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Spider Veins Causes

 The causes of telangiectasia can be divided into congenital and acquired factors.

Congenital causes

  • Goldman states that "numerous inherited or congenital conditions display cutaneous telangiectasia". These include;
  • Naevus flammeus (port-wine stain)
  • Klippel-Trenaunay syndrome
  • Maffucci's syndrome
  • Hereditary hemorrhagic telangiectasia (Osler-Weber-Rendu syndrome)
  • Ataxia telangiectasia
  • Sturge-Weber syndrome, a nevus formation in the skin supplied by the trigeminal nerve and associated with facial port-wine stains, glaucoma, meningeal angiomas and mental retardation.

Acquired causes

Venous hypertension

Telangiectasia in the legs is often related to the presence of venous hypertension within underlying varicose veins. Flow abnormalities within the medium sized veins of the leg (reticular veins) can also lead to the development of telangiectasia. Factors that predispose to the development of varicose and telangiectatic leg veins include

  • Age: The development of spider veins may occur at any age but usually occurs between 18 and 35 years, and peaks between 50 and 60 years.
  • Gender: Females are affected approximately four to one to males.
  • Pregnancy: Pregnancy is a key factor contributing to the formation of varicose and spider veins. The most important factor is circulating hormones that weaken vein walls. There's also a significant increase in the blood volume during pregnancy, which tends to distend veins, causing valve dysfunction which leads to blood pooling in the veins. Moreover, later in pregnancy, the enlarged uterus can compress veins, causing higher vein pressure leading to dilated veins. Varicose veins that form during pregnancy may spontaneously improve or even disappear a few months after delivery.
  • Lifestyle/Occupation: Those who are involved with prolonged sitting or standing in their daily activities have an increased risk of developing varicose veins. The weight of the blood continuously pressing against the closed valves causes them to fail, leading to vein distention.
Other acquired causes

Acquired telangiectasia, not related to other venous abnormalities, for example on the face and trunk, can be caused by factors such as

  • Acne rosacea
  • Environmental damage such as that caused by sun or cold exposure
  • Trauma to skin such as contusions or surgical incisions.
  • Radiation exposure such as that experienced during radiotherapy for the treatment of cancer
  • Chemotherapy
  • Carcinoid syndrome
  • CREST syndrome (a variant of scleroderma)
  • Chronic treatment with topical corticosteroids may lead to telangiectasia.
  • Spider angiomas are a radial array of tiny arterioles that commonly occur in pregnant women and in patients with hepatic cirrhosis and are associated with palmar erythema. In men, they are related to high estrogen levels secondary to liver disease.

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