Varicose Veins And Spider Veins

About half of the population will one day have a vein problem. In the U.S., as many as 40 million people live with varicose veins.

The appearance of these veins usually causes the sufferer to feel self-conscious because they are often twisted and bulging. Some people have thinner, blotchy spider veins, but varicose veins can also have noticeable bulging or cause itching or burning.

Some people find varicose veins bothersome. Sometimes, however, they can be painful. They can cause pain and throbbing and even serious problems like skin sores that won't heal, bleeding, and either superficial blood clots or more dangerous ones called deep vein thrombosis. Should a clot travel to the lungs, it can be fatal.

Learn more about varicose veins and spider veins, what factors put you at risk for developing varicose veins, and how varicose veins can be treated.

Key Takeaways: Varicose and Spider Veins

• Varicose veins and their smaller counterparts, spider veins, develop when one-way valves in the veins are weakened, causing blood to pool and the veins to bulge.
• Risk factors include family history, being overweight, standing or sitting for long periods, and pregnancy.
• Lifestyle changes can help. You can't fully prevent varicose veins, but maintaining a healthy weight and regular exercise can help reduce your risk.
• Varicose vein treatments are available. Options range from conservative measures like compression stockings to medical procedures such as sclerotherapy or laser ablation for more severe cases.
• You should see a doctor if your varicose veins symptoms cause you pain or get worse.

What Are Varicose Veins?

Varicose veins are enlarged veins that are usually visible through the skin, blue or blue-purple and appear twisted. Varicose veins can develop anywhere in the body, but most varicose veins occur in the legs due to the pressure of body weight, the force of gravity and the task of carrying blood from the bottom of the body back to the heart.

What Causes Varicose Veins?

Our veins have one-way valves that keep the blood flowing toward our hearts. If these valves are damaged or weakened, they begin to stop pushing the blood towards the heart and instead the blood pools in your veins, causing swelling. These veins are varicose veins.

Sitting or standing for long periods can cause blood to pool in the veins, increasing the pressure within them. In persons prone to varicose veins, this increased pressure can cause the veins to stretch.

This stretching of the veins may weaken the walls and damage the valves, resulting in thick varicose veins or spider veins.

Obesity, aging, leg injury, pregnancy, smoking, hormones, and heredity (being born with weak vein valves) can also contribute to weakened vein valves and varicose veins.

"Veins are the roads or the tubes that then transfer blood back to the heart," said Neal Ramchandani, MD, vascular surgeon at Franciscan Health Indianapolis. "I like to think of it as elevators. There's a variety of elevators in the veins, and they're contained in the superficial portion of the leg. So, as you imagine, an elevator goes up a floor at a time. Unfortunately, those floors, if they give out, what happens? The elevator drops to the next floor. Similarly, when the valves give way, the blood then drops to the next floor. Unfortunately, that results in pooling or swelling in the leg. So, when these incompetent veins occur, they then bulge with blood, and then result in varicose veins. The varicose veins is merely the backing up of blood from those bad vein, those faulty veins."

Are Varicose Veins And Spider Veins The Same?

Spider veins, a milder type of varicose veins, are smaller than varicose veins, often red or blue, and look like a sunburst or “spider web.” This miniature version of varicose veins looks like interconnected spider webs or tree branches on the surface of your skin.

Where Do Varicose Veins Appear?

Spider veins are commonly found on the face and legs.

What Are Risk Factors For Varicose Veins?

Unfortunately, varicose veins don’t discriminate. Nearly anyone at any age can develop them. However, there are specific risk factors that can be involved.

Seven common risk factors for varicose veins are:

1. Your age

Varicose veins usually affect people between the ages of 30 and 70. The wear and tear of aging, unfortunately, increases our risk for varicose veins. With advancing age, the elastic shell of the vein begins to weaken, increasing the chance that the vein will dilate.

2. Your gender

Women are particularly susceptible to varicose veins because of the influence of progesterone on the veins and the effects of pregnancy. Hormonal changes in women are believed to affect risk factors for varicose veins, which is why women tend to get varicose veins more often than men.

3. Your weight

Being overweight or obese is a significant risk factor for varicose veins. That extra weight can increase pressure on your veins, increasing your risk of developing varicose veins or spider veins.

4. Your family history

Having a family member who has had varicose veins plays some role in developing varicose veins, but the specific factors responsible for this have not been identified.

5. Being inactive

Prolonged standing or sitting increases pressure in the veins. Working at a desk job or consistently on your feet for long periods may force your veins in your legs to work harder to pump your blood to your heart, causing damage and ultimately varicose veins.

6. Pregnancy

Pregnant women have an increased risk of developing varicose veins due to the hormonal influences of pregnancy on the veins. Increased blood volume and pressure during pregnancy put stress on the veins.

Usually, the veins return to normal within one year of childbirth. Women who have multiple pregnancies may develop permanent varicose veins.

7. Previous injury

If you have injured your leg at any point in your life, the veins can weaken their ability to move blood back to your heart, increasing your risk for varicose veins.

What Are Signs Of Varicose Veins?

While a bulging, enlarged vein is a key sign of varicose veins, other signs include:

• Aching pain in your legs
• Swelling
• Leg fatigue
• A sensation of “heaviness”
• Muscle cramping
• Painful veins
• Itching legs
• Burning or throbbing legs
• Discoloration or large bluish veins are highly visible underneath the skin.

A common complaint is that these symptoms worsen in warmer weather or if one has been standing for long periods of time. Rest and elevation may also relieve these symptoms.

Sometimes, the signs of varicose veins are not always visible.

The symptoms of varicose veins may resemble other medical conditions or problems. Always consult your physician for a diagnosis.

How Are Varicose Veins Diagnosed?

In addition to a complete medical history and physical examination, diagnostic procedures for varicose veins may include one or more of the following:

Duplex ultrasound

A type of vascular ultrasound procedure done to assess blood flow and the structure of the leg veins. “Duplex” refers to the two modes of ultrasound used: Doppler and B-mode. The B-mode transducer (like a microphone) obtains an image of the vessel being studied. The Doppler probe within the transducer evaluates the velocity and direction of blood flow in the vessel.

Color-flow imaging

Also called triplex ultrasound, color-flow imaging is a procedure similar to duplex ultrasound that uses color to highlight the direction of blood flow. Vessels in which blood is flowing are colored red for flow in one direction and blue for flow in the other, with a color scale that reflects the speed of the flow.

Magnetic resonance venography

Magnetic resonance venography, or MRV, uses a combination of a large magnet, radiofrequencies, and a computer to produce detailed images of organs and structures within the body. An MRV uses magnetic resonance technology and intravenous (IV) contrast dye to visualize the veins. Contrast dye causes the blood vessels to appear opaque on the X-ray image, allowing the physician to visualize the blood vessels being evaluated. MRV is useful in some cases because it can help detect causes of leg pain other than vein problems.

How Do You Treat Varicose Veins?

If you believe you have varicose veins, talk to your doctor for a diagnosis to begin appropriate treatment. It is essential to address and manage these symptoms before they worsen.

Specific treatment for varicose veins will be determined by your physician based on:

• Your age, overall health, and medical history
• The extent of the condition
• Your signs and symptoms
• Your tolerance of specific medicines, procedures or therapies
• Expectations for the course of the condition
• Your opinion or preference

Medical treatment may not be necessary if there are no symptoms. However, varicose veins may sometimes worsen without treatment.

Multiple treatments can help you in your path to relief and peace of mind. Treatment for varicose veins involves both surgical and nonsurgical approaches. 

Conservative Management

Medical compression stockings support the venous system in the legs. These elastic stockings squeeze or compress the veins and prevent blood from flowing backward. They are useful for decreasing mild leg swelling and slowing the progression of varicose veins. Compression socks are generally worn throughout the day and for long periods of time.

"Often, compression stockings, you can get them over the counter and they'll do wonders," Dr. Ramchandani said. "We'll often begin with compression therapy. If there's still persistence of issues, then we can cross the bridge over to a potential intervention.

You also may be instructed to elevate your feet above the level of your heart three or four times a day for about 15 minutes at a time. If you need to sit or stand for a long period of time, flexing (bending) your legs occasionally can help keep blood circulating. Elevating your legs can help reduce leg swelling and relieve other symptoms if you have mild to moderate varicose veins.

Other ways to manage varicose veins can include lifestyle changes, such as exercise, weight loss and avoiding standing for long periods of time.

Medical Procedures For Varicose Veins

When symptoms are severe and you need to prevent complications or want to improve your appearance, it might be time to consider a medical procedure to get rid of the varicose veins. Treatment options for varicose and spider veins include lasers, injecting the vein with a chemical that causes it to collapse, and different types of surgery, which are usually reserved for very large varicose veins. Remember that while varicose vein treatment can help existing varicose veins, it can't stop new ones from forming.

Sclerotherapy or surface laser

Sclerotherapy or surface laser treatment is the most common treatment for spider veins. It is often used to treat visible spider veins and small varicose veins near the surface of the skin. This procedure involves injecting a saline or chemical solution into the varicose veins, which causes them to close and eventually be absorbed by the body. Blood that would normally return to the heart through these veins returns to the heart through other veins.

Adhesive treatment

Adhesive treatment uses a specially formulated medical adhesive to seal and close the diseased vein. Using ultrasound, a tiny catheter is inserted into the affected vein, and the adhesive permanently seals it so blood is rerouted through nearby healthy veins. Patients are generally encouraged to resume normal activities immediately after the procedure.

Endovenous ablation

With endovenous ablation, a tiny catheter is inserted into the affected vein using ultrasound. An energy source (such as laser or radiofrequency) is used to cause damage to the inside of the vein wall, causing is to seal down on itself and then eventually be absorbed by the body. Patients are generally encouraged to walk immediately after the procedure and resume normal activities the next day.

Varithena

Varithena is minimally invasive. Your physician injects the foam inside diseased veins to close them down, allowing blood to flow through other, healthier veins.

When Should I Call My Doctor About Varicose Veins?

Talk to your doctor right away if:

• A varicose vein becomes swollen, red, tender or warm.
• You develop sores or a rash on the leg or near the ankle.
• The skin of your calf and ankle thickens and changes color.
• A varicose vein bleeds.
• Symptoms are getting in the way of everyday life.
• You start to experience any pain.

If you experience varicose vein symptoms, consult your doctor for a diagnosis and discuss varicose vein treatment. Early intervention can prevent complications and improve your quality of life.

What Are Complications From Varicose Veins?

While they are not considered a severe medical condition, varicose veins can be uncomfortable and can lead to more serious problems such as phlebitis (inflammation in the leg) or a blood clot.

"We usually deal with swelling, but they can result in venous ulcers and wounds," said Dr. Ramchandani. "Once that happens due to the edema and swelling of the leg, then certainly an intervention will be warranted. It's not necessarily life-threatening, but it can be because of those varicose veins bleed, then certainly it will cause an issue."

Varicose veins can also be a cosmetic concern to some people.

Can Varicose Veins Be A Sign Of A More Serious Medical Problem?

Varicose veins, usually are not linked to a serious condition called deep vein thrombosis (DVT). However, in some severe cases, there is a small increased chance of developing DVT. DVT requires immediate medical attention. Symptoms of DVT include sufdden, severe leg swelling and can result in blood clots that travel to the brain or the heart.

Can I Prevent Varicose Veins And Spider Veins?

While you can not fully prevent varicose veins or spider veins, small changes can help.

Lifestyle changes can play a significant role in managing varicose veins and spider veins. Here are some key recommendations to reduce your chances of developing new varicose or spider veins:

Regular exercise

Exercise regularly to improve your leg strength, circulation and vein strength. Focus on exercises that work your legs, such as walking or running.

Maintain a healthy weight

Being overweight can put additional pressure on your veins, exacerbating varicose vein symptoms. By maintaining a healthy weight, you can reduce this pressure and alleviate discomfort.

Elevate your legs

Elevating your legs above the level of your heart for 15-20 minutes several times a day can help reduce swelling and improve circulation in your legs.

Avoid sitting or standing for long periods of time

If your job requires long periods of sitting or standing, try to take breaks to move around and stretch your legs. This helps prevent blood from pooling in your veins. Avoid crossing your legs for long periods while sitting.

Wear compression socks

Compression stockings apply gentle pressure to your legs, helping to improve blood flow and reduce swelling. They are especially beneficial for individuals who spend long hours on their feet or have a family history of varicose veins.

Follow a healthy diet

Eating a diet rich in fiber, fruits and vegetables can help prevent constipation, which can contribute to the development of varicose veins. Additionally, reducing your sodium intake can help decrease swelling.

Stay hydrated

Drinking an adequate amount of water throughout the day can help maintain healthy blood flow and prevent dehydration, which can exacerbate varicose vein symptoms.

Avoid tight clothing

Tight clothing around the waist and legs can restrict blood flow and exacerbate varicose vein symptoms. Opt for loose-fitting clothing instead.

Quit smoking

Smoking can weaken your veins and impair circulation, making varicose veins worse. Quitting smoking can improve overall vascular health and reduce the risk of complications.