Overview
Other Treatments
What are varicose veins and spider veins ?
The heart pumps blood to supply oxygen and nutrients to all parts of the body. Arteries carry blood from the heart towards the body parts, while veins carry blood from the body parts back to the heart. As the blood is pumped back to the heart, veins act as one-way valves to prevent the blood from flowing backwards. If the one-way valve becomes weak, some of the blood can leak back into the vein, collect there, and then become congested or clogged. This congestion will cause the vein to abnormally enlarge. These enlarged veins can be either varicose veins or spider veins.
Varicose veins are very swollen and raised above the surface of the skin. They are dark purple or blue in color, and can look like cords or very twisted and bulging. They are found most often on the backs of the calves or on the inside of the leg, anywhere from the groin to the ankle. During pregnancy, varicose veins called hemorrhoids can form in the vagina or around the anus.
Spider veins are similar to varicose veins, but they are smaller, are often red or blue in color, and are closer to the surface of the skin than varicose veins. They can look like a tree branch or spider web with their short jagged lines. Spider veins can be found on both the legs and the face. They can cover either a very small or very large area of skin.
How common are abnormal leg veins ?
As many as 60% of all American women and men suffer from some form of vein disorder, but women are more affected -- up to 50% overall. It also is estimated that 41% of all women will suffer from abnormal leg veins by the time they are in the 50s.
What causes varicose and spider veins ?
No one knows the exact cause of spider and varicose veins, but there are several factors that cause a person to be more likely to develop them. Heredity, or being born with weak vein valves, is the greatest factor. Hormones also play a role. The hormonal changes that occur during puberty, pregnancy, and menopause, as well as taking estrogen, progesterone, and birth control pills can cause a woman to develop varicose veins or spider veins.
During pregnancy, besides the increases in hormone levels, there also is a great increase in the volume of blood in the body that can cause veins to enlarge. The enlarged uterus also puts more pressure on the veins. (Within 3 months after delivery, varicose veins usually improve. However, more abnormal veins are likely to develop and remain after additional pregnancies.)
Other factors that weaken vein valves and that may cause varicose or spider veins include aging, obesity, leg injury, and prolonged standing, such as for long hours on the job. Spider veins on the cheeks or nose of a fair-skinned person may occur from sun exposure.
How can I prevent varicose and spider veins ?
There are several easy things you can do to help prevent varicose and spider veins and to relieve discomfort from the ones you have:
- Protect your skin from the sun by wearing sunscreen to limit spider veins on the face.
- Exercise regularly to improve your leg strength, circulation, and vein strength. Focus on exercises that work your legs, such as walking or running.
- Control your weight to avoid placing too much pressure on your legs.
- Do not cross your legs when sitting. However, try to elevate your legs when resting.
- Do not stand for long periods of time. If you have to stand for long periods of time, shift your weight from one leg to the other every few minutes. If you have to sit for long periods of time, stand up and move around or take a short walk approximately every 30 minutes.
- Wear elastic support stockings, but avoid clothing that is too tight or that will constrict your waist, groin, or legs.
- Make sure to include high-fiber foods in your diet since constipation can contribute to varicose veins. High fiber foods include fresh fruits and vegetables and whole grains, like bran. Control your salt-intake. Salt, or sodium, can cause you to retain water or swell.
Should I see a doctor about varicose veins ?
Remember these important questions when deciding whether to see your doctor :
- Has the varicose vein become swollen, red, or very tender or warm to the touch?
- If yes, see your doctor.
- If no, are there sores or a rash on the leg or near the ankle with the varicose vein, or are there circulation problems in your feet?
- If yes, see your doctor.
- If no, continue to follow the self-care tips above.
How are varicose and spider veins treated ?
Besides a physical examination, your doctor can take x-rays or ultrasound pictures of the vein to assess the cause and severity of the problem. You may want to speak with a doctor who specializes in vein diseases (phlebology). You should discuss which treatment options are best for your condition and lifestyle. It is important to remember that not all cases of varicose veins are the same. Doctors may differ in the ways they treat you.
Some available treatments or surgeries include :
- Sclerotherapy : -
Of all available treatments, this one is most commonly used for both spider veins and varicose veins. It involves injecting a solution into the vein that causes the lining of the vein walls to swell, stick together, and eventually seal shut. The flow of blood is stopped and the vein turns into scar tissue. In a few weeks, the vein should fade. Although the same vein may need to be injected with the solution more than once, sclerotherapy is very effective if done correctly.
The American Academy of Dermatology states that most patients can expect a 50% to 90% improvement. Also, a new and improved type of sclerotherapy called microsclerotherapy uses improved solutions and injection techniques that increase the success rate for removal of spider veins. Sclerotherapy does not require anesthesia, and can be done in the doctor's office.
Some side effects may only occur at the site of the injection, such as stinging or painful cramps; red raised patches of skin, small skin ulcers, and bruises. Spots, brown lines, or groups of fine red blood vessels could appear around the vein being treated. These usually disappear. The treated vein could become inflamed or develop lumps of coagulated or congested blood. These are not dangerous.
Applying heat and taking aspirin or antibiotics can relieve inflammation. Lumps of coagulated blood can be drained. Health insurance coverage varies. If the treatment is done for cosmetic reasons only, it may not be covered.
- Electrodesiccation : -
This treatment is similar to sclerotherapy except the veins are sealed off with an electrical current instead of the injection of solution. This treatment may leave scars.
- Laser surgery : -
Until recently, laser treatments mostly were used for treating spider veins on the face. Varicose veins in the legs did not respond consistently to this treatment, and some doctors doubted whether laser treatment actually worked, and it was not covered by most health insurance plans. Now, however, new technology in laser treatments can effectively treat varicose veins in the legs.
Laser surgery works by sending very strong bursts of light onto the vein that makes the vein slowly fade and disappear. Lasers are very direct and accurate, and only damage the area being treated. All skin types and colors can be safely treated with lasers. The American Academy of Dermatology believes that the new laser technology is more effective with fewer side effects.
Laser surgery is more comfortable for patients because there are no needles or incisions. When the laser hits the skin, the patient only feels a small pinch, and the skin is soothed by cooling both before and after the laser is applied. There may be some redness or swelling of the skin right after the treatment, but this disappears within a few days.
The skin also may be discolored, but this will disappear within one to two weeks. Treatments last 15 to 20 minutes, and depending on the severity of the veins, two to five treatments are generally needed to remove varicose veins in the legs. Patients can return to normal activity right after treatment.
There are several types of lasers that can be used to treat varicose veins and spider veins on the legs and face. Although your doctor will decide which type is best to treat your condition, some of the lasers used to treat veins include yellow light lasers, green light lasers, and other intense pulsed light systems. Again, health insurance coverage varies. If the treatment is done for cosmetic reasons only, it may not be covered.
Closure Technique
The U.S. Food and Drug Administration (FDA) in March 1999 approved this new procedure for use in the United States. Although it is not as widely used as sclerotherapy, some doctors feel it may become the standard for treating varicose veins. It is not very invasive and can be done in a doctor's office.
This method involves placing a special catheter or a very small tube into the vein. Once inside, the catheter sends radiofrequency energy to cause the vein wall to shrink and seal shut. Healthier veins surrounding the closed vein can then restore the normal flow of blood. As this happens, symptoms from the varicose vein decrease. The only side effect is slight bruising. Surgery is used mostly to treat very large varicose veins.
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Varicose Veins 
Radiofrequency Occlusion
Sclerotherapy
Vein Stripping 
Lower Leg Ulcers 
Vascular Malformations 
