Once you catch sight of either varicose veins or spider veins on your own legs, it’s a truly shocking day. You can’t wait to get rid of them! But proceeding with wisdom can save you a lot of heartaches if things go wrong or don’t proceed forward at all with inferior methods of dealing with them.

Understanding Varicose Veins

Varicose veins are different from spider veins. Varicose veins are a lot more serious. They are swollen veins that become twisted. Usually there are not any signs or symptoms associated with the condition but sometimes they can cause blood clots, pain and even ulcers in the skin because the venous return is not working as it should.

People suffering from varicose veins in their legs may feel as if their legs are heavy, and their legs may throb or cramp. Their ankles may also swell due to the varicosities, and sometimes skin will change color and darken from the varicosity.

What Causes Varicose Veins?

Veins become varicose veins when the valves in the veins become weakened or damaged from trauma. This is when they will swell, allow blood to pool and lose their normal structure because they become stretched. Hemorrhoids are varicose veins that are found in and near the rectum

Some habits contribute to the formation of varicose veins, such as being a couch potato and limiting movement, staying overweight and/or obese, and participating in sports that make you susceptible to leg trauma. Standing in one place for long periods of time and wearing high heels may also cause varicose veins.

Pregnancy and family history of varicosities can also make you susceptible to them forming.

Understanding Spider Veins

Spider Veins are present in about 41% of women over the age of 50. They are found in two-thirds of patients before the age of 25. Spider veins are an important aesthetic problem.

They are similar to varicose veins but are a smaller version of them. Spider veins are problems with the capillaries, not the actual veins themselves unless they are located on the legs. Here they are comprised of a feeder vessel and venous sprouts in the dermis.

Spider veins are as deep as 180 um and 1 mm in the skin. However, their diameter could reach several millimeters.

They are called spider veins because they can look like the web of a spider. Spider veins are usually found on the legs and face. About 90% of patients who have spider veins have a positive family history of them.

Varicose Veins Treatment

There are a few different treatments for varicose veins:

Sclerotherapy

In sclerotherapy treatment, a chemical is injected into the vein. The chemical irritates and scars the inside of the vein and the vein then closes down. Several treatments may be needed. One treatment may be done every 4-6 weeks. Elastic bandages are worn to decrease any swelling and accelerate healing.

The downside is that most chemicals used can also cause uncontrolled clotting, damage of untargeted arteries or veins. The most common complications include skin pigmentation matting, scarring, and allergic reactions to the chemical. All the chemicals used in this process are thought to be a compromise between toxicity and efficacy.

One treatment clears anywhere from 50%-84% of the spider veins in 70%-80% of patients. To clear them all, up to six treatments may be needed.

The cost for spider vein treatments is about $80 (USD) per treatment.

Laser Surgery

With laser surgery, there is no injection of chemicals into the vein. A laser light is shined onto a small varicose vein and the vein is obliterated.

In a study performed on 46 female patients where the doctors used high energy long pulse Nd: YAG laser, laser produced favorable results. It is recommended for those who have matting, allergy reactions to the chemicals used in sclerotherapy or who are afraid of needles.

The combination of laser plus sclerotherapy where the sclerotherapy is provided first will clear a higher percentage of the spider veins. Complications of laser therapy include pain, hyperpigmentation, scarring and ulceration.

The cost of a laser treatment is between $250-$400 (USD) per treatment.

Endovenous Ablation Laser Therapy

Lasers or radiowaves may be used in this outpatient procedure to close off a varicose vein. First the surgeon will numb the area and then make a cut in the skin near the varicose vein to be treated. Next a catheter will be inserted and the tip of the device at the end of the catheter is heated up. The heat closes off the vein.

Endoscopic Vein Surgery

This procedure is similar to the endovenous ablation laser therapy but the doctor uses a tiny camera at the end of the tube to view the walls of the vein. The camera allows them to go to exactly the right spot of the vein where a surgical device closes off the vein.

This type of procedure is only done when the varicose veins are severe and causing ulcers on the skin. Downtime lasts a few weeks after the procedure.

Ambulatory Phlebectomy

This procedure is where small amounts of the varicose veins are removed via small cuts in the skin above them. It’s only for superficial varicosities, not deep ones. The downtime is not as much as with endoscopic vein surgery.

Vein Stripping and Ligation

This procedure is left for only the most severe cases of varicose veins. You’re given sleeping pills at the beginning of the procedure as the veins are tied shut and then removed from your body through cuts in your skin. It’s an outpatient procedure but recovery time is up to four weeks.

Spider Veins Treatment

There are a few different treatments for spider veins:

Microsclerotherapy

This is where a chemical is injected into a vein, causing it to close.

The Given Needle Technique

Described in medical literature, this technique was reported in 2015 by doctors and surgeons at Georgia Regents University. It’s called the Given Needle technique because it’s named after its founder, Dr. Kenna Given.

The technique utilizes a microneedle with an insulated shaft with an exposed beveled tip that is inserted into the hand piece. The unit is then plugged into a mono-polar electrical generator. The needle is inserted into the spider vein and the current is turned on, obliterating the spider vein.

In the study performed at the university, 20 patients had more than a 70% reduction in their spider veins. Fifteen patients had redness in the skin, followed by bruising in 13 patients but both these were completely resolved in 2-3 weeks.The results are comparable to sclerotherapy and laser treatment. Cost per treatment is about $40 for the needle technique.

Laser (as mentioned previously)

What We've Learned

Everyone’s case is different so make sure you see a board-certified plastic surgeon and discuss your options. The one thing to remember is that spider veins and varicose veins can be remedied.