade over 4–8 weeks. Most patients need 2–4 sessions for optimal results.

Advantages: Cost-effective, suitable for all sizes >0.3 mm, immediate procedure, no downtime.

2. Transdermal Laser

Laser energy selectively targets haemoglobin in the blood, heating and sealing the vessel. Best for vessels <0.3 mm too small for injection, and for facial telangiectasias.

3. Combined Approach

Most effective — treating the reticular "feeder" veins with sclerotherapy first, then addressing the residual spider veins. This reduces recurrence significantly.

✅ Realistic Expectations

Complete eradication of all spider veins is rarely achieved in a single session. Improvement of 70–90% is a realistic target. New vessels can develop over time as the underlying tendency persists — but treated vessels do not return.

After Your Treatment

  • Compression stockings for 2 weeks post-sclerotherapy
  • Avoid direct sun on treated areas for 2 weeks to prevent pigmentation
  • Mild bruising and temporary matting (fine pink vessels) are common and resolve
  • Return to all activities immediately

Ready to Eliminate Your Spider Veins?

Book a consultation with Dr. Mohamed Haggag to assess your veins and design your personalized treatment plan

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