What Causes Varicose Veins and Spider Veins
Normally there are very tiny one way valves inside your veins which prevent blood from flowing back down the vein. When the valves become damaged or malfunction the blood starts to pool inside the vein instead of flowing through it wuickly. The accumulated blood causes the veinto become enlarged and congested with blood. These defective veins are called spider veins or varicose veins.
Spider veins and varicose veins are the same but different sizes. Spider veins are small and look red, blue or purple on the surface of the skin. Varicose veins are larger and look like ropes worming their way under the skin.
Symptoms of Varicose Veins and Spider Veins
Well, the first problem with varicose veinsand spider veins is that they are very unattractive. Most patients, especially women who are judged more strictly on the appearance of their legs, do not like them and would be happy to be rid of them. Contrary to popular beliefe they are not dead veins though. They are alive but dysfunctional. Because of this the patient may have other symptoms such as pain, swelling, and tired legs, heaviness in the legs, aching, burning, throbbing, itching, cramping. Although spider veins pose no real health problem they can be uncomfortable and cause a lot of morbidity (suffering). Varicose veins, however, can cause real health issues. These can be skin problems like eczema, inflammation or even ulceration (non-healing wounds) of the lower leg. These symptoms are often made worse by prolonged standing or sitting.
Treatment of Varicose Veins and Spider Veins
Over the last 20 years as medical science has developed and doctors have become more saavy in treating venous disease patients are essentially given 4 options:
- Surgery or Vein Stripping: This is the old tried and true treatment for varicose veins. Get in there and rip out the problem vein. However, most patients are rightfully reluctant to have surgery. There are many potentially serious side effects and risks with surgery. You could develop a blood clot (that could kill you); this occurs approximately 30% of the time. Yu coud have bleeding or develop an infection. Surgery will also always leave some type of scars on the legs which sometimes can be very disfiguring.
In addition to the operation itself there are risks with the general anesthesia that will be required for vein stripping. In my opinon as one the U.S. top experts in the field of Phlebology surgery should be the absolute last resort. In my practice of over 1,000,000 patients I have had to send patients to surgery only 1% of the time.
- Sclerotherapy or Injections: For all of my patients with spider veins sclerotherapy or injection of the bad veins is the ONLY treatment of choice. Even patients with varicose veins on the surface of the skin can be treated most of the time non-surgically with sclerotherapy. Laser treatment of spider veins of the legs is almost a complete waste of time and money. It works rarely and often times leaves bad scarring. Facial veins on the other hand can now be treated most of the time with laser therapy.
- Endovenous Laser Treatment or Endovenous Laser Ablation (EVLT or EVLA): When skin varicose veins are being "fed" by larger superficial varicose veins, such as the Greater Saphenous Vein, from deeper in the skin EVLT is the most modern, safe, and effective procedure or treatment. With this new laser technology we can now treat even the largest varicose veins without surgery and get a successful result 98% of the time!
(Extra note) Closure (Radio Frequency Ablation) and Amubulatory Phlebectomy for varicose veins are both options that are still available, but Closure has been mostly replaced by the faster, more effecient and more successful EVLT/EVLA. We can also treat a larger variety of vein veins (larger) with the laser technology than the older RFA. Ambulatory phlebectomy is a type of limited surgery and it's useful in situations where sclerotherapy is contraindicated (not safe or ineffective), such as large painful varicose veins of the foot and ankles.