What are spider veins? What are varicose veins?
Spider veins are also known as broken capillaries. Spider veins are tiny blood vessels no more than 2 mm in diameter that may appear on the face, legs and ankles. They are bluish, purple or red and often form a web-like netting just below the skin’s surface. Spider veins are generally just an unattractive nuisance, although when they become large they can cause heaviness in the legs, night cramps and itching.

Varicose veins are veins near the surface of the skin on the legs which have become permanently distended and filled with blood. Veins have valves that are designed to prevent blood from flowing backwards due to gravity. When a valve malfunctions or vein walls weaken, blood collects in the vein, forcing it to bulge. Varicose veins are unsightly, bluish or purple in color and can protrude from the leg. They may cause discomfort such as swelling, throbbing, heaviness, night cramps and long-term complications such as ulcerations or bleeding.

What causes them?
For both varicose and spider veins, heredity is the main cause. The risk of developing these leg vein problems increases for women who are pregnant or using birth control pills because hormones such as estrogen can further weaken vein walls. Obesity and lack of exercise which weaken the system of leg veins are also factors. The risk of developing varicose veins increases with age for both men and women.

The "second heart" is a system of muscles, veins and valves in the calf and foot that work together as a pump to keep blood moving toward the heart against gravity. This system, though strong and capable of carrying tremendous weight and pressure, has a weak link: the venous (vein) system. Like the heart in our chest, the second heart keeps healthy through regular exercise.

How can I help prevent them?
Almost 80 million women and men in this country alone experience leg vein problems, including half of the women over the age of 40. Once spider and varicose veins develop, however, there is no way for the body to cure them. Fortunately, there are simple ways to prevent these problems from spreading and alleviate symptoms. The sum of these preventive measures is referred to as the conservative approach. Wearing support stockings with compression is the most common type of conservative treatment. Regular exercise promotes healthy circulation within the second heart and also slows the development of new varicose and spider veins. Diet, lifestyle changes, dietary supplements, and other natural alternatives can also compliment the conservative approach. There are other things you can do to promote good leg vein health, including:

• Avoid birth control pills
• Eat a high fiber diet to prevent constipation
• Don’t wear tight clothes
• Elevate legs at bedtime (about 6 to 12 inches above the heart)
• Explore natural alternatives, such as massage and dietary supplements (vitamins C &E may help relieve swelling and other symptoms of poor circulation)
• Avoid crossing your legs

Following these measures is the best defense against the spread or development of these vein problems. If you are at risk for developing either spider or varicose veins, start these conservative and preventive measures soon.

What are the medical treatment options?
Medical treatment options restore venous circulation to its proper functioning by removing varicose and spider veins and rerouting blood to healthy vessels. Cosmetically, these medical options are best at eliminating existing spider and varicose veins. Some methods eliminate varicose and spider veins by collapsing the affected blood vessel, while other techniques remove a vein through surgery.

Non-surgical options include sclerotherapy, a painless way to get rid of these vein problems by injecting a chemical into the affected vein to close it. Laser therapy can also be used to collapse small veins in the face and legs. Duplex-guided sclerotherapy is used to access veins in areas that are difficult to reach such as in the knee and groin. Surgical methods include in-office mini-phlebectomy where small sections of the damaged vein are removed through an almost invisible incision. For ambulatory surgery, there is a procedure called ligation and stripping to treat the affected main leg vein and valve. Both non-surgical and surgical treatments are often combined for the best results.

Although reopening of treated veins is uncommon, problematic veins may appear in other areas. Return visits for treatments are usually required every 1 to 3 years. Since most of these procedures are deemed cosmetic, most insurance companies will not cover the related costs. It is therefore important for anyone considering treatment to contact their insurance company.

If you would like a referral to a doctor who treats for varicose and spider veins, please call our Referral Service at 1(800) 420-4004.