Varicose veins appear as enlarged, rope-like veins that are typically recognizable as blue, red or even flesh colored. Varicose veins are most often a sign of underlying venous disease. Specifically, venous insufficiency is a malfunction of the valves which regulate the return flow of blood from the legs to the heart. This valve malfunction causes blood to back up and pool in the surface veins, which often lie very close to the surface of the skin. The increased pressure results in the bulging that can be seen above the skin. It is often thought that varicose veins are just a cosmetic issue and that they are synonymous with spider veins. However, if left untreated, varicose veins can lead to serious medical issues including phlebitis (vein inflammation), thrombosis, blood clots and even skin ulcers.
Symptoms of Varicose Veins include:
Patients with varicose veins often complain that these symptoms interfere with their daily life, causing difficulty standing for long periods of time, difficulty with exercise, or even sitting for long periods of time. While much of this results from the hereditary condition of venous disease, it is often triggered or worsened with life events such as:
What occupations increase the risk of developing varicose veins?
Although roughly 40% of Americans suffer from varicose and spiders veins, they are most common among women because they typically have more of the above mentioned risk factors. Woman also experience the painful symptoms associated with varicose veins sooner than men because they are related to fluctuations in estrogen. Although men may not share as many of the same risk factors, they have similar occupational factors, specifically working conditions that contribute to their varicose veins. Men also tend to experience their venous disease issues with more severity, often having more high pressure, bulging veins and more instances of bursting or bleeding veins and venous ulcers.
The key to effective treatment is accurate and early detection of venous insufficiency. When a patient has venous insufficiency, it requires a correction of the valve malfunction. This is done with a procedure known as Endovenous Ablation that we perform in the office with no down time. However, some smaller varicose and spider veins may not require the valve correction procedure and only require a procedure called Sclerotherapy. Sclerotherapy involves a series of injections of a sclerosing solution that allows the vein walls to collapse, close off, and absorb into the body allowing the blood to reroute through healthier veins. As with Endovenous Ablation, this procedure is done in the office with no down time. Both procedures require the use of compression therapy in the form of a gradient compression stocking, which is specifically sized for you to help the veins to close effectively. Many patients find that the daily use of a compression stocking will also lessen some of their symptoms, such as the tired and achy feeling caused by venous disease.
As always with any medical procedure, it is recommended that you only work with qualified experts! The International Vein Clinic’s physicians are accredited with ICAVL (Intersocietal Commission for the Accreditation of Vascular Laboratories), which ensures that we provide only the highest level of diagnostic testing and diagnosis for our patients. Our physicians are board certified and members of the American College of Phlebology. Participation in these organizations and accreditations demonstrates the International Vein Clinics’ attention to providing the highest most effective quality of patient care.
Venous leg ulcers are a serious result of venous disease and varicose vein issues that have been left untreated. This occurs in approximately 20% of all people suffering from varicose veins and likely a higher percentage of people who are suffering from recurrent ulcers who don’t know that it is probably a venous issue.
An ulcer (non-healing open sore) in the skin refers to a place where the normal skin covering has been wiped away and the subcutaneous tissue under the skin is exposed. Venous ulcers most commonly occur in the leg between the knee and the foot. Leaking venous valves cause high pressure and abnormal circulation in the tiny vessels of the skin. When the abnormal circulation from long-standing reflux in the superficial or other veins causes the skin to become thickened and inflamed, it can actually break down into an open sore.
A patient’s tolerance to venous ulcers can vary; they can be both painful and painless. If left without proper treatment, a venous ulcer will continue to grow larger until it encircles the leg and causes severe disability, pain, and may require amputation.
How does it happen?
When blood pools in the smaller veins next to the skin, pressure in the surrounding veins is increased. This increased pressure causes fluid to ooze out of the veins beneath the skin, resulting in swelling, thickening of the skin, and damage to the skin. When the damaged skin eventually breaks down, an ulcer is formed. The increased pressure of blood in the leg veins is due to blood pooling in the smaller veins next to the skin. Pooling occurs because the valves in the larger veins are damaged by a previous thrombosis (blood clot) causing blockage of the vein, or by weakening of the walls of the veins. As a result, the valves malfunction and become varicose veins. When the valves no longer function properly, gravity causes blood to backflow down the leg when standing. Then blood pools in the lower leg veins, increasing the pressure which, in turn, damages the surrounding tissue. Eventually, the skin breaks down and ulceration results. These malfunctioning valves may require a procedure called Endovenous Ablation, to repair the problem and restore normal pressure and blood flow to the affected area. Venous ulcers may also be caused by:
Treatment begins with accurate diagnosis and treatment of the specific veins and valves that are malfunctioning. Elastic stockings or rigid leg coverings may be prescribed. Seeing a Wound Care Specialist is highly recommended. With specific diagnosis and aggressive correction, more than half of leg ulcers can be healed sufficiently to prevent recurrence.
Early diagnosis and treatment of varicose and spider veins is essential to preventing venous ulcers. What starts as a minor aesthetic annoyance can easily escalate in to a symptomatic vein problem, and then lead to serious venous ulcers. Sclerotherapy and Endovenous Ablation procedures treating the early-stage varicose and spider veins are much easier and less invasive than the treatment venous ulcers require.
Most people think all visible leg veins are spider veins. In fact, spider veins and varicose veins are very different.
A large percentage of our patients seek treatment for what they assume is a spider vein. That’s why it’s so important to receive an accurate diagnosis by a specialist in vein care. This will prevent you from spending a lot of money treating veins that will never clear up or will reoccur because of the presence of an underlying issue, such as vein disease.
We make every effort to educate our patients on the difference between a true spider vein and varicose veins.
Spider veins, medically referred to as Telangiectasias, are small, dilated blood vessels, usually under 3mm in diameter that appear near the surface of the skin. These superficial blood vessels can be red, blue or even purple in color and commonly occur in the legs. However, they can be found on the face (rosacea) and other areas of the body, and have been linked to excessive sun exposure. Treatment for veins on the face and the body is much more delicate and thus is treated differently than spider veins on the legs.
These dilated blood vessels are small, about the width of a hair, and often form sunburst-like patterns. While some have the appearance of a spider web, other may resemble a tree with branches. Depending on factors such as lifestyle, health issues and physical appearance, spider veins will look different on everyone. Some patients may even see them as small clusters of light patches vs. the spidery appearance described.
Spider veins, while not preventable, are easily and effectively treated with Sclerotherapy treatments. Sclerotherapy involves a series of injections of a sclerosing solution that allows the vein walls to collapse, close off, and absorb into the body allowing the blood to reroute through healthier veins. This treatment allows for a nearly 90% chance for a greatly improved appearance and look.
Both men and women can develop spider veins, although women are more likely to develop them as a result of pregnancy and hormonal effects.
Although spider veins cannot be prevented, there are things patients can do to minimize their appearance and speed recovery after treatments:
Deep Vein Thrombosis (DVT), also called venous thrombosis, is a blood clot that develops in a vein deep in the body. The clot may partially or completely block blood flow through the vein. Most DVTs occur in the lower leg, thigh or pelvis, although they also can occur in other parts of the body including the arm, brain, intestines, liver or kidney.