Varicose and spider veins can leave unsightly discoloration and texture to the skin. The medical treatment that Dr. Cameron Rokhsar will choose for you depends on the following factors:
Different methods of treating varicose and spider veins1 are sclerotherapy and laser technologies such as Nd:YAG laser. Sclerotherapy is the most common way to treat spider and varicose veins on the leg. It is in the form of an injection and can be found in other forms such as foam, ultrasound, and laser-assisted sclerotherapy. When the chemical is injected the veins collapse and block any further blood flow in that area, which ultimately eradicates their appearance through the skin.
The surrounding veins take over for the collapsed veins and regular blood flow continues. The injection may only feel like a pinprick if anything at all. The number of treatments varies from patient-to-patient based on the criteria listed above. The long-pulsed Nd:YAG laser is an alternative treatment for those patients who wish to avoid the needles. This form of laser treatment is typically used for spider veins and smaller varicose veins2. This new technology effectively treats the veins by sending strong bursts of light into the vein, which will make the vein slowly fade and disappear.
During pregnancy, and to a lesser degree also during periods, fluctuations in the female sex hormone (especially estrogen and progesterone), cause softening of the vein walls and valves. This makes women’s veins more prone to stretching and enlargement with increased pressure. Increased blood volume, which is needed to provide circulation to the fetus, also causes increased pressure on the vein walls. The growing fetus also exerts pressure on the pelvis, which in turn, exerts pressure on the leg veins. Some women see spider veins that develop during their pregnancies and persist after their baby is born. Others see that their veins disappear after the baby is born, only to reappear later in life.
Prolonged standing and sitting
Prolonged standing and sitting cause a great amount of pressure to develop in the leg veins. In both conditions, the calf muscles are inactive and therefore cannot help push the venous blood to return to the heart. This causes blood to pool in the veins, thus resulting in increased pressure on the vein walls.
This pressure drops once one begins to walk, so if your job requires you to stand or sit for prolonged periods, remember to take short breaks and walk around for a couple of minutes every hour.
In some people, spider veins appear after injury or trauma to the vein, such as after a broken ankle, surgery, car accident, or sports injury. Bruising, which is pooled blood resulting from broken veins under the skin, can also lead to an inflammatory response, which in turn, can result in enlarged veins. Sometimes, spider veins can appear many years after the wound has healed.
In men, spider veins are usually the result of blow-outs from nearby varicose veins. High pressure from these veins cause adjoining superficial veins to stretch, enlarge, and change in color. These spider veins are usually darker and have larger diameters than the spider veins in women. Spider vein matting, which resembles bruises that do not go away, is often caused by the healing process of injuries and bruises, as well as complications from sclerotherapy. Ankle flares, or spider veins found on the inside ankle, is often associated with chronic venous insufficiency (CVI), a condition where venous blood is not returned efficiently to the heart.
Spider veins are small threadlike veins that lie close to the surface of the skin. They connect to the larger veins but are non-essential. Spider veins are usually not associated with symptoms.
Causes of Spider Veins
Heredity is the number one contributing factor causing varicose and spider veins. Women are more likely than men to suffer from abnormal leg veins with up to half of American women being affected. Hormonal factors including puberty, pregnancy, menopause, the use of birth control pills, estrogen, and progesterone contribute to this condition. It is very common for pregnant women to develop varicose veins during the first trimester since pregnancy causes increases in hormone levels and blood volume which in turn causes veins to enlarge. Varicose veins3 due to pregnancy often improve within 3 months after delivery. However, with successive pregnancies, abnormal veins are more likely to remain. Other predisposing factors include aging, standing occupations, obesity and leg injury.
The Difference Between Spider & Varicose Veins
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 backward. 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.
New technology in laser treatments can effectively treat spider veins in the legs. Laser surgery sends very strong bursts of light onto the vein. This can make the vein slowly fade and disappear. Lasers are very direct and accurate. So the proper laser controlled by a skilled doctor will usually only damage the area being treated. Most skin types and colors can be safely treated with lasers.
Laser surgery is more appealing to some patients because it does not use needles or incisions. When the laser hits the skin, the patient may feel a heat sensation. Cooling helps reduce pain. Laser treatments last for up to twenty minutes. Depending on the severity of the veins, 2 to 5 treatments are generally needed to remove spider veins in the legs. Typically, patients can return to normal activity right after treatment.
Sclerotherapy is a procedure in which a chemical solution is injected into veins to cause them to collapse and form scar tissue that permanently closes them. Nearby veins take up re-routed blood flow. Sclerotherapy requires multiple treatments to close off all affected veins. Additional treatments may be needed from time to time as newly enlarged veins appear. Side effects of sclerotherapy4 may include slight swelling, bruising, and redness, and itching at injection sites.
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1 Spider Vein Treatment. Available: https://www.plasticsurgery.org/cosmetic-procedures/spider-vein-treatment/procedure.
2 Varicose Veins. Available: https://www.healthline.com/health/varicose-veins.
3 Understanding Varicose Veins — Treatment. Available: https://www.webmd.com/skin-problems-and-treatments/understanding-varicose-veins-treatment.
4 Injection Sclerotherapy. Available: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3036277/.