Vein Therapy

Varicose Veins and Spider Veins

Varicose and spider veins are, in actual fact, superficial veins that have been damaged (by any of numerous possible causes) so that blood no longer flows easily through them. These conditions affect half of all people over the age of 50. They are more common in women than men. Spider veins are like varicose veins, but they are smaller.

Exercising, maintaining proper body weight, elevating your legs when resting and avoiding crossing your legs for excessive periods of time while sitting will help keep varicose veins from getting worse. Avoid standing for long periods of time and wear loose clothing as well. There are many options for treatment of these often uncomfortable or unsightly varicose veins. Treatment results are remarkably positive for most patients.
 

Treatment Methods

At Long Ridge Dermatology, we combine lasers with the use of chemical injections (sclerotherapy) to treat veins from 0.5 to 4 mm in diameter.

Larger veins are treated with sclerotherapy first and the smaller veins that remain are treated with a laser. After the initial treatment with chemical injections, the larger veins are sealed; often the smaller veins receive this treatment as well.

A laser is used to seal the veins that remain open, bringing about a gradual but continuing improvement over the period of one or more months.

Sclerotherapy:
Tiny needles are used to inject a chemical solution into each varicose vein, causing the vein to seal, re-routing blood to other veins. Microsclerotherapy uses special solutions and injection techniques that increase the success rate for removal of spider veins. Sclerotherapy does not require anesthesia and most patients report very minimal discomfort, if any at all. Most patients see dramatic results – in fact, a 50% to 90% improvement is quite common. Possible side effects include:

• Temporary stinging or cramps at the injection site
• Temporary sensitive or red raised patches of skin at the injection site
• Temporary discoloration or bruises at the injection site
• Diminutive spots around the treated vein that generally disappear
• Thin brown lines around the treated vein that usually fade away
• Groups of fine red blood vessels near the treated vein that frequently vanish

The treated vein can also become inflamed or develop insignificant blood clots, which are not dangerous. Applying heat and massaging the area, along with taking aspirin or antibiotics will often relieve the inflammation.

Laser Ablation:
Intense bursts of light onto the veins seal them off, causing them to dissolve over time, so they slowly fade and eventually disappear altogether. Lasers are very direct and accurate, only affecting 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 is less invasive, but there can be some discomfort on the skin surface, which cooling helps to reduce. Laser treatments last from 15 – 20 minutes. Depending on the severity of the veins, two to five treatments are generally needed to remove spider veins in the legs. Patients can return to normal activity right after treatment, just as with sclerotherapy. For spider veins larger than 3 mm, laser therapy is not a practical option. Possible side effects of laser surgery include:

• Redness or swelling of the skin after the treatment that disappears within a few days.
• Mild discoloration, which diminishes or fades away completely within one month or so.

Thermal ablation:
Similar to sclerotherapy, this process seals the veins with an energized current instead of a chemical solution. It has been a huge breakthrough, replacing surgery for the vast majority of patients with severe varicose veins. This technique is not very invasive.

In the procedure, a miniature catheter is threaded into the vein. Once inside, the catheter sends out radio frequency or laser energy that shrinks and seals the vein wall. Healthy veins around the closed vein restore the normal flow of blood. As this happens, symptoms from the varicose vein improve. Veins on the surface of the skin that are connected to the treated varicose vein will also usually shrink after treatment. When needed, these connected varicose veins can be treated with sclerotherapy or other techniques.

Slight bruising is the most common side effect.

How common are abnormal leg veins?

About 50 – 55% of American women and 40 – 45% of American men over the age of 50 suffer from some form of vein problem. Many factors increase a person’s chances of developing varicose or spider veins. These include:

• Age
• Having a family history of vein problems or being born with weak vein valves
• Hormonal change, including puberty, pregnancy, and menopause. Taking birth control pills and other medicines containing estrogen and progesterone also increase the risk of varicose or spider veins.
• Pregnancy…during pregnancy there is a huge increase in the amount of blood in the body. This can cause veins to enlarge. The expanding uterus also puts pressure on the veins. Varicose veins usually improve within three months after delivery. A growing number of abnormal veins can appear with each additional pregnancy
• Obesity
• Leg injury
• Prolonged standing or crossing of the legs and lack of exercise, all of which weaken vein valves
• Sun exposure, which can cause spider veins on the cheeks or nose of fair-skinned individuals

Are varicose veins and spider veins painful or dangerous?

Spider veins usually do not need medical treatment. But varicose veins typically enlarge and progress over time. Severe varicose veins can cause health problems. These include:

• Severe venous insufficiency. This slows the return of blood to the heart. This condition can cause blood clots and severe infections, compromising the proper function of both the heart and lungs. This requires immediate medical attention.
• Sores or skin ulcers. These can occur on skin tissue around varicose veins.
• Ongoing irritation, swelling and uncomfortable or persistent rashes on the legs.

How can I prevent varicose veins and spider veins?

Not all varicose and spider veins can be prevented, but you can be proactive to reduce your chances of getting new varicose and spider veins. These same measures are helpful in easing discomfort from the ones you already have:

• Wear sunscreen to protect your skin from the sun and 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
• Elevate your legs when resting as much as possible
• Do not stand or sit for long periods of time. If you must stand for a long time, shift your weight from one leg to the other every few minutes. If you must sit for long periods of time, stand up and move around or take a short walk every 30 minutes
• Wear elastic support stockings and avoid tight clothing that constricts your waist, groin or legs
• Eat a low-salt diet rich in high-fiber foods. Eating fiber reduces the chances of constipation which can contribute to varicose veins. High fiber foods include fresh fruits and vegetables and whole grains, like bran. Eating too much salt can cause you to retain water and often leads to swelling

If you notice veins that are red, swollen or tender, please schedule an office visit with one of our doctors immediately. You should also call if you have sores or a rash on or near the leg or ankle with the varicose vein. If you are concerned about circulation in your feet, you should bring this to our attention as well.