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‘Veiny hands’ is a common term used to refer to small blood vessels on the hands of the skin that have abnormal collection of blood and appear red or blue in color.

Spider Veins V/S Varicose Veins

Blood vessels known as spider veins (or telangiectasias), can be considered as a milder variant of varicose veins. Varicose veins are more commonly noted in women than in men. It has been estimated that about 36% of women and 19% of the men in the US suffer from varicose veins.

These blood vessels (veins) would have become nonfunctional leading to abnormal collection of blood in them. The term ‘spider vein’ is used, as the affected veins may be connected at times resembling the appearance of a spider web.

The term, ‘varicose veins’ refers to the abnormal collection of blood noticed in the larger blood vessels, especially in the leg. While spider veins are commonly observed on the hands or face, varicose veins are noticed in the legs. However, both spider and varicose veins can occur anywhere in the body.

Heredity has been put forth as the main cause of varicose veins. In some cases, certain birth defects may be the possible cause. It has been proposed that female hormones may have a role in the development of spider veins. Hormonal changes in women typically noted during puberty, with use of birth control pills, pregnancy, or hormone replacement therapy may be responsible for their increased appearance. In some women, wearing tight girdles or hosiery that is held up tight with elastic bands may contribute to formation of spider veins.


The treatment of varicose veins or spider veins is based on the size of the varicose veins, their location and the severity of the condition. The treatment option is individualized and the physician offers the best mode of treatment appropriate for you. In certain cases a combination of treatment options may be required. The different treatment options available to treat varicose veins and spider veins have been listed below.

Conservative Treatment

Conservative treatment involves self-care wherein mild-to-moderate cases of spider/varicose veins respond quite well to self-care either at home or at work. Self-care measures work well for those suffering from transient type of varicose veins (such as in pregnant women).

  • If you need to stand continuously for long periods of time you may benefit with breaks taken at regular intervals.  
  • Keeping the affected arm or leg elevated when resting or sleeping, aids in better return of blood to the heart from the blood vessels in the arms and legs.
  • Reduction in body weight in case of obese individuals may provide some relief.
  • Wearing of graduated compression stockings has been found to beneficial in improving blood supply in the legs and also in pain relief. Such stockings help compress the enlarged veins in the legs to a certain extent and prevent pooling of blood within them. However, a physician’s advice has to be taken before you start using them for prolonged duration. 
  • Walking and regular exercise has also been suggested especially in those who live a sedentary life. Being active also helps you to lead a healthy life.

Nonsurgical Treatment

Nonsurgical treatment therapies are minimally invasive treatment options, which do not require for an individual who is undergoing treatment to be admitted at the hospital for the procedure. These are often prescribed for individuals with mild-to-moderate varicose veins or spider veins who have not been benefited with conservative therapy. This includes:

  • Sclerotherapy
  • Laser therapy or Radiofrequency ablation
  • Ambulatory phlebectomy
  • Vein ligation


This procedure involves injecting a chemical solution into the affected veins that results in formation of scars within these veins thereby closing them. The blood from these affected veins is rerouted automatically through other healthier veins nearby. This is a simple procedure that does not require the administration of general anesthesia. This method may be used for spider veins on the hands of the affected individuals.

Laser Therapy or Radiofrequency Ablation

This mode of therapy involves the use of amplified light or radio waves to close the affected veins. The laser therapy or radiofrequency ablation is beneficial in spider veins. The light or the radio waves are passed through a small tube into the vein to generate heat into the affected veins that causes them to close. The healthier veins in the surrounding region take up the transport of blood from these closed veins. Laser therapy or radiofrequency ablation is the preferred mode of treatment for spider veins on the face.

Ambulatory Phlebectomy

Ambulatory phlebectomy procedure is used to treat small varicose veins or spider veins on the arms or legs. This procedure done under local anesthesia involves removal of the affected veins through a series of incisions done over the skin.

Vein Ligation

Vein ligation is also performed under local anesthesia wherein one of the main veins that supplies the affected vein is closed. During this procedure, an incision is placed over the skin to identify the affected vein. Once identified, the vein is tied (ligated) with certain specific material to block the vein permanently. The blood flow in the leg is taken over by other healthy veins following this procedure. This procedure may be reserved for larger spider veins of varicose veins.    

Surgical Treatments

The surgical treatments are more invasive procedures that are employed to treat severe cases of varicose veins. These procedures may or may not require you to be admitted at the hospital depending on the severity of the varicose veins. The complications associated with these procedures are generally minimal. However, you may need some time to recover before fully resuming the day-to-day activities and regular works. The surgical treatment options include:

  1. Vein stripping
  2. CHIVA

Vein Stripping

This procedure involves removal of the complete length of the affected vein. This is generally a less complicated procedure and the treated individuals can often resume normal activities within 2 weeks of the surgery. The vein stripping therapy is usually reserved for individuals who have severe pain or ulcers owing to varicose veins.


CHIVA, which stands for conservative and hemodynamic cure of incompetent varicose veins in ambulatory patients, is a new procedure being studied extensively. This procedure involves placement of small 1 –4 incisions under local anesthesia. The aim of this procedure is to prevent the abnormal flow of blood into the varicose veins. Further research is being conducted on CHIVA to promote its use in the treatment of varicose veins.