The ugly truth about varicose, spider veins

Whether for cosmetic or medical reasons, there are treatment options to treat venous insufficiency

There’s good news and bad news about those bright purple and blue, roping veins that you may have on your legs.

The bad news: There’s no true way to prevent spider veins and their close cousins varicose and reticular – all of which are caused by a condition called venous insufficiency. A lot of it is bad luck and genetics, says Kristy Wiebke Conlon, D.O., vascular surgeon with St. Joseph’s/Candler – Vascular Specialists.

The good news: There are options to rid your legs of any spider, reticular or varicose veins whether for cosmetic or health reasons.

What are spider, reticular and varicose veins?

Venous insufficiency occurs when there’s improper functioning of the vein valves in the leg, causing swelling and skin changes. Spider veins form first and are the smallest of the veins that can occur due to venous insufficiency.

Spider veins look like tiny spider webs made up of very small blood vessels, less than a milliliter in size, Dr. Conlon says. They are typically blue and red in color.

Once spider veins grow larger than a milliliter, they are termed reticular veins. Reticular veins start to take the form of a vein and are usually blue and purple.

Varicose veins are large – about a half centimeter in size – and dilated. They bulge out of the soft tissue and have the appearance of a rope-shaped vessel, Dr. Conlon describes. These too are blue and purple.

How do they form?

As you probably remember from school, arteries carry oxygenated blood away from the heart to all parts of your body. Veins then bring the blood flow back up to the heart to get re-oxygenated by your lungs, Dr. Conlon explains. Within these veins, a series of one-way valves allow blood to go up and not back down, preventing pooling in your legs. Sometimes these valves don’t work correctly, and what happens is too much blood sits in the legs and can’t get out.

“With age, with being a woman, with being overweight, with genetics or family history, patients can get leaky valves,” Dr. Conlon says.

Spider and reticular veins are rarely a serious health problem but may cause slight discomfort to some. Varicose veins are accompanied by more symptoms, Dr. Conlon says, including:

• Pain around the site of the varicose vein
• Heaviness in your legs
• Leg fatigue
• Swelling, primarily below the knee
• Tightness in portions of your leg
• Discoloration of skin

Why did I get them?

Varicose, reticular and spider veins develop more in women but can occur in men. Some people develop these veins as early as their teen years while some may not see them until their 60s, 70s or even 80s.

Most people develop venous insufficiency because of heredity. If your grandmother or mother has them, most likely you will be predisposed to develop varicose, reticular or spider veins, Dr. Conlon says. Other factors that may contribute to these veins are:

• Occupations that involve a lot of standing, such as nursing or waitressing
• Pregnancy or other hormonal influences such as menopause or birth control pills
• Obesity
• A history of blood clots

What can I do about them?

“There’s not a lot you can do to prevent it, but early diagnosis of it is going to be the most critical for you,” Dr. Conlon says. “If you start to see them, you should follow up with a vascular surgeon so we can discuss treatment options and have it monitored closely because you can develop complications from venous disease such as leg wounds that are painful to treat.”

Spider and reticular veins are primarily treated from a cosmetic standpoint or to keep from getting larger. Dr. Conlon can treat these with an injection, such as sclerotherapy, where a medicine is injected into the vessels, decreasing the appearance of them. Patients start to see the effects of the injection within a couple of weeks, Dr. Conlon says, adding patients are really happy with the end results.

Varicose veins can be treated under insurance if a patient fails conservative management, which is typically three months of documented medical following of compression therapy, or wearing medical-grade compression stockings, Dr. Conlon says.

Once a patient fails conservative management, there are options to treat varicose veins in a minimally-invasive manner. One example uses a catheter to deliver radio-frequency energy to heat the vein wall therefore shrinking it. Another treatment option uses lasers to send bursts of concentrated light into the vein, collapsing it.

If you are concerned about spider, reticular or varicose veins whether from a cosmetic or medical standpoint, Dr. Conlon encourages you to talk to your primary care physician or see a vascular specialist. Depending on your insurance, a referral may be needed to see a vascular specialist.

For more information about St. Joseph’s/Candler – Vascular Specialists, visit our website or call 912-354-8331.