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What’s Going On – Everything You Need to Know about Spider and Varicose Veins

Dr. Dietzek paid a visit to iHeart Radio to discuss varicose & Spider Veins with Loraine Ballard Morrill.

Loraine Ballard Morrill: I’m Loraine Ballard Morrill. So many of us have to deal with unsightly Varicose veins. We’re going to talk to a vascular surgeon and vein specialist, Dr. Charles Dietzek. Let’s define Spider Veins or Varicose veins. Are there any distinctions between those two phrases, or are they the same?

Dr. Charles Dietzek: When we think of Spider Veins, we think of those small veins at the skin’s surface. Those are different than Varicose veins, which are below the skin surface and sometimes can bulge through the skin, giving a ropy appearance. These are much larger veins and are usually due to more medical issues, whereas Spider Veins are more of a skin surface cosmetic problem.

Spider Veins can typically be treated by simple in-office procedures in order to eradicate them. One of the more common ways is sclerotherapy. Another way is laser therapy. These quick office procedures can remove a lot of veins in a short time.

Unfortunately, as we continue to be on Earth and have gravity affecting our extremities, we will get recurrences. That’s one of the big causes for Spider Veins, standing and sitting for long periods of time. There are other reasons to have Spider Veins, most commonly genetics. Some people will have them in their twenties and thirties. By the time you’re in your sixties, about 60% of women will have some degree of Spider Veins.

Varicose veins, on the other hand, are not as common as Spider Veins, although about 30 million people in the United States have Varicose veins. This is also caused by multiple factors. It can be genetics. Pregnancy is one of the big causes. The hormonal influences and the pregnancy experience, having pressure in the pelvis, can result in a lot of pressure on the veins and cause the valves inside veins to fail and then subsequently develop Varicose veins.

The treatments are completely different. With Spider Veins, we may do sclerotherapy, as I mentioned. Typically, we have to do an ultrasound study with Varicose veins to diagnose which veins are not working properly. Then, we can do office procedures to treat the underlying cause for the Varicose veins and then subsequently office procedures to take care of the Varicose veins themselves. This is a little bit more of a complex issue.

Loraine Ballard Morrill: Is there a danger, a medical risk, to having Varicose veins?

Dr. Charles Dietzek: Yes, there definitely is. Varicose veins can lead to a condition known as chronic venous insufficiency, and if left untreated, this can cause a lot of changes to the lower extremity. One can develop skin discoloration, hardness, and thickening of the skin, and in the worst cases, you can have actual ulceration and breakdown of the skin. Also, Varicose veins can cause to develop of superficial vein blood clots. In some small percentages, this can result in deep vein blood clots.

Certainly, Varicose vein is a medical condition and one that should be evaluated, and if you’re having symptoms or any problems with your Varicose veins, this is a condition that is a covered medical issue and can be taken care of with office treatments to eradicate this problem.

Loraine Ballard Morrill: Are women more prone to Spider Veins and Varicose veins than men, or are we equally afflicted?

Dr. Charles Dietzek: Fifty to 60 percent of women will have a vein issue at some point in their life. When it comes to men, it’s usually in the 30 to 40 percent range that men will have some vein problem.

Loraine Ballard Morrill: Dr. Dietzek, what specific treatments are used to treat Spider Veins and Varicose veins?

Dr. Charles Dietzek: Regarding the Spider Veins, the skin surface veins can be treated typically with sclerotherapy which is the premier treatment. This is where we inject solutions into the veins in order to eliminate those unsightly small venous channels.

Many people in the past have referred to this as saline injections. We no longer use saline in our practice because it causes a lot of burning and irritation and can cause problems with the skin itself. We can inject a more modern type of solution into the veins. These solutions do not cause any pain or burning sensation at all. The needles that are utilized are also as fine as hair. The pain associated with spider vein injection is really quite minimal.

As far as Varicose veins, there have been dramatic improvements in the treatment for Varicose veins and the underlying condition known as venous insufficiency. In the past, people would refer to this type of surgery as vein-stripping surgery. After the procedure, people could be laid up for weeks afterward with many discomforts.

Nowadays, we can utilize different types of catheters, which can be inserted into the veins through needle sticks. The catheter heats up and can seal the vein shut, then treating the underlying problem as to why they have Varicose veins. This office procedure can take 15 to 20 minutes, and you can literally get off the treatment table and go back to doing your work that same day. This is a dramatic improvement, and there’s really no downtime associated with this kind of therapy.

Loraine Ballard Morrill: Dr. Dietzek, are there any misconceptions about Varicose veins or Spider Veins?

Dr. Charles Dietzek: One of the misconceptions is that there’s a simple thing that someone can do in order to avoid them. Unfortunately, there’s not.

The good news is that over the last decade, there have been dramatic improvements in how we treat this. Before, when there was surgery, a lot of people were scared of having surgical procedures to treat their veins, more commonly, now, we can do office-based procedures in order to eliminate Varicose veins and decrease the signs and symptoms associated with them. One of the biggest myths is that you need to have surgery to deal with a varicose vein problem.

One of the myths about Spider Veins is that many people are afraid that Spider Veins will turn into Varicose veins, and that’s not the typical situation, either. If you have isolated Spider Veins on the surface of your skin, these will remain as Spider Veins and not become Varicose veins.

Loraine Ballard Morrill: Dr. Dietzek, I wonder if you could speak to the fact that it seems like a lot of different types of establishments deal with Spider Veins in particular, and you often see Groupons for these sort of medispas and places like that. You are a vascular surgeon and a vein specialist. I wonder if you can speak to that why it might be preferable to go to someone who is actually trained in this area.

Dr. Charles Dietzek: The important thing is understanding the entire disease spectrum and exactly what one is looking at. Too often, places will look at just the tip of the iceberg and want to treat what they see without appreciating that more problems are going on.

The spectrum of venous disease is broad, and sometimes a person will have little Spider Veins, but coexistent with that could be Varicose veins and other medical issues that are going on. Unfortunately, some institutions or places will try to approach just one little area without understanding the big picture.

As a vascular surgeon, I’m trained to understand the full dynamics of the arterial and the venous system and then determine the most appropriate treatment algorithm. Sometimes, you get what you pay for, and that’s true when it comes to the treatment of vein problems.

Unfortunately, I have patients that have come to me that have gone elsewhere and had very poor results, and it’s only to understand that the underlying problem was never fully addressed. Therefore, while they may have gotten a discounted price to have something done to them, it was really that they wasted their money completely because the underlying issue was never addressed. It also puts them at risk of having a kind of therapy performed by somebody other than a vascular specialist.

To have an optimum result, I would suggest that when you look at this condition, do your research, do your homework, and investigate who is treating you and if they have the knowledge and background to provide full care of your vein problem.

Loraine Ballard Morrill: I mention this specifically because I have a personal friend who actually went to one of these locations that had, I guess, spider vein therapy, and she had a very bad experience with it. It really alerted me to the fact that many practitioners out there are putting up their shingles and telling people that they can deal with this and clearly are not. I think that it’s obviously very important to go to someone who truly knows the full length and depth of the issue. Do you have a website?

Dr. Charles Dietzek: My website is On that website, you can garner a lot of information about venous disease and learn about different vein conditions and the types of treatments we perform. It’s a good educational resource. At the same time, we have a blog where you can read a lot of information about venous disease and begin to understand that it’s just not a simple treat what you see mentality. It understands the full depth of the problem to design the best treatment program such that we’re going to get a good result.

I want to jump back for a second. One of the myths many people have is that if we treat our veins, you’re never going to get any veins in the future. Unfortunately, as long as we are on Earth and there is gravity, and as long as we maintain our genetics, which we always do, the prevalence of getting vein problems in the future is there. It’s only through proper education and going to a facility that educates the patients appropriately that you’re then going to end up with the result that you’re satisfied with because you have full disclosure and full understanding of your condition.

Unfortunately, in some of these places that people go to, they walk in, expecting something to be done. They’re told that something will be utilized to eradicate their veins and never have another vein again. There’s a lot of bad information out there. Again, that gets back to your point, making sure that one does go to someone who specializes in this area.

Loraine Ballard Morrill: I want to thank you so much for joining us on the line and giving us all the good information about how to address Spider Veins and Varicose veins. Again, as I say, I think we all have to be very careful about who we trust to deal with this issue. Certainly, doing the research you suggest is very important before getting any of these treatments. Dr. Charles Dietzek, a vascular surgeon and vein specialist, thank you so much for joining us today.

Dr. Charles Dietzek: Thank you as well.

Loraine Ballard Morrill: I’m Loraine Ballard Morrill.

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