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Why do spider veins appear?

Medical expert of the article

Dermatologist, onkodermatolog
, medical expert
Last reviewed: 04.09.2021

The stars are beautiful when you contemplate them in the firmament or the branches of the New Year tree. On the human body, such "adornments" in the form of an interlacing of swollen capillaries called "spider veins" do not look so attractive. In addition, they can appear in the most uncomfortable places, for example, on the face or décolleté, on the nose or cheeks, arms, legs and other parts of the body. But some areas cannot be covered with clothing in order to hide a defect under it. So it turns out that such an indicator of ill health is obvious in the literal sense of the word, although it is not always about ill health that we are talking about. 

What are spider veins called?

If you think about it, spider veins are not quite a suitable name for a disease, which is a pathological expansion of capillaries associated with a violation of blood microcirculation. In addition, such formations from small vessels can have a different shape and look like snowflakes, spiders, a lattice, or be separate slightly convex red, burgundy and even bluish stripes.

Vascular asterisks or nets are a kind of unwanted “adornments” on the body called by the people. In medical circles, pathology is treated somewhat differently, therefore the scientific name of the phenomenon does not sound so pleasant - telangiectasia .

This name was not given to vascular neoplasms by accident. The term comes from 3 Greek words. The first part of the word, which we read as "tele", is derived from "telos", which means the ending in Russian. The second part "angi" is transformed from "angeon" and means a vessel, a capillary, and the third - "ectasia" is almost an exact copy of the Greek word "ectasis", which means expansion, expanded part. [1]

Depending on the form of the capillary neoplasm, it can be called stellate or arachnoid telangiectasia. If the vascular tubercle has a bright red or burgundy color and its inner part protrudes noticeably above the skin surface as a mole, such spider veins are often called angiomas (sometimes hemangiomas) due to the external similarity of pathologies.

The word "angioma" is usually used to denote a tumor consisting mainly of vessels (blood vessels, lymph), which does not quite correctly reflect the essence of telangiectasias. After all, angioma is not a malignant proliferation of blood (or lymphatic) vessels, but telangiectasia - an expansion of blood capillaries.

Spider veins in the form of single swollen capillaries in the facial area are called rosacea in cosmetology . In dermatology, the same violation of microcirculation in small blood vessels is usually referred to as telangiectasias. [2]

Are spider veins dangerous?

Any neoplasms on the human body cause heightened interest and some concerns. The excitement about this is especially strong in our time, when information about the spread of oncological diseases, and in particular skin cancer, is pouring in from all sides.

We can reassure our readers, because spider veins have nothing to do with malignant tumors. As well as angiomas - benign vascular tumors with a low probability of degeneration into cancer. Moreover, telangiectasias can be attributed to disorders rather than a disease, although they are often regarded as symptoms of certain pathologies of the liver, cardiovascular system or hereditary weakness of the connective tissue, from which capillary membranes are formed, and the proximity of the location of vessels to the skin surface (sometimes say thin skin).

In most cases, spider veins are more likely to be attributed to a cosmetic defect that distorts the aesthetic appearance of the human body, especially if telangiectasias are located on open parts of the body and on the face. They can suddenly appear and disappear after a while, when the action of the factor that caused them fades away. [3]

It must be said that the expansion of the lumen of venules, arterioles and capillaries, belonging to small vessels, does not pose a particular danger in itself. Even with an accidental damage to the neoplasm, there is no point in being afraid of severe bleeding, because the blood flow rate in the capillaries is lower than in other, larger vessels. Another thing is that the wound can become a source of infection, which can spread throughout the body with the blood flow.

Telangiectasias may cause aesthetic discomfort, but in general they are harmless. Much more dangerous are the main diseases in which vascular networks may appear. Therefore, they should be considered as a signal to pay attention to your health. Check the heart, liver and other vital organs, hormones will not be superfluous. [4]

Cause

Spider veins can form from both small venous and arterial vessels (arterioles), not to mention capillaries, the walls of which are extremely thin and can noticeably stretch at high blood pressure. In this case, telagniectasia should not always be considered as a symptom of the disease. In a narrow sense, vascular networks and nodules act as a symptom of varricosis, liver cirrhosis, hepatitis. But in a broad sense, they can be considered as a reflection of some syndrome or phenomenon, a reflection of the processes occurring in the body.

Hereditary predisposition is one of the most important factors that determine the appearance of spider veins in some people and their absence in others under the same conditions. It is believed that the appearance of vascular elements on the surface of the epidermis is facilitated by solar radiation. But at the same time, some people do not hide from the sun and do not have such defects on their skin, while in others spider veins immediately appear on open parts of the body.

The glycoprotein endoglin is a regulator of angiogenesis, i.e. The process of formation and development of vascular walls. Its deficiency, caused at the gene level, is transmitted to children according to the dominant type, i.e. The likelihood of a tendency to develop vascular pathologies (we are talking about a hereditary disease called hemorrhagic telangiectasia) is higher than the chance that the predisposition can be avoided. The truth about the high risk is said if the dominant gene is passed from both parents.

Hemorrhagic telangiectasia is manifested by the formation of multiple vascular elements on the body and their bleeding.

A gene that causes a high level of growth factor in the inner lining of blood vessels (endothelium) can also be inherited, which also leads to the appearance of spider veins.

Weakness of the vascular wall can be observed with congenital metabolic and autoimmune disorders. So with Raynaud's syndrome, vasospasm is noted, and with congenital weakness of the connective tissue syndrome, the vascular membrane does not have the necessary elasticity and they expand under blood pressure. At the same time, the expansion is persistent, irreversible, therefore, stars and meshes appearing on the body from small vessels do not disappear, as is the case with an imbalance of hormones. [5]

We have already said that telangiectasias that form in the upper layers of the skin and consist of vessels of small diameter (up to 1 mm) in the female body reflect the state of the hormonal background. Particular attention should be paid to estrogen.

In addition to the fact that this useful hormone prevents the formation of cholesterol plaques on the walls of blood vessels, it also dilates blood vessels, multiple small capillaries located close to the epidermis become more visible. Unsurprisingly, pregnancy, when levels of this hormone rise, are among the main risk factors for women of reproductive age. A decrease in estrogen levels later in pregnancy is often accompanied by the disappearance of telangiectasias. But for some mothers, they disappear after giving birth, after a few months.

But pregnancy is a temporary phenomenon, unlike menopause, when spider veins can also appear. And not always their appearance needs to be explained by venous congestion or hemodynamic disorders. Hormonal imbalance has a negative impact on almost all organs and systems. Surprisingly, a sharp decrease in estrogen levels also does not have the best effect on the condition of the choroid. In this case, vascular changes will be more persistent than during pregnancy.

Risk factors for spider veins also include abortion, miscarriages, and some gynecological pathologies (for example, ovarian cysts) that can affect hormonal levels. This also includes the use of hormonal methods of contraception.

Since estrogen has an expanding effect on the vessels, which is much more in the female body than in the male, it turns out that spider veins appear in women more often than in men. This is also confirmed by  statistics. Men are faced with such "jewelry" 4 times less often than women, which is understandable (women have more reasons for vascular disorders).

Not only sex hormones have a dilating effect on blood vessels. Histamine, serotonin, and other vasoactive substances also have the same property. If they are present in the body in increased quantities, the risk of spider veins becomes noticeably higher. Anoxia (violation of oxygen metabolism), infections, some physical effects against the background of hormonal changes or predisposition can be considered as triggers that trigger the pathological process in small vessels.

I must say that spider veins are a "privilege" not only of adults. They can also appear in childhood. The cause can be both hereditary predisposition and prolonged exposure to the sun, as well as skin injuries. Damage to the epidermis and deeper layers of the skin is often accompanied by damage to small vessels located in these areas (compression, rupture of the membrane). At the site of such injuries, vascular elements can form in the form of convex asterisks, branches, reticules, linear telangiectasias. Usually they do not last long and soon disappear without leaving a trace.

As you can see, spider veins can be viewed both as a symptom of serious disorders in the body, and as a reflection of the physiological processes taking place in it. Not paying attention to them, you can miss a dangerous disease. But to determine what the appearance of telangiectasias is connected with, only a specialist washes after a preliminary examination of the patient.

Pathogenesis

Spider veins can appear on different parts of the body. Their appearance on the legs is most understandable, and then such vascular defects are associated with a disease called "varicose veins" or simply "varicose veins". It is more difficult to understand the occurrence of vascular neoplasms in the face, neck, chest. Upper limbs, etc.

It must be said that in some situations, the appearance of telangiectasias remains a mystery even for doctors who cannot establish the causes of the appearance of spider veins. This happens if all known options are enumerated, but none of them is suitable in a particular situation.

But why do spider veins actually appear? What pathological factors do doctors consider as possible causes of this phenomenon?

The following pathologies can be considered the probable reasons for the appearance of spider veins on the body:

  • Cardiovascular diseases and in particular chronic vascular diseases. Most often, in such cases, nodules from the vessels appear on the lower extremities in the lower leg and thighs. It is important to understand that spider veins are inherently not specific symptoms of varicose veins, although a mild form of varicose veins (reticular varicose veins) has certain similarities with telangiectasias (the appearance of foci of dilated small veins under the skin). This is a separate disorder, which in some cases can be viewed as a mild variant of chronic vascular disease, and in others as a temporary phenomenon.

The common cause of varicose veins and telangiectasias is hereditary weakness of small vessels, metabolic and hormonal disorders (predisposing factors),  [6]but varicose veins in most cases are caused by venous congestion (hemodynamic disorders) due to large body weight, regular compression of the vessels of the legs, heavy loads in a standing or sitting position wearing high-heeled shoes. In telangiectasias, such a relationship is not traced, moreover, spider veins can appear on other parts of the body. In this case, not only small veins are expanded, but also arterioles carrying arterial blood, as well as capillaries, where gas exchange is carried out (interchange of venous, oxygen-poor, and capillary blood), while peculiar spider veins on the legs with varicose veins are seals from venous vessels that have lost their elasticity. [7]

Quite often, on the lower extremities, one can notice simultaneously the manifestations of varicose veins and telangiectasias (capillary nets, neoplasms from small arteries). But the appearance of vascular networks is usually not accompanied by other symptoms of ill health (in some cases, patients may complain of soreness and itching in the area of the neoplasm). Varicose veins, especially in the lower extremities, are also characterized by swelling of the legs, a feeling of heaviness in them at the end of the day, dull pain, sometimes night cramps (convulsions). [8]

A severe variant of CVD is chronic venous insufficiency, as a result of which numerous vascular networks from smaller and larger veins appear on the legs of patients (this reason is more typical for men).

  • Liver disease. It is not for nothing that the liver is considered one of the main filters of the body (along with the kidneys). This important organ contributes to the elimination of poisons and toxins from the body from outside, as well as hazardous substances formed during the life of the body itself. If the liver is sick, harmful substances accumulate in the body, provoking various disorders.

Intoxication of the body affects the metabolic processes occurring in it. The body tries to remove all "debris" through the skin, which immediately becomes noticeable by a change in its appearance, the appearance of inflammatory elements, and a local change in pigmentation. Vessels (primarily small, which have a thin membrane) lose their elasticity and under pressure of blood can stretch and even burst.

The appearance of spider veins on the skin, which is often the case with liver cirrhosis , is also associated with organ dysfunction. Quite often, intoxication is the reason that the working tissue of the liver (parenchyma) changes its structure, degenerates into a denser fibrous tissue that cannot serve as a filter. Other causes of cirrhosis can be congestive heart failure, diseases of the biliary system, hereditary metabolic disorders, and infections. But regardless of the cause that caused the disease, there is always a decrease in the functionality of the organ.

Another serious liver disease is hepatitis . The disease can have different pathogens of an infectious (viral) nature and route of transmission, therefore hepatitis A, B and C. Discoloration of urine and feces, deterioration of the skin and small vessels. [9]

As in liver cirrhosis, spider veins in hepatitis appear primarily on the back and face (an inflammatory rash most often appears immediately), while with varicose veins changes in the vessels often cover the surface of the lower extremities (less often the pelvic, perineal, scrotum in men, etc.).

It should be understood that venous insufficiency can also be triggered by chronic liver diseases, and in this case, nodules and networks of dilated veins can appear in different parts of the body, including internal organs.

Spider veins and liver disease are linked as a pathology and its consequences. Whatever the name of the disease, but if at the same time the liver's working capacity is disrupted, the body begins to "decorate" with capillary nets, trees, specks. [10]

  • Hormonal disorders (the most common cause of telangiectasia in women). They can be both pathological and physiological (pregnancy, menopause). The leading role in the appearance of spider veins is played by the female hormone estrogen. Its increased production increases the risk of vasodilation.

Often, in patients complaining of vascular defects, other skin changes can be noticed, even with a healthy liver. It's about cellulite. Spider veins and cellulite are frequent neighbors, because they have similar roots. Vascular (venous) asterisks are often viewed as the result of venous stasis. But a violation of the outflow of venous blood and stagnation of lymph, in turn, increase the permeability of blood vessels. The liquid part of the blood (plasma) seeps through the weakened vascular networks and accumulates in soft tissues, forming a peculiar pattern on their surface. The surface of the body becomes uneven, bumpy, similar in structure to the skin of an orange or tangerine. This explains the frequent proximity of spider veins and "orange peel".


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