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What Causes Spider Veins?
Spider veins are caused by similar
factors that cause varicose veins and
chronic venous insufficiency. These
factors include:
Genetics
Most women with spider veins
have mothers and/or female
relatives with this vein
condition. Weak vein walls and
valves, as well as shortage of
vein valves, seem to be
inherited characteristics, and
may play a role in determining
who develops spider veins and at
what age.
Pregnancy
During pregnancy, and to a
lesser degree also during
periods, fluctuations in the
female sex hormone (especially
estrogen and progesterone),
cause softening of the vein
walls and valves. This makes
women's veins more prone to
stretching and enlargement with
increased pressure. Increased
blood volume, which is needed to
provide circulation to the
fetus, also cause increased
pressure on the vein walls. The
growing fetus also exerts
pressure on the pelvis, which in
turn, exerts pressure on the leg
veins. Some women see spider
veins that develop during their
pregnancies and persist after
their baby is born. Other see
that their veins disappear after
the baby is born, only to
reappear later in life.
Prolonged standing and sitting
Prolonged standing and sitting
cause a great amount of pressure
to develop in the leg veins. In
both conditions, the calf
muscles are inactive and
therefore cannot help push the
venous blood to return to the
heart. This causes blood to pool
in the veins, thus resulting in
increased pressure on the vein
walls.
This pressure drops once one
begins to walk, so if your job
requires you to stand or sit for
prolonged periods, remember to
take short breaks and walk
around for a couple of minutes
every hour.
Injury
In some people, spider veins
appear after injury or trauma to
the vein, such as after a broken
ankle, surgery, car accident, or
sports injury. Bruising, which
is pooled blood resulting from
broken veins under the skin, can
also lead to an inflammatory
response, which in turn, can
result in enlarged veins.
Sometimes, spider veins can
appear many years after the
wound has healed.
Vein Conditions
In men, spider veins are usually
the result of blow-outs from
nearby varicose veins. High
pressure from these veins cause
adjoining superficial veins to
stretch, enlarge, and change in
color. These spider veins are
usually darker and have larger
diameters than the spider veins
in women. Spider vein matting,
which resemble bruises that do
not go away, is often caused by
the healing process of injuries
and bruises, as well as
complications from
sclerotherapy. Ankle flares, or
spider veins found on the inside
ankle, is often associated with
chronic venous insufficiency
(CVI), a condition where venous
blood is not returned
efficiently to the heart.
About
the sclerotherapy procedure
A
typical sclerotherapy session is
relatively quick, lasting only about
15 to 45 minutes. After changing into
shorts your legs may be photographed
for your medical records. You will be
asked to lie down on the examination
table and the skin over your spider
veins will be cleaned with an
antiseptic solution. Using one hand
to stretch the skin taut, your doctor
or nurse will begin injecting the
sclerosing agent into the affected
veins. Bright, indirect light and
magnification help ensure that the
process is completed with maximum
precision.
What are some of the most common
benefits of this procedure?
Although treatment does not prevent
the development of new spider veins,
the removal of existing veins can
dramatically improve the appearance
of the affected area, providing a
more youthful, healthy look and an
even color pattern to the skin. Veins
lighten after each treatment. Two or
more sessions are usually required
for the best results.
Planning your spider vein treatment
During
your initial consultation, your legs
will be examined. Your doctor may
draw a simple sketch of your legs,
mapping out the areas affected by
spider veins or other problems.
During the examination, you will be
checked for signs of more serious
"deep vein" problems, often indicated
by swelling, sores, or skin changes
at the ankle. A hand-held Doppler
ultrasound device is sometimes used
to detect any backflow within the
venous system. If such problems are
identified, your surgeon may refer
you to a different specialist for
further evaluation. Problems with the
larger veins must be treated first,
or sclerotherapy of the surface veins
will be unsuccessful.
How long does the procedure take?
Sclerotherapy normally takes fifteen
minutes to one hour, depending on the
number and length of the spider
veins. A series of treatments at
bi-weekly or monthly intervals may be
required.
Will I need to stay in a hospital?
No. Because anesthesia is not
necessary, the procedure is usually
performed in the doctor’s office or
at an outpatient facility.
How much pain is there?
Most patients report minimal pain.
However, the type of sclerosing
solution used is a factor in the
amount of pain involved. Be sure to
discuss with your doctor the benefits
and drawbacks of the sclerosing
solution that he/she recommends.
Ideal spider vein
treatment candidate:
In general, the best candidates for
sclerotherapy:
Enjoy good physical health
Are psychologically stable
Do not smoke
Want to improve their appearance
Are well informed about the procedure
Hold realistic expectations about the
outcome
Do not have a blood-borne disease or
condition affecting the vascular
system
Are not currently pregnant or nursing
The above is only a partial list of
the criteria that your surgeon will
consider in determining whether or
not this procedure is appropriate for
you.
What will happen at
the initial consultation?
During the consultation, your doctor
will talk to you about the changes
that you would like to make in your
appearance. He/she will explain the
different options available to you,
the procedure itself, its risks and
limitations, and the costs.
Your doctor will begin with a
physical exam and a complete medical
history. He/she will need to know the
medications you’re currently taking,
any history of blood-borne diseases,
and whether or not you are pregnant
or nursing. In some cases, elaborate
tests such as ultrasound or Doppler
may be performed, but this is usually
not necessary. Often patients will
have both spider veins and varicose
veins, and your doctor may need to
use these tests to clearly
differentiate between the two. (More
elaborate tests are sometimes
performed in scientific studies.)
Be sure to tell your doctor about any
discomfort you may be having, such as
pain, itching or swelling. These
symptoms may indicate more serious
circulatory problem. If your doctor
does suspect a more serious
condition, you may be referred to a
specialist for further evaluation.
Any underlying condition should be
treated before sclerotherapy
treatment is begun.
Be sure to ask all the questions you
have about the procedure, and ask to
see photos of the doctor’s recent
patients, before and after treatment.
Also ask for, and follow up on,
patient references. Learning
everything you can about your
options, risks and benefits is the
key to making an informed decision.
Preparing for the
spider vein treatment procedure
You will receive specific
instructions from your physician on
how to prepare for your
spider vein treatment. Carefully
following these instructions will
help the procedure go more smoothly.
You'll be instructed not to apply any
type of moisturizer, sun block or oil
to your legs on the day of your
procedure. You may want to bring
shorts to wear during the injections,
as well as your physician-prescribed
support hose, and slacks to wear
home. When scheduling your procedure,
keep in mind that your legs may be
bruised or slightly discolored for
some weeks afterward. You probably
won't be comfortable wearing shorts,
a swimsuit or a mini skirt until
after your legs have cleared up a
bit.
How is
sclerotherapy performed?
Your doctor may recommend that you
avoid aspirin and alcohol, as well as
herbal medications and
anti-inflammatory medications, for
two weeks prior to your treatment to
minimize bleeding during the
procedure. On the day of your
treatment you will be asked not to
use moisturizers, sunblock or oil on
the affected area. You should wear
shorts or other comfortable clothing
that exposes the spider veins.
Your doctor will apply antiseptic to
the area, then inject a solution into
the affected veins with a very fine
needle. Each injection covers about
one inch of the vein. During the
procedure, you may feel a slight
pinch as the needle is inserted and a
burning sensation as the solution is
injected. Next, cotton dressing and
compression tape will be applied to
the area. After one area is injected
and taped, the doctor will proceed to
the next area.
Generally a second treatment will be
required in order to complete the
collapse of the vein. If you have
many veins requiring treatment,
multiple sessions may be required.
What can I expect
after the procedure?
You may experience temporary itching
or cramping at the injection site.
You will be asked to wear a
compression wrap for several days.
During this time you must keep the
area dry. Your doctor may prescribe
support hose to be worn for several
weeks. This helps to keep the treated
vein collapsed. It also reduces the
likelihood of blood clots.
What is the
recovery period like?
Although you should avoid activities
that put pressure on the treated area
(such as heavy lifting or jogging)
for a few days, your doctor will
probably suggest a regular walking
program to increase circulation and
promote healing.
When the compression wrap is removed,
you will notice bruising and
discoloration. This will gradually
fade over a period of several weeks.
What is the
long-term outcome like for most
people?
Most patients report a high degree of
satisfaction with the procedure and
relief at no longer having to hide
unsightly veins. The treated areas
are noticeably clearer and in most
cases the skin continues to improve
with each successive treatment.
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