Vein conditions like spider veins and varicose veins occur when the function of the one-way valves within the vein is compromised. These valves typically prevent the backflow or reflux of blood being pumped back to the heart; however, these valves can weaken or fail to close completely, thus allowing blood to flow backward and pool in the veins. This causes veins to swell, resulting in conditions known as varicose veins and spider veins.
Spider veins commonly occur on the legs and face. As the name suggests, the thin red or purple blood vessels near the surface of the skin may resemble a spider web or tree branches. They may occur in a small area or may cover large patches of skin. Treatment of spider veins is typically motivated by the desire to improve the cosmetic appearance of the skin. Spider veins may occasionally cause discomfort.
Varicose veins are large “rope-like” veins that typically rise above the surface of the skin. They may be skin-colored or may appear blue, green, or purple. Varicose veins typically grow in size and may cause increasing discomfort. Pain from varicose veins may be dull, throbbing, or burning.
Various vein treatments are available, depending on the type of vein condition observed.
Endovenous laser therapy utilizes a thin laser fiber inserted into the affected vein through a small puncture in the leg. Laser energy is delivered through the fiber causing the vein to close as it is gradually removed from the vein. The treatment takes about an hour and utilizes local anesthesia to numb the area being treated.
Phlebectomy (sometimes called ambulatory phlebectomy or stab avulsion) is a technique for removing varicose veins. The area to be treated is numbed with local anesthesia and several tiny incisions are made through which the varicosed vein is removed. Stitches are typically required. This procedure may be used in conjunction with other vein treatments.
Sclerotherapy is a popular treatment for spider veins and small varicose veins. Small amounts of sclerosant liquid are injected into to affected vein using a very fine needle. The liquid causes the lining of the vein to swell and the blood to clot, thus sealing the vein shut. Over time the treated vein becomes scar tissue that is absorbed into the body. Sclerotherapy is a brief, in-office procedure that does not require anesthesia.
A venous leg ulcer is long-lasting sore that takes more than 4 to 6 weeks to heal. They often develop on the inside of the leg, just above the ankle, as a result of persistently high pressure in the veins. Leg ulcers can by itchy and painful. They can often be cured with endovenous laser therapy and can be improved with weekly wound dressings and compression therapy.
Lipodermatosclerosis is a condition which causes changes to the skin of the lower legs due to venous pressure. Lipodermatosclerosis may cause pain, hardening of the skin, changes in skin color (redness), swelling, and a tapering of legs above the ankles. Lipodermatosclerosis is typically treated with endovenous laser therapy and compression therapy.
Atrophy blanche is a chronic condition that presents as painful recurrent ulcers on the lower leg or foot with subsequent scarring. As the ulcer heals, the blood supply is poor and healing is delayed, leaving a white scar. This condition is improved by treating the affecting veins with endovenous laser therapy, phlebectomy, or sclerotherapy. In addition, long-term anticoagulation and compression therapy may also be recommended.