Common questions about varicose veins and spider veins

We understand patients may have questions, and we want to make sure that you have all the answers you may need. Below are questions we receive most often. After reviewing these questions and answers, if you need additional information, please feel free to contact us at (717) 791-2800.

What are varicose veins?

Varicose veins are enlarged, weakened, dilated veins that no longer carry blood from the legs back up to the heart effectively against gravity. This is secondary to the failure of the valve system (valvular incompetence) in the veins, which normally would allow blood to only flow back to the heart. Now the blood and pressure (venous hypertension) builds up from gravity.
Varicose veins commonly cause many symptoms in the legs including:

  • Tiredness
  • Fatigue
  • Heaviness
  • Aching
  • Throbbing
  • Itching
  • Burning
  • Swelling

These symptoms are typically worse at the end of the day but get better with rest or by elevating legs. Effective treatment of these diseased veins usually eliminates the symptoms.

If left untreated, varicose veins always worsen over time and may lead to significant complications, such as:

  • Clots
  • Skin inflammation and even
  • Venous ulceration in later stages of disease

It’s important to not ignore varicose veins and symptoms of venous hypertension to prevent long-term complications of the disease.

What causes varicose veins?

Several factors contribute to varicose veins. The most important, but unalterable, factor is genetics. A genetic tendency causes veins to weaken and wear out over time. The greater this genetic tendency, the sooner it happens.
Other contributing factors include:

  • Pregnancy
  • Obesity
  • Estrogen/progesterone containing medications
  • Previous blood clots

In most cases, nothing can be done to prevent the development of the condition, but if effective treatment is given early in the course of the disease, complications like phlebitis, blood clots and ulcerations can be prevented and symptoms relieved.

How are varicose veins treated?

New developments and physician expertise have revolutionized the treatment of venous disease. Most new treatments are non-invasive, performed in the office under local anesthesia with immediate recovery and no down time for patients. Duplex ultrasound plays a critical role in diagnosing the problem so your physician can customize treatment appropriate to you.

  • Conservative therapy: Compression stockings help to alleviate the swelling and pain caused by varicose veins. However, they do not treat the underlying condition. The compression stockings have to be worn indefinitely, whenever the leg is not elevated.

Conservative treatment is usually reserved for those patients too weak or sick to undergo definitive treatment. However, some insurance companies now require patients to wear prescription-strength compression stockings for three to six months before they will consider treatment reimbursement. This does not treat the valvular incompetence and is aimed at controlling symptoms rather than curing the disease.

What are spider veins?

Spider veins, also known as telangiectasias, are abnormally dilated blood vessels in the skin. They usually appear on the legs but can also occur on the face, chest, arms, and back.

Contrary to what many doctors think, spider veins can cause the same symptoms as much larger varicose veins, including:

  • Itching
  • Burning
  • Heaviness, and Fatigue in the legs.

Although they may be symptomatic, spider veins are not usually a health hazard and do not lead to serious complications. In rare cases, they can bleed profusely after being injured; but otherwise, they are treated mostly as a cosmetic problem.

Spider veins appearing in unusual locations, such as the inside of the calf or ankle, usually indicate a more serious vein problem. Treating these unusual spider veins may not be successful until the deeper vein problem is treated.

What causes spider veins?

Spider veins may develop in two ways.

  • Tiny pre-existing veins can enlarge and become dilated over time.
  • Your body actually grows new veins where it doesn’t need them…in the skin. Pregnancy, estrogen-containing medications, and hormonal fluctuations may stimulate their appearance, thus, spider veins are more common in women.

Contrary to what many people believe, spider veins are not caused by crossing the legs or by years of prolonged standing or sitting at work.

The tendency to develop abnormal veins is largely hereditary, and there is not much you can do to prevent them. Support hose, exercise, and dietary supplements are helpful for symptoms, but do not prevent new spider veins (or varicose veins) from appearing. In some cases, spider veins may indicate larger diseased veins underneath the skin.

Our medical professionals may use ultrasound to search for any hidden diseased veins. If larger diseased veins are found, they need to be treated first and eliminated or spider vein treatment will be ineffective.

How are spider veins treated?

Sclerotherapy is used to treat spider veins. A solution or foam is injected into the abnormal veins causing them to shrink and disappear. Blood is re-routed into nearby healthy veins.
Immediately following treatment, spider veins may be more prominent than they were prior to treatment as they become inflamed. This resolves with time as the body absorbs the veins.