Spider angiomas, also known as spider nevi or spider telangiectasias, are common benign vascular lesions. They get their name from their appearance, which often resembles a spider’s body with legs radiating outwards. While often harmless and temporary, especially in children and pregnant women, they can sometimes indicate underlying health conditions.
Appearance and Characteristics
A spider angioma presents as a small, flat or slightly raised red to purple dot, often less than 1/4-inch (0.5 cm) in diameter. From this central dot, fine red or purple lines extend outward, resembling a spider’s legs. These radiating vessels are dilated capillaries. The entire lesion typically ranges from 1 to 10 millimeters.
Applying pressure to the center of a spider angioma causes it to temporarily blanch or disappear as blood is pushed out. Upon releasing the pressure, the lesion rapidly refills. This phenomenon, known as blanching, is a distinguishing characteristic. Spider angiomas commonly appear on sun-exposed areas like the face, neck, upper chest, and arms. In children, they are also frequently found on the hands and fingers.
Causes and Associated Conditions
Increased estrogen levels in the bloodstream are a primary factor contributing to their development. This hormonal influence explains their common occurrence during pregnancy, affecting approximately 60% of pregnant women. Individuals using oral contraceptives, which contain estrogen, may also develop spider angiomas.
Liver disease, particularly cirrhosis, is another significant cause. A compromised liver can struggle to metabolize hormones, leading to an accumulation of estrogen in the body. About 33% of patients with cirrhosis exhibit spider angiomas. While often associated with these conditions, spider angiomas can also appear in otherwise healthy individuals, including many children. In such cases, these lesions are generally considered benign and may resolve on their own over time.
When to Seek Medical Advice
While spider angiomas are often harmless, certain situations warrant a medical evaluation. Consult a healthcare provider if there is a sudden increase in the number or size of existing spider angiomas, or if many new lesions appear.
Seeking advice is important if spider angiomas are accompanied by other symptoms. These might include yellowing of the skin or eyes (jaundice), unusual fatigue, or swelling in the abdomen. Such signs could indicate a more serious underlying condition, such as liver disease. A healthcare provider can determine the cause and recommend appropriate management.
Diagnosis and Treatment Options
Diagnosing a spider angioma primarily involves visual examination due to its distinct appearance. A healthcare provider can identify the lesion by observing the central red dot and radiating blood vessels. If there are multiple angiomas or other concerning symptoms, blood tests may be ordered to assess liver function and rule out underlying medical conditions. This helps determine if the angiomas relate to a systemic issue.
Treatment for spider angiomas is typically for cosmetic reasons, as they are generally benign and pose no health risk. Common methods include laser therapy, such as pulsed dye laser (PDL), which targets and closes off blood vessels with light. Electrocautery, using heat to seal vessels, is another option.
While these procedures effectively remove lesions, there is a small risk of scarring, and treated angiomas can sometimes recur. If an underlying condition, such as liver disease, is the cause, treating that condition may lead to the regression or disappearance of the spider angiomas.