Spider nevus is a new formation of vessels on the skin. The condition is relatively common. In most cases, the visual changes are clearly visible because the arterial vessels of the skin dilate. In addition, it is possible that the spider nevus appears in some of the affected patients as a so-called liver skin sign. As such, it develops in the context of chronic diseases of the liver.
What is spider nevus?
Spider nevus is synonymously called spider nevus, nevus araneus, star nevus or vascular spider by some doctors. In the course of the disease new arterial vessels are formed on the skin, which in the majority of cases are benign. The starting point of the phenomenon is usually raised nodes of vessels. From these centers of new vessel formation, delicate spurs branch out into the surrounding areas of the skin. This usually results in a pattern that appears star-shaped or resembles a spider web. This is also the origin of the common disease term spider nevus. If pressure is applied to the nevus, the thin extensions are temporarily invisible. However, the central vessel does not disappear, but always shows a reddish color.
Causes
The causes of spider nevus formation vary, but most cases involve benign changes in the arterial vessels of the skin. In numerous patients, spider nevus develops in the upper half of the body. Especially the neck and face area as well as the hands are affected by the changes. A spider nevus is often associated with telangiectasia and is an expression of this disease. In many cases, spider nevi develop in patients in childhood and then are usually without identifiable cause. In some cases, the development of a spider nevus is related to an existing pregnancy. In addition, the changes in the skin vessels may also appear in patients who use hormonal contraception. Sometimes spider nevi are favored by excessive sun exposure, as a result of which the skin is chronically damaged. In some patients there are serious causes for the development of spider nevus. Thus, the skin changes sometimes develop in the context of diseases of the liver. For example, the occurrence of a spider nevus as a concomitant of liver cirrhosis is possible here.
Symptoms, complaints, and signs
The appearance of a spider nevus can be relatively clearly distinguished from other changes on the skin. The phenomenon is primarily characterized by the spider web-like pattern that it forms on the skin of the affected patient. As a rule, there is a central vessel, which is usually red in color. From this main vessel, numerous small offshoot vessels meander into the surrounding area. The branches become thinner with increasing distance from the central vessel. Basically, these are so-called telangiectasias of the capillary skin vessels. The further away they are from the main vessel, the more they fade. In numerous cases, spider nevi are found on the neck, chest wall or facial area. Here they appear mainly on the forehead. A spider nevus may be an expression of an underlying disease and in such a case may facilitate its diagnosis. For example, spider nevi develop in connection with Osler’s disease, pregnancy or hepatitis with a chronic course. In principle, however, spider nevi also occur in healthy individuals. Only in some cases does the spider nevus indicate the existence of an underlying triggering disease.
Diagnosis and course of the disease
Spider nevus is usually diagnosed relatively quickly and straightforwardly on the basis of its typical appearance. Nevertheless, the diagnosis follows the standard procedure, so that a medical history is taken at the beginning. Here, the respective patient describes his symptoms and any known factors relevant to the development. In addition, the patient describes his or her lifestyle, which may help the physician to better classify the symptoms. The physical examination consists of the attending physician examining the affected areas of the skin with a special magnifying glass. However, since the appearance of the spider nevus does not reveal anything about its cause, further examinations are usually necessary to rule out or diagnose potential underlying diseases.
Complications
In most cases, those affected with spider nevus suffer from discomfort to the skin. These complaints can thereby lead to a significantly reduced aesthetic appearance in the patient. In this case, inferiority complexes or reduced self-esteem also frequently occur, causing patients to feel ashamed of the discomfort and uncomfortable with it. This can sometimes promote depression or other psychological upsets. Especially on the face, the discomfort can be very uncomfortable. However, spider nevus does not necessarily indicate another disease in every case. Nevertheless, when these complaints appear, a medical examination should be performed to avoid further complications. The treatment of this disease takes place without complications with the help of laser therapy. Thus, the skin complaints can be limited and treated relatively well. However, if the spider nevus is triggered due to another underlying disease, it usually needs to be treated as well. In most cases, this disease does not reduce the patient’s life expectancy. However, the symptoms may recur even after treatment. In this case, the affected persons are dependent on renewed treatment.
When should one go to the doctor?
A spider nevus should always be examined and treated by a doctor. Since self-healing cannot occur with this disease, the affected person is always dependent on treatment. This is the only way to prevent further complications. The earlier a doctor is consulted in the case of spider nevus, the better the further course of the disease usually is. A doctor should be consulted if there are symptoms on the skin that do not disappear on their own and persist over a longer period of time. Spider web-like patterns form, which can significantly reduce the aesthetics of the affected person. In most cases, the spots do not cover the entire body, but only individual areas. If these complaints occur over a longer period of time, a doctor must be consulted in any case. As a rule, a spider nevus can be treated by a dermatologist or by a general practitioner. In this case, there are no particular complications and, as a rule, the course of the disease is positive.
Treatment and therapy
Apart from the possible underlying diseases that require urgent treatment, the spider nevus itself is primarily a cosmetic blemish. As such, it can be treated and eliminated using a variety of procedures. As a rule, laser therapy is the method of first choice to make the spider nevus fade or disappear completely. However, the search for the triggering factors should not be ignored. In the course of the removal of the spider nevus by laser treatment, a so-called deep laser is used in numerous cases. The dilated arterial skin vessels are strongly heated. As a result, the spider nevus progressively fades, and several sessions may be required for complete removal. The results satisfy the majority of patients.
Prevention
Prevention of spider nevus is fundamentally difficult because it occurs either idiopathically or as a result of a variety of underlying conditions. Therefore, targeted measures to prevent the formation of new arterial skin vessels are virtually impracticable.
Follow-up
A spider naevus does not require special follow-up care. It is a harmless skin change that occurs in the setting of chronic liver disease. After cosmetic surgery, the patient usually needs to spend a few more days in the hospital. As soon as the surgical wound has healed, the patient can leave the hospital. Mild painkillers are sometimes prescribed as part of the aftercare. In addition, a consultation with the doctor takes place to discuss the further course of action. Several sessions may be necessary to completely remove the skin lesion. The actual aftercare usually only includes a final discussion with the doctor, in which open questions of the patient are clarified. Should a spider naevus form again after recovery, the doctor must be consulted in any case. If necessary, a therapist can be consulted to advise the patient further. Particularly in the case of psychological complaints, psychological care is advisable due to the skin changes.The responsible physician can establish contact with a suitable therapist. Aftercare for a spider naevus is provided by the head physician in the clinic or the internist who is already treating the liver condition. If the liver disease has been cured, the primary care physician can provide follow-up care.
What you can do yourself
The disease is accompanied by a visual stain. For this reason, building and promoting self-confidence are particularly important. In everyday life, feelings of shame or fear should be overcome. If this does not succeed to a sufficient degree, therapeutic help should be sought. Dealing openly with the disease and informing people from social life about the peculiarities of the skin help to reduce unpleasant looks or questions to a minimum. Often, just wearing certain clothing or accessories is enough to sufficiently cover the affected areas of the body. The focus is on promoting well-being and joie de vivre. The changes in skin appearance should not determine the entire life. Mental stability is particularly important to avoid psychological sequelae. Although negative thoughts may arise, care should be taken to avoid brooding or other mentally stressful situations. To avoid complications or a deterioration of the skin’s appearance, cosmetic articles should only be used in consultation with the attending physician. The ingredients and active substances should be checked for the needs of the organism before use. If unpleasant situations or insults occur in everyday life, these should be discussed with other people.
