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Treatment of spider veins with ointments, tablets, laser

, medical expert
Last reviewed: 22.10.2021
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With the expansion of the venous capillaries and postcapillary venules located in the skin, blood circulation in the microcirculatory bed is impaired (blood outflow worsens) with the formation of the so-called spider veins - morphogenic malformations of the superficial vessels. Treatment of spider veins can be medication and operative.

It should be borne in mind that this pathology refers to diseases of the circulatory system, more precisely, to diseases of the capillaries -  telangiectasia , in which dilatation of small vessels can have various visual forms: reddish or purple dots, branched lines, stars. Foreign specialists spider veins are often called vascular spiders or spider angiomas, and this condition is defined as arachnoid telangiectasis. Usually, in the center of the vascular anomaly, a red dot is visible - a dilated arteriole, and the red "spider legs" are capillaries through which blood flows. If you press and quickly release such a spider-star, you can see that the empty capillaries are again filled with blood from the central point. [1]

It is noted that the presence of more than three such vascular malformations can be a sign of liver disease, and also indicate the development of esophageal varices.

When the subcutaneous blood vessels on the face expand and stellate telangiectasia develops due to a decrease in skin elasticity, the term couperosis is used for this  .

Which doctor should I contact with spider veins? If they appear on the face - to a dermatologist, and if on the lower limbs and other places - to a phlebologist or vascular surgeon.

Effective remedies for spider veins

Since the spider veins under the lower end skin are etiologically associated with varicose veins, the use of phlebotonic agents (vasotonics) and angioprotectors may be recommended. First of all, these include such creams, ointments and gels from spider veins, such as:  heparin ointment ; 2% Troxerutin gel, synonyms - Troxevasiin, Troxevenol; 1% gel Thrombocid, Eskuzan (Eskuven). [2]

Heparin ointment, synonyms - Trombless (gel), as well as Hepatrombin, Heparil, Venolife, Venobene, Viatromb, etc. Contain heparin (or heparan sulfate). Heparin is a drug of animal origin, a complex linear polysaccharide of the glycosaminoglycan family, consisting of chains of repeating disaccharide units (including glucosamine and uronic acid). It is a direct anticoagulant that inhibits the coagulation cascade, that is, reduces blood clotting. External application of heparin (twice a day) improves microcirculation, and this is its positive effect, since, as you know, slowing down blood flow with the expansion of vascular lumens affects the rheological properties of blood, and it becomes more viscous.

Troxerutin or Troxevasin contain a derivative of the natural rutin, a plant pigment (flavonoid), which is obtained for medical use from the leaves and inflorescences of buckwheat, leaves of Japanese sophora (Styphnolobium japonicum) and large-nosed eucalyptus (Eucalyptus macrorhyncha). Also, the sources of rutin can be the leaves of some other types of eucalyptus and ginkgo biloba, linden flowers, leaves and flowers of hawthorn, St. John's wort herb.

Rutin helps to strengthen the walls and increase the tone of capillaries and venules. Troxerutin (Troxevasin) should be rubbed into the skin of the affected segment twice a day. These funds should not be used on damaged skin and mucous membranes. Possible side effects are skin irritation and flushing.

Thrombocid gel, which contains an anticoagulant substance - pentosan polysulfate, classified as a heparinoid and, like heparin, helps to normalize blood circulation in the capillaries. On vascular malformations, the agent should be applied with rubbing movements - up to three times during the day. In some cases, the skin at the site of the platelet application may become drier.

Similarly, external agents for spider veins and chronic forms of venous insufficiency with horse chestnut extract containing glycosides esculin and fraxin are used, which contribute to an increase in vascular tone. These are ointments, gels and creams Eskuzan (Eskuven), Venitan, Venastat, Cycloven. And in the composition of Venosan, in addition to horse chestnut extract, there is heparin.

You can also apply Venozol and Sophia creams to areas of skin with dilated capillaries, which contain leech extract, and Sophia's cream also contains horse chestnut extract, two or three times a day.

Oral spider veins

The drug for oral administration Diosmin (other trade names - Detralex, Diosven, Venarus, Venozol, Venosmin, Venalex, Vasculera, Arvenum) has a positive effect on the vascular tone and the state of the capillary endothelium, as well as on local blood circulation. Its active substances are the flavone glycosides diosmin (diosmetin 7-O-rutinoside) and hesperidin (hesperetin-7-rutinoside). The standard daily dosage is two tablets (one in the morning and one in the evening, during meals). Among the most frequent side effects of this remedy are nausea, vomiting, epigastric discomfort, bowel upset; allergy with skin manifestations is not excluded. 

Tablets and solution with horse chestnut extract - Eskuzan or Eskuvit - reduce the manifestations of venous stasis, which has a positive effect on the state of the lumen of blood vessels and venous valves. In the form of a solution, the drug is taken three times during the day - 12 drops (before meals, with water); also take pills three times (one pill per dose). Treatment can take about three months.

Preparations with horse chestnut extract are contraindicated for systemic use in case of kidney failure, pregnancy and during breastfeeding. Side effects are manifested by nausea, malfunctioning of the gastrointestinal tract, the development of allergic reactions.

In addition, to strengthen the capillaries, doctors advise taking vitamins from spider veins: vitamin C (ascorbic acid) and  vitamin P - rutin  (or rutoside), preferably in combination with magnesium, iron and potassium.

Vitamins C and P are contained in the combined agent Ascorutin (take one tablet twice a day).

Whether succinic acid can help from spider veins, learn from the publication -  The benefits of succinic acid .

Removal of spider veins

Can a spider vein pierce to remove it? You can't do anything like that!

Removal of spider veins is carried out using:

  • injection sclerotherapy, which is carried out by introducing special sclerosing substances into the dilated vessel, under the influence of which the walls of the vessels "stick together"; [3],  [4], [5]
  • laser ablation (coagulation) using lasers of various modifications (fractional carbon dioxide, alexandrite, pulsed PDL, Sciton ClearScan, Elos Plus); [6]
  • radio wave surgery (radio scalpel) is the removal of spider veins with Surgitron, a generator of high-frequency radio waves that allows all manipulations to be carried out without contact with the skin surface and leaving no scars on it. [7]
  • high-frequency electrocoagulation, which is now being used less and less because of the painfulness of the procedure and the formation of scar tissue and areas of skin depigmentation.

Since the mid-2000s, the minimally invasive VeinWave Therapy technology developed by British vascular surgeons has been introduced into the practice of leading foreign clinics for the treatment of telangiectasia that struck very thin vessels (too small for sclerotherapy and laser coagulation). The essence of the method is thermocoagulation of a dilated vessel using an electric device that supplies a unipolar fluctuating current to an ultrathin insulated needle, which painlessly pierces the outermost layer of the skin without passing through the vascular wall.

Read also -  Removal of spider veins at home

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