Why are spider and varicose veins a concern?
Varicose and smaller spider veins are a common medical condition, affecting as estimated 80 million adults in the U.S. Even shapely legs can look less attractive with bulging blue veins or a network of spider veins.
The exact cause of spider and varicose veins is unknown, although heredity, pregnancy and hormonal changes are believed to be contributing factors. As people age, these unsightly veins become more common and often more pronounced. Forty-one percent of women aged 40-50 years old have varicose veins, increasing to 73% of women aged 60-70 years old. Among men aged 30-40 years old, 24% have varicose veins, increasing to 43% among 70 year old men.
While usually a cosmetic condition, varicose veins may also pose a health risk. In fact, 6 million workdays each year are lost due to complications from varicose veins. The abnormal circulation resulting from varicose veins may cause ulcers, and it is estimated that nearly 100,000 Americans are totally disabled by the condition.
What are spider and varicose veins?
Spider veins are formed by the dilation of a small group of blood vessels located close to the surface of the skin. Although that can appear anywhere on the body, spider veins are most commonly found on the face and legs and look like red or purple sunbursts or web patterns. Spider veins are also referred to as telangiectasia or broken capillaries. They usually pose no health hazard by may produce a dull aching in the legs after prolonged standing.
Varicose veins are swollen or enlarged blood vessels caused by weakening in the vein's wall or valves. They are located somewhat deeper than spider veins, are sometimes raised, and often appear blue. The origin of these varicose veins may be hidden under the skin. Advanced cases of varicose veins can be harmful to a patient's health because they may be associated with the development of one or more of the following conditions:
- Venous statis ulcers, which can result when the enlarged vein does not provide adequate drainage of fluid from the skin. The swollen skin received insufficient oxygen and an ulcer forms
- Phlebitis, which is an inflammation of the vein
- Thromboses, which are blood clots forming in the enlarged vein.
Who is qualified to treat spider and varicose veins?
Dermatologic surgeons have extensive training and experience in the diagnosis and treatment of vein disorders. As specialists in diseases of the skin, dermatologic surgeons are uniquely qualified to select the treatment method or combination of methods that works best in a particular situation and provides the optimal cosmetic results.
How are veins treated?
Sclerotherapy
Sclerotherapy is a safe and effective procedure that can be performed by a dermatologic surgeon in the doctor's office with minimal discomfort. A concentrated saline, sugar, glycerin or specially developed chemical or detergent solution is injected with s very small needle in the spider vein. The sclerosing (hardening) solution causes the vein to close up or collapse and become scar tissue that eventually is absorbed by the body. The work of carrying the blood id shifted to other healthy blood vessels nearby.
Sclerotherapy generally requires multiple treatment sessions. One to three injection sessions are usually required to effectively treat any vein, and 10 to 40 veins may be treated in one session. The same area should not be retreated for four to six weeks to allow for complete healing, although other areas may undergo treatment during this time.
Occasionally, diagnostic tests such as ultrasound or plethsmography may be recommended to enhance the results of the treatment.
Post-treatment therapy typically includes wearing compression bandages and/or support hose for two days to three weeks following treatment. Walking and moderate exercise also help speed recovery. The treated blood vessels generally disappear over a period of six months. Although sclerotherapy works for existing spider veins, it does not prevent new ones from developing.
Other treatments
Other treatments for spider and varicose veins include:
- Ambulatory phlebectomy: This technique involves removal of an undesired vein through a series of tiny punctures along the path of the enlarged vein. Using a specially designed instrument to "hook" the varicose vein into the surgeon's view, the damaged vein can be removed entirely by gently pulling from tiny puncture to puncture. This safe, outpatient procedure performed un local anesthesia can treat large varicose veins as well as spider veins with minimal risks, reduced side effects and decreased recurrence.
- Laser and light-based therapy: This innovative technique tends to be effective for certain leg veins and facial blood vessels. The heat from a laser beam or pulsed light device selectively destroys the abnormal veins. Cryogenic sprays and instrument tips to cool the skin are often used to enhance patient comfort and cosmetic results.
- Surgical ligation and stripping: This method involves an incision in the skin and either tying off or removing the blood vessel. The procedure may require the use of general anesthesia, is usually performed by a vascular surgeon in the hospital, and is generally reserved for larger veins. It is being replaced by less invasive endovenous techniques performed under local anesthesia in the doctor's office.
- Endovenous radio frequency closure technique: This minimally invasive procedure for varicose involves inserting a small tube called a catheter into the defective vein through a small needle puncture or during an ambulatory phlebectomy procedure using local anesthesia. The catheter delivers radio frequency energy to the vein wall, causing the damaged vein to shrink and seal shut. Neighboring, healthy veins take over to restore normal blood flow
- Endovenous laser technique: Like radio frequency techniques, this approach involves a small needle puncture through which a laser fiber is placed into the vein. The laser energy heats and shrinks the vein from the inside. The damaged vein is hen slowly absorbed by the body and healthy veins restore normal blood flow.
