Understanding the causes of spider veins

Written by: Mr Alastair Lewis
Edited by: Karolyn Judge

Spider veins, medically known as telangiectasia or thread veins, are a common vascular condition that affects a wide range of individuals. In this article leading venous surgeon Mr Alastair Lewis explores the causes of spider veins, offering insights to help you better understand this condition.

Close up of spider veins on someone's skin

What are spider veins?

Spider veins are tiny, dilated blood vessels that appear close to the surface of the skin. They often resemble a web or a spider's legs, hence the name. These veins are most commonly found on the legs, although they can also occur on the face and other parts of the body. Although they are largely harmless in themselves, they are unsightly and often cause significant cosmetic concerns.



What causes spider veins?

The formation of spider veins is a normal part of the healing process, so anything that can cause stress in the skin can trigger the formation of new areas. Common triggers are minor injuries, exposure to heat or cold and surgical incisions on the legs. Prolonged standing and concurrent varicose veins tend to aggravate the development of spider veins. Genetic and hormonal factors are very important which explains why some patients are more prone to making new spider veins than others.



What can you do about spider veins?

If you’re concerned about the development of spider veins or already have them, it's essential to consult with a vascular specialist. The most effective treatment option is microsclerotherapy. Creams and lotions have no effect on spider veins. Treatments with cosmetic laser such as IPL are often either ineffective or vastly inferior to microsclerotherapy.



How does microsclerotherapy work?

A liquid is injected into the veins which strips off their non-stick lining. Injected veins take on a darker appearance for a few weeks. After that, most of the treated veins will fade away while a small proportion recover. It usually takes two or three treatment sessions to obtain a desirable result.



I’ve had treatment in the past but it didn’t work, what can I do?

It is important to attend a clinician who has a large experience of treating spider veins. The most common cause for failed treatment is underlying veins that have been missed at the last attempt. A detailed ultrasound assessment can identify small veins that helped keep the spider veins from responding to treatment.




If you’re concerned about spider or thread veins, arrange a consultation with Mr Lewis via his Top Doctors profile.

By Mr Alastair Lewis
Vascular surgery

Mr Alastair Lewis is a leading minimally invasive venous surgeon who specialises exclusively in the treatment of varicose veins. He works in full time private practice mainly based in Belfast and Dublin as well as attending Ballykelly and Hillsborough. He is an expert in the non-surgical management of varicose veins and thread veins with EVLT, radiofrequency ablation of veins, foam sclerotherapy and microsclerotherapy. He is a fully trained and accredited in venous ultrasound. He practises privately at Kingsbridge Private Hospital Belfast, the Fitzwilliam Clinic and Hillsborough Private Clinic as well as Kingsbridge Private Hospital North West, and The Vein Clinic at The Beacon Hospital, Dublin.

Mr Lewis is one of a small number of full-time varicose vein practitioners in the UK and Ireland and the only one working in Northern Ireland. He was appointed as a consultant vascular surgeon to the Southern Health and Social Care Trust in 2007 and played a central role establishing the regional varicose vein service in Northern Ireland.

He enjoys a national reputation as an authority in the management of all aspects of venous disease has been invited to speak on the expert management of varicose veins at the Royal Society of Medicine’s Venous Forum, The British Association of Sclerotherapists and Vascular Society of Great Britain and Ireland meetings on a regular basis in recent years. He has been a member of the board of The British Association of Sclerotherapists since 2021. He holds the prestigious Diploma in Venous Disease from the European Society of Phlebology.

He offers keyhole treatments for thread veins, varicose veins and complications of chronic venous insufficiency. Treatments offered include endogenous laser ablation, foam sclerotherapy, microsclerotherapy and non-injectable treatment of facial veins. He has significant experience in the treatment of veins on the face, chest, hands, feet and in the management of pelvic venous disorders.

View Profile

Overall assessment of their patients

  • Related procedures
  • Cryo-sclerotherapy
    Botulinum toxin (Botox™)
    Vascular disease
    Surgery and vascular testing
    Pathology of the carotid arteries
    Acute limb ischaemia
    This website uses our own and third-party Cookies to compile information with the aim of improving our services, to show you advertising related to your preferences as well analysing your browsing habits. You can change your settings HERE.