More than 80 million people in the United States have problems with their veins, the vessels that return blood to the heart once it has circulated through the body. Many people suffering from venous disorders come to vascular surgeons looking for treatment to either relieve pain or improve the visible appearance due to diseased veins.
Veins have one-way valves that help keep blood flowing in the proper direction. If these valves stop functioning the way they are supposed to, blood can flow backwards and pool in the vein branches, causing them to stretch and become varicose veins. This condition is known as venous insufficiency.
These enlarged blood vessels fall into two groups: spider veins and varicose veins. Spider veins are visible on the surface of the skin as red, blue or purple lines. Varicose veins are larger and deeper and often look like bluish bumps under the skin.
Varicose veins serve no useful purpose in the body. They are swollen, dark blue or purple blood vessels that you can see and feel beneath the skin. They often look like twisted cords or may take a straight path under the surface of the skin. Varicosities usually appear on the calves, inside or on top of the thigh, and around the ankles.
Varicose veins form when the valves within a vein weaken and allow some blood to flow backward. The vein weakens under the additional strain and balloons outward, raising the skin surface. Patients often complain of aching, heaviness, swelling, throbbing, itching, cramping, restless legs and general discomfort with standing or dependency. However, some rather large varicose veins remain asymptomatic.
Correct treatment often takes care of the discomfort associated with the condition. Some people with varicose veins seek cosmetic treatment to reduce their appearance on the legs. Sometimes, however, more significant problems can develop if veins are left untreated. Some patients go on to develop swelling, skin discoloration or rash at the calves and ankles with eventual ulceration of the skin. This is due to the elevated pressure at the skin level veins in the lower leg. Some enlarged varicose veins are prone to develop a superficial phlebitis which is a painful, firm clot in a varicose vein. In other cases veins can rupture and result in significant bleeding. For this reason, patients with varicose veins should be examined by a professional who specializes in vein treatment.
Spider veins, or telangiectasias, are small, thin, blood vessels visible beneath the skin. They appear most commonly on the face and legs and may look like a series of lines, tree branches, or a spider- or web-like shape with a dark center. They serve no useful purpose in the body. It is estimated that they affect nearly half of adult women in the U.S.
Spider veins are caused by a variety of factors, including heredity, pregnancy (and other conditions that involve changes in hormone levels), weight gain and long periods of standing and leg dependency. They often appear red or blue, and because they form on the face, thighs, calves and ankles, many patients are bothered by the way they look. Others seek medical treatment for uncomfortable symptoms such as aching, burning, swelling and cramping. The standard treatments for spider veins are sclerotherapy and laser or pulsed light treatments.
Also known as feeder veins, reticular veins are dilated veins that appear as blue or green lines under the skin, affecting as much as 80% of all adults. They are often large and unsightly and may lead to the development of spider veins in some patients. Some patients may experience tenderness, burning and itching in the legs, although these symptoms are considered rare.
These veins often develop as a result of genetic factors, but may also be caused by hormonal imbalances or weak veins. Although they do not often cause any painful symptoms or medical complications, many patients are bothered by the appearance of reticular veins and seek treatment to achieve clear, smooth skin.
Sclerotherapy is most often performed to treat reticular veins, while some cases can be treated with a miniphlebectomy, a less invasive alternative to sclerotherapy. Reticular veins should be treated before spider veins so as to prevent early recurrence of the spider veins. Your doctor will decide which treatment option is best for you after a thorough evaluation of your condition.