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Varicose and Spider Veins: What You Need To Know

Varicose veins in leg

Veins. They run throughout our bodies and are essential to our overall health and wellness. While arteries have the important job of pumping blood out of the heart to the rest of the body, veins do the hard work of transporting blood back into the heart. As you might imagine, many issues can come from an insufficient blood flow throughout the veins in your body. Two very common, but treatable conditions that can develop are varicose veins and spider veins. Not only is there a cosmetic concern, but varicose and spider veins can become uncomfortable, painful and worsen over time if left untreated. To learn more about these vascular conditions, we enlisted the help of Dr. Arthur Topoulos, vascular medicine specialist at Penn Presbyterian Medical Center.

Understanding Vein Problems

Varicose Veins

Varicose veins are enlarged, superficial veins that develop from venous reflux disease and affect up to 50 percent of women and 25 percent of men. They occur when the blood that normally flows up the leg, travels down the leg, causing the veins to enlarge, twist and bulge. Varicose veins usually occur in the superficial veins just under the skin, but can also be a sign of a deep vein problem.

Common causes include:

  • Age
  • Birth control pills
  • Hereditary
  • Hormone replacement therapy
  • Obesity
  • Pregnancy
  • Professions that require prolonged standing or sitting
  • Sedentary lifestyle
  • Trauma

While varicose veins might appear to be simply a cosmetic issue, they can also cause lower leg swelling and pain. Legs may feel tired or heavy or may develop a burning sensation as this vascular disease goes untreated. In more severe cases, varicose veins may cause the skin to change color resulting in eczema, ulceration, bleeding and/or pigmentation changes. If left untreated, varicose veins usually worsen over time.

Spider Veins

Spider veins are very thin, small, purplish-blue or red veins that can occur anywhere on the leg. They can be isolated in clusters and often look like spider webs or starbursts. These veins are more common in women and often occur after pregnancy. There are usually reticular or “feeder” veins which are larger and have a greenish color feeding the spider veins. Spider veins may also cause pain, discoloration and can occasionally lead to bleeding from a ruptured vessel.

Symptoms include:

  • Pain and tenderness to the touch
  • Phlebitis (inflammation around area of vein)
  • Redness and swelling
  • Skin discoloration and pigmentation changes

What are your treatment options?

Good news! Both of these conditions are treatable. Depending on the severity of your varicose veins or spider veins, the treatment options vary.

Compression Therapy

To treat minor pain from varicose veins, a compression stocking can help. The compression stocking will assist the leg in pumping blood back to the heart. While the symptoms may be relieved, compression stockings will not make the varicose veins go away.

Medical Sclerotherapy

Sclerotherapy is a non-surgical procedure in which a tiny needle is used to deliver sclerosing agent into the vein, causing it to shrink. The number of veins treated per session depends on the patient’s specific medical condition, tolerance to the medication and the size and location of the veins. The number of treatments depends upon the extent of the disease. Once treated, the veins are gone.

Ambulatory Phlebectomy

Larger veins can be removed with a micro-incision through a tiny hole. No stitches are required and there is no scarring.

Endovenous Ablation Therapy

Endovenous ablation therapy is a minimally invasive procedure used to treat more serious and painful varicose veins at the source. During this procedure, a thin catheter is inserted into the diseased vein through a small puncture using ultrasound. A medical adhesive or heat energy (radiofrequency) is then delivered through the catheter which causes the vein to close as the catheter is pulled back in the vein.

If you suffer from painful or unwanted varicose veins, free vein-screenings are available at Penn Presbyterian Medical Center and Penn Heart and Vascular Center Cherry Hill throughout the year. The screening will take less than 15 minutes, in a private setting with a vascular medicine specialist. To schedule a screening, please call 800-789-7366.

About this Blog

The Penn Heart and Vascular blog provides the latest information on heart disease prevention, nutrition and breakthroughs in cardiovascular care.


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