Spider veins are popping up, literally, all over the world. These enlarged blood vessels, also known as telangiectasia, appear near the surface of the skin on the face and legs as blue or red veins that often are short. Although they occur in both women and men, they occur more frequently in women due to hormone fluctuation. The specific cause of spider veins is unknown, but treatment has become readily available through various products and procedures.
Spider veins often appear suddenly, and according to Eric F. Bernstein, MD, the cause of spider veins may lie in genetics. “[Spider veins] are hereditary 90 percent of the time,” said Bernstein, who attributes the appearance of spider veins to hormonal shifts. These hormonal shifts can occur at any stage in life, whether a result of puberty, pregnancy or menopause.Puberty, birth control pills, pregnancy or hormone replacement all may contribute to the development of spider veins, according to the American Academy of Dermatology. “Of the people that have them already, one-third of them got worse during pregnancy,” added Bernstein, who noted that spider veins actually are extra veins and not broken veins.
The oldest treatment for spider veins, according to Bernstein, is sclerotherapy, or the injection of veins with either a salt or sugar solution. Sclerotherapy is a means of irritating and injuring the vein so that the body reabsorbs it.
Bernstein has seen the popularity of laser treatments for spider veins grow in the last 10 years. According to Bernstein, they are more effective in treating veins due to a decreased possibility in developing matts post treatment. Matts, or matt telangiectasia, are small clusters of veins that resemble bruises. “Anywhere from 15 to 24 percent of those who receive sclerotherapy develop matt veins at the site where the injections occur,” said Bernstein.
Laser treatment for veins involves the use of either an orange or a green light to heat the lining of the vessel enough to injure it. An orange or green light is chosen based on its ability to target the hemoglobin in the vein while safely avoiding the skin. “What is amazing is when you do it you can see [the vein] disappear,” said Bernstein. A cooling laser also is used before the treatment to cool the top of the skin, thereby reducing the interference of the laser with the skin .
Bernstein finds that laser treatment in conjunction with prescription topical treatments often is the most effective means of eliminating spider veins. Bleaching agents such as alpha hydroxy acid, or a combination of hydroquinone, tretinoin and fluocinolone acetonide, are used by Bernstein pre- and post-treatment to reduce the amount of melanin in the skin. “One of the biggest problems in treating veins is unwanted pigmentation. I use bleaching agents to lighten the skin before and after the treatment so there is less injury to the part of the skin I want to protect,” added Bernstein. For Bernstein, the use of topical creams with laser treatments results in safer and more effective spider vein elimination.
There are many OTC topical products on the market today that claim to reduce the appearance of spider veins. Although these products may claim to help eliminate spider veins, Bernstein believes a consumer looking to eliminate spider veins need to seek professional treatment. “In my experience, I have never seen [a topical cream for veins] that worked,” said Bernstein. He finds that OTC topical treatments for veins to be temporary. “There is no way to make a vein disappear with a topical treatment. You have to undergo a procedure to fully eliminate them,” added Bernstein. In the future, Bernstein believes a cream that turns off the growth factors that increase the size of veins may be invented.
The future of laser treatments looks promising, according to Bernstein, who feels that there will continually be new developments in the field. He particularly looks forward to a larger company developing a product specifically formulated for pre- and post-laser treatments. “Right now, we are in the infant stage in developing products to aid the reduction of side effects of using a laser,” stated Bernstein. “There is no major product to treat pre- and post-lasered skins, but there is a need for a good one. Bernstein believes that the resources already are available to develop a successful pre- and post-laser treatment cream and added that the need is growing. “The time [for a laser treatment cream] is right for sure.”