Causes of spider naevi include:
- cirrhosis - most frequently, alcoholic
- oestrogen excess - usually in association with chronic liver disease; part of normal hepatic function is the inactivation of oestrogens
- hyperthyroidism
- rheumatoid arthritis - rarely (1)
Spider naevi may also be noted transiently in:
- viral hepatitis
- pregnancy - usually appear during the second to fifth months but disappear in the final trimester
Facial spider naevi may occur in acne rosacea
Spider naevi may occur in association with use of the combined oral contraceptive pill.
Reference:
- Graham-Brown RAC and Sarkany I. The hepatobiliary system and the skin. In: Freedberg IM, Eisen AZ, Wolff K, Austen KF, Goldsmith LA, Katz SI, et al. Editors. Fitzpatrick’s Dermatology in General Medicine. McGraw Hill 1999.
- Effect of contraceptives on the skin. Aust Fam Physician. 1988 Oct;17(10):853, 856.