by J. Kevin Paulsen, M.D., F.A.C.S.
Originally Appeared in The Peoria Woman, January 2004

If you are a woman – especially one who has experienced several pregnancies, spends extensive time on your feet or is overweight – you already may be experiencing varicose or spider veins.

If you aren’t dealing with them yet, you may eventually become one of the many adults who have varicose or spider veins. In fact, approximately one in six women and one in ten men in the United States are affected by venous disease of the lower extremity. While varicose and spider veins are more likely to occur as you get older, individuals as young as thirty may begin to notice them.

Varicose veins are swollen, twisted veins near the surface of the skin. Spider veins are small, bluish lines that resemble a spider’s web or branches of a tree. Both are most often found on the legs, but spider veins can also be present on the face. Varicose and spider veins on the legs can be the result of extended periods of sitting or standing, pregnancy, obesity, increasing age, heredity and conditions that cause increased pressure in the abdomen.

The symptoms of varicose veins include pain, burning, throbbing, swelling and heaviness in the legs. Varicose and spider veins most often aren’t a cause for alarm – but are instead a matter of appearance and varying degrees of discomfort.

However, in rare cases, varicose veins can be an indicator of an underlying medical condition. Because of this, it’s important to have your varicose veins evaluated. If your physician diagnoses varicose or spider veins, there are several treatment options.

In some situations, lifestyle changes and at-home treatments can help control minor cases of spider veins and varicose veins. Treatments may include wearing support stockings, losing weight (if weight is deemed to be a factor), variation in daily activities (i.e. taking a break from long periods of standing or taking a break from prolonged sitting with a short walk) and elevating the legs.

For more pronounced cases, patients may benefit from outpatient services such as topical laser treatment, sclerotherapy, vein ligation or stripping.

Utilizing laser technology, spider veins of the face can often be treated with minimal or no bruising at all. The underlying spider veins are effectively removed in one or two brief sessions while the overlying skin is left undamaged, avoiding the need for any recovery time. In most cases, people are able to return to either work or their usual activities immediately following the treatment.

Small varicose veins and spider veins of the legs are treated by sclerotherapy. This rather simple procedure involves injecting a solution into the veins using a very fine gauge needle. This solution causes the veins to collapse and fade. In addition to the cosmetic benefit, sclerotherapy may also remedy the uncomfortable symptoms associated with spider or varicose veins, including aching, burning, swelling and night cramps.

For larger veins, or those with medical ramifications of leaving them untreated, vein ligation or stripping may be the best option. These procedures can also be done on an outpatient basis using regional or general anesthetic.

Vein ligation is accomplished using several small incisions that allow the surgeon to tie off the vein at a point close to the source of the blood flow. The blood is then rerouted to another vein. Vein stripping is completed in a similar manner – however, the affected vein is actually removed.

Of course, prevention is the best way to have legs that are free of varicose veins. Many of the lifestyle changes that are recommended to control the effects of varicose and spider veins can be used to prevent them. They include:
• Maintaining a healthy weight
• Exercising moderately
• Avoiding prolonged sitting or standing
• Avoiding crossing your legs
• Elevating your legs periodically

As already mentioned, in most cases, spider veins and varicose veins are a matter of appearance and varying degrees of discomfort. However, in some rare instances, they can be a sign of an underlying medical problem or can lead to complications. If you experience any of the following symptoms, you should contact your physician:

• Change in skin color around the ankles and lower legs
• Open sores, especially near the ankles
• Bleeding from a varicose vein
• Tender lump in your leg
• Sudden swelling in your leg, accompanied by pain

In order to determine your most effective treatment – and to ensure there are no underlying medical issues – it’s best to have a thorough evaluation by a qualified vascular surgeon, plastic surgeon or dermatologist. When selecting your treatment provider, it is best to choose one with significant experience, a caring support staff and a commitment to quality patient care.