Prof. Kittipan Rerkasem
Leg Vein Clinic Thailand
What Are Ankle Spider Veins?
Ankle spider veins are tiny red, purple, or blue veins that appear on the skin around the ankle and foot. Although not dangerous, many people feel embarrassed and avoid wearing open‑back shoes or walking barefoot.
Image left image shows spider vein around ankle and right image shows spider vein in the foot
Causes of Ankle Spider Veins
- Genetics – Family history increases risk
- Hormones – Especially estrogen in women
- Aging – Weakened vessel walls
- Prolonged standing or sitting – Causes blood pooling at the ankle
- Venous insufficiency – Often the most overlooked cause; ankle spider veins may be only the “tip of the iceberg”
Ankle Spider Veins: The Tip of the Iceberg
Visible spider veins at the ankle can sometimes be a sign of reflux in the larger veins of the leg. High venous pressure pushes downward, causing ankle spider veins to dilate.
If the root cause is not treated, spider veins often return even after injection or laser.
This is why **duplex ultrasound by a vascular specialist** is essential before treatment.
Associated Symptoms
- Red or purple web‑like veins
- Pain, heaviness, or burning around the ankle
- Evening swelling
- Skin discoloration or even chronic ulcer in severe cases
Treatment When There Is *No* Major Vein Reflux
Two effective, safe modern options:
- **Sclerotherapy**
Medicine is injected into the small veins, causing them to seal and fade.
- Ideal for small–medium veins
- No surgery
- Outpatient procedure
- Mild temporary bruising
Image shows sclerotherapy
- **Laser Therapy**
Laser energy targets very small superficial veins.
- No needles
- Best for tiny vessels
- Results improve gradually over 2–6 weeks
Image shows laser therapy
Treating the Root Cause
If ultrasound detects reflux in major leg veins, the underlying issue must be treated with:
- Endovenous laser ablation (EVLA)
- Radiofrequency ablation (RFA)
- Adhesive closure (medical glue)
These minimally invasive treatments require only local anesthesia; patients walk in and walk out without hospital admission.
Self‑Care Tips
- Exercise regularly (walking, cycling, swimming)
- Avoid prolonged standing or dangling legs
- Maintain healthy weight
- Elevate legs when resting
- Wear medical‑grade compression stockings as advised
FAQ
Q: Are ankle spider veins dangerous?
A: Usually not. But if caused by major vein reflux, treatment is important to prevent future ulcers.
Q: Do I need hospital admission after treatment?
A: No. Both laser and injection treatments are outpatient.
Q: Do I need to wear stockings afterward?
A: Most doctors recommend 5–7 days for best results.
Q: Will spider veins come back?
A: If the root cause is untreated, they may return—ultrasound diagnosis is crucial.
Conclusion
Ankle spider veins may seem minor, but they can be a warning sign of deeper venous reflux. Effective treatment involves proper diagnosis and addressing both the superficial veins and the root cause. Modern techniques like sclerotherapy and laser are safe, simple, and require no hospital stay.
If you have ankle spider veins, consult a vascular specialist for long‑lasting and confident results.