Spider Veins
Spider veins are appear as thin, red/blue/purple very small dilated blood vessels that are just under the skin and frequently appear in clusters. Spider veins develop due to increased pressure in the deeper veins and are associated with larger reticular veins that appear as a blue/green color.
Varicose Veins
Varicose veins are larger diameter veins that are deeper than spider and reticular veins, they become dilated, twisted and swollen when the valves in the veins do not function properly and the pressure within the vein increases.
What is the Cause of Vein Problems
Spider veins and varicose veins can occur anywhere on the body, but most frequently develop in our legs. Factors that contribute to the development of spider and varicose veins are:
- Heredity (genetic predisposition)
- Advanced age
- Prolonged standing
- Being overweight
- Hormonal changes during pregnancy
- The use of birth control medications
- Hormone replacement therapy
- Previous venous surgery
- Exposure to ultraviolet light rays (tanning)
When is Treatment Necessary
If varicose veins or spider veins cause you to have discomfort with standing and activity, or if you develop an open sore near a varicose vein, you should discuss this with your physician. Your doctor may suggest treatment or may refer you for diagnostic testing such as ultrasound evaluation.
Treatment Options
The goals of treatment are to decrease symptoms, reduce the risk of complications and to improve the appearance of the involved areas. Conservative treatment options include the use of compression stockings which are available at many drug stores, your physician should recommend the amount of compression that it right for you. Additional conservative care includes regular walking exercise, weight loss, elevation of your legs while sitting and avoiding standing for long periods of time. Conservative treatment does not always provide satisfactory relief of symptoms and does not typically improve the vein appearance. Alternative treatment may then be necessary and includes sclerotherapy, laser and light treatment, and surgical treatment.
Sclerotherapy
Sclerotherapy is used to treat spider veins and reticular veins by injection a liquid chemical solution through very fine (small diameter) needle directly into the vein. This causes the vein to close and eventually to be reabsorbed by the body. Liquid and foam sclerotherapy are done in the same manner; foam sclerotherapy uses the same chemical solutions mixed with carbon dioxide or air. Foam sclerotherapy is typically used for larger diameter veins, such as reticular veins. There is very little discomfort associated with sclerotherapy injections.
What to Expect After Sclerotherapy
You will need to avoid sun exposure on the treated areas for 2 weeks after treatment; this will decrease the chances of hyperpigmentation at the treatment sites. It is also best to not have treatment for 1-2 weeks after you have been tanning. After treatment you will need to wear 20-30 mm Hg compression stockings for the first 48 hours. Walking activity is encouraged during the first 48 hours and airline travel should be avoided for 2 weeks.
You should expect that you will look worse before you look better, there is always bruising and discoloration of the treated area/veins. You may get pigment changes in your skin, which in most cases resolves in 4-6 months. You will not be able to use hot tubs or whirlpools and should avoid strenuous activities for a period of time after sclerotherapy. Many individuals experience clearing of the involved veins in 1-2 treatments, but others may require additional sclerotherapy treatments or other forms of treatment such as laser treatment.
Possible Complications
Sclerotherapy continues to be the “gold standard” for treating spider veins and reticular veins, but as with any medical treatment there are possible risks and complications that can occur. These include: increased pigmentation of the skin, incomplete closure of the vein, allergic reaction, the formation of a scab or scaring and small ulcerations of the skin.
It is important to remember that even though sclerotherapy provides excellent results without complications in most cases, reoccurrence is possible. Your body will have a tendency to form new spider veins if you continue to have increased pressure in your veins or hormonal changes such as those that occur during pregnancy. You should expect to be advised to follow up with your doctor every 12-18 months to treat any new spider veins before they become clusters that require multiple treatments.
Insurance Coverage and Cost
The treatment of spider veins is not typically covered by insurance; coverage for symptomatic varicose veins is covered in some instances. The cost of your treatment will depend on the size of the areas that need to be treated and how many total treatments you will require. Our office offers initial evaluation with information on treatment and cost at no charge.
