Causes of Varicose Veins and Spider Veins
A number of factors predispose a person to varicose veins and spider veins. These include:
- Occupations that involve a lot of standing, such as nurses, hair stylists, teachers, and factory workers
- Hormonal influences of pregnancy, puberty, and menopause
- The use of birth control pills
- Postmenopausal hormonal replacement
- A history of blood clots
- Conditions that cause increased pressure in the abdomen, such as tumors, constipation, and externally worn garments like girdles.
Other reported causes include trauma or injury to the skin, previous vein surgery, and exposure to ultraviolet rays.
Other Risk Factors for Varicose Veins and Spider Veins
Varicose veins and spider veins develop more often in women than in men. They increase in frequency with age. An estimated 30% to 60% of adults have varicose veins or spider veins.
Symptoms of Varicose Veins and Spider Veins
Many people with varicose veins complain of pain, described as an aching or cramping in the legs. Other common symptoms include tiredness, restlessness, burning, throbbing, tingling, or heaviness in the legs. Pain from these veins is usually relieved by elevating the legs or by wearing support hose.
In women, symptoms may be worse during certain parts of the menstrual cycle or during pregnancy. Less common is swelling, ulcers and a darkening of the skin, especially in the ankle region. Occasionally, varicose veins can form a painful blood clot with inflammation of the vein, a condition called thrombophlebitis.
Treatment Options for Varicose Veins and Spider Veins
There are seven major forms of treatment for varicose veins and spider veins:
1. Support stockings. The most conservative approach is simply to wear properly-fitting support hose, especially when the veins cause painful or uncomfortable symptoms. These stockings can generally be purchased at any surgical supply store and at some pharmacies. They come in below-the-knee, above-the-knee, and pantyhose styles.
2. Lifestyle changes. Good skin hygiene, weight loss (if needed), and walking can help treat varicose veins and spider veins.
3. Sclerotherapy. This procedure, which has been available since the 1930s, is another treatment option. This procedure uses a highly concentrated saline (salt) solution or a specially made detergent that is injected directly into the vein, causing the vein to disappear gradually over three to six weeks. The procedure is simple, relatively inexpensive, and can be performed in an outpatient setting.
4. Endovenous laser treatment is a procedure in which a small laser fiber is inserted into the vein. Pulses of laser light are delivered inside the vein, which causes the vein to collapse. The procedure is done as an outpatient under local anesthesia.
5. Radiofrequency occlusion. A small catheter is inserted into the vein. The catheter delivers radiofrequency energy to the vein wall, causing it to heat, collapse, and seal shut. The procedure is generally done in an outpatient or office setting, sometimes under local anesthesia.
6. Surgery. Surgical techniques to treat varicose veins include ligation (tying off of a vein) and stripping (removal of a long segment of vein). Another procedure, ambulatory phlebectomy, allows for the removal of large surface veins through very small incisions that do not need stitches. Surgery may be performed using local, spinal, or general anesthesia. Most patients return home the same day as the procedure. Surgery is generally used to treat large varicose veins.
7. Lasers and intense pulsed light. Surface laser or intense pulsed light treatments, such as Vasculight and PhotoDerm, are other options. These devices use heat energy to selectively damage or destroy abnormal veins. An advantage of these treatments is that no needles or sclerosing solutions are required; however, there may be some minor discomfort. Side effects do occur, including discoloration or staining and blister formation. The results are often disappointing.
Not everybody with varicose or spider veins has pain or other symptoms. They might want the veins removed, however, for cosmetic reasons.