Varicose
Veins and Spider VeinsThe
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. 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. 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. The
veins in the legs have the toughest job of carrying blood back to the heart. They
endure the most pressure -- pressure that can overcome the strength of these one-way
valves. The force of gravity, the pressure from body weight, and the task of carrying
the blood from the bottom of the body up to the heart make the legs the primary
location for varicose and spider veins. Medical
treatment usually is not required for varicose or spider veins. However, varicose
veins can become quite uncomfortable as well as look unattractive. Varicose veins
usually enlarge and worsen over time. They can cause the legs and feet to swell.
Although severe leg pain is not common, leg muscles may feel fatigued or heavy,
or throb and cramp at night. The skin on the legs and around the ankles also can
itch or burn. In
some cases, varicose veins and spider veins can cause more serious problems, and
medical treatment will provide benefits. If the veins become severe, they can
cause a condition called venous insufficiency, a severe clogging of the blood
in the veins that prevents it from returning to the heart. This condition can
cause problems like a deep-vein thrombosis (blood clot), or a severe bleeding
infection. These usually are caused by injury to the varicose vein. A blood clot
can be very dangerous because of the possibility of it traveling from the leg
veins to the lungs, where it may block the heart and lungs from functioning. Lastly,
because the skin tissue around the varicose vein may not receive enough nourishment,
sores or skin ulcers may develop. 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.
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.
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. - VNUS®
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. Available surgical options
include: - Surgical
Ligation and Stripping - With this treatment, the veins are tied shut and completely
removed from the leg. Removing the veins will not affect the circulation of blood
in the leg because veins deeper in the leg take care of the larger volumes of
blood. The varicose veins mostly removed through surgery are superficial or surface
veins, and collect blood only from the skin. This surgery requires either local
or general anesthesia and must be done in an operating room on an outpatient basis.
Serious
side effects or complications with this surgery are uncommon. However, with general
anesthesia, there always is a risk of cardiac and respiratory complications. Similar
to the risks of sclerotherapy, bleeding and congestion of blood can be a problem,
but the collected blood usually settles on its own and does not require any further
treating. Wound infection, inflammation, swelling and redness also can occur.
This surgery also can leave permanent scars. A very common complication is the
damage of nerve tissue around the treated vein. Small sensory nerve branches are
difficult to avoid when veins are removed. This damage can cause numbness in small
areas of skin, burning, or a change in sensation around the surgical scar. The
most serious, but rare, complication of surgery is the creation of a deep vein
blood clot that may travel to the lungs and heart. To be safe, many surgeons give
injections of heparin, a drug that reduces blood coagulation, for one to two days
before the surgery. However, heparin also can increase the normal amount of bleeding
and bruising after the operation. - Ambulatory
Phlebectomy - With this surgery, a special light source marks the location
of the vein. Tiny incisions are made in the vein, and then with surgical hooks,
the vein is pulled out of the leg. This surgery requires local or regional anesthesia.
The vein usually is removed in one treatment. Side effects and complications are
similar to those of ligation and stripping. The most common side effect is slight
bruising. Compared to traditional surgery, ambulatory phlebectomy allows the removal
of very large varicose veins while leaving only very small scars. Patients can
return to normal activity the day after treatment.
Current
treatments for varicose veins and spider veins have very high success rates. Although
it is uncommon, these veins can return after treatment. One reason may be hidden
areas in the body where there is a lot of pressure on the veins. This pressure
may cause new spider veins. Doctors can diagnose this with ultrasound. Another
cause may be new re-growth of vein branches. Doctors have found that tiny vein
branches can grow through scar tissue to connect to both deep and superficial
veins even after surgery.
Womenshealth.gov
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