You’re So Vein: How To Treat Varicose And Spider Veins

While summer is typically the time to enjoy shorts and higher hemlines, not everyone welcomes the opportunity to show some leg. For those dealing with inflamed varicose veins and spider veins, the struggle of slipping into your beach best can be all too real. And it’s not just about veinity — ahem, vanity. The tracks of purple-blue squiggles dotting the gams can be painful, too.

“Leg vein disease impacting blood vessels is a very common condition that affects up to 50 percent of all adults,” says Washington Square Dermatology’s board certified cosmetic dermatologist Samer Jaber, MD. Varicose and spider veins form when regular blood flow is interrupted, causing blood to pool in the veins. While it isn’t always easy to control the onset of varicose or spider veins, there are plenty of ways to improve the condition — and it all starts with a proper diagnosis.

Varicose Veins vs. Spider Veins

For starters, varicose veins and spider veins are not the same thing. “They are two very distinct conditions and need to be treated accordingly,” says NYC-based board certified dermatologist Cheryl Karcher, MD, who specializes in treating spider veins.

Perhaps the most obvious difference between the two is size. Known for their large diameter (three millimeters or greater) and raised appearance, varicose veins are swollen blood vessels that often twist and turn in a rope-like pattern. Spider veins, on the other hand, are smaller (usually around one millimeter) red, blue, or purple vessels. While both are visible through the surface of the skin, spider veins do not bulge like their varicose counterparts.

Another distinction? The side effects that accompany them.

Symptoms of varicose veins include leg cramping and/or heaviness that can often be painful, but spider veins are generally considered painless and don’t directly pose any health risks beyond cosmetic concerns.

While both most commonly appear on the legs, spider veins can also present on the face — and the list of potential causes for each runs deep. “Although women are more likely to develop venous diseases than men, factors such as aging, family history, prolonged periods of standing or sitting, smoking, not getting enough exercise, hormonal changes during pregnancy or due to birth control, a history of blood clots, or injury to the veins can lead to either condition,” says Dr. Jaber.

Once properly diagnosed, there are plenty of remedies — ranging from minimally invasive treatments to surgical procedures — that can bring back smooth, vein-free skin.

How to Treat Varicose Veins and Spider Veins

Patients who begin to notice the appearance of veins and experience symptoms like leg aching or cramping, mild swelling, or itchiness may wish to consult with their doctor about diagnosis and treatment options (anyone who suddenly experiences severely inflamed veins, discoloration, or ulceration of the skin should immediately contact his or her provider).

During the visit, your doctor will likely perform a Doppler ultrasound or venogram to get a better sense of the severity of the condition before deciding how to proceed. “There’s not much you can do to prevent spider veins or varicose veins,” says Dr. Karcher. “But your treatment options are both safe and easy.”

Here, The AEDITION breaks down some of the most effective ways to address venous disorders like varicose and spider veins, which involve either closing the veins or removing them entirely.

Vein Closure Procedures

Sclerotherapy

Among the most popular treatments for both spider and small varicose veins, sclerotherapy is a minimally invasive closure procedure that involves injecting a solution (i.e. sclerosing agent) into damaged veins to force the pooled blood to reroute through healthier veins. The injected vein will collapse and be reabsorbed into local tissue before it eventually fades.

Sclerotherapy is not only effective in diminishing the appearance of veins, but it also helps reduce pain and cramping in patients who suffer from severe varicose veins. The treatment lasts anywhere between 15 to 45 minutes and costs about $350. Studies have shown that as many as 50 to 80 percent of injected veins can be eliminated in a single sclerotherapy session (though multiple visits may be required), but how quickly a patient sees results depends on the severity of his or her condition.

“The vessels first turn red, then purple, then brown, and, finally, yellow,” says Dr. Karcher. “These can take a few weeks to fade, but within a month or more, you will be free of any veins.”

Laser Therapy

Laser therapy is a non-invasive option for those looking to close veins in sensitive areas (think: the face) or are allergic to certain injection solutions. Strong bursts of laser light target the red color of the blood cells in the veins and break them down.

For smaller spider veins, the resulting blood clots usually dissipate immediately with very little healing time required. Dr. Jaber, for example, uses an Nd:YAG laser to treat small spider veins. In the case of larger veins, the areas targeted during laser treatment will first darken before disappearing in one to three months.

Laser therapy is more expensive than some of the other treatment options — costing an average of $450 per session — but each in-office procedure lasts just 15 to 20 minutes. Multiple sessions are often required in order to see the best results, and those appointments are usually spaced six to 12 weeks apart.

Endovenous Ablation Therapy

The minimally invasive treatment uses laser or radiofrequency (RF) energy to cauterize abnormal veins. A small incision is made in the affected area through which a thin tube carrying the laser or RF device is inserted. An ultrasound is used to visualize the vein, and the heat burns the blood vessel. This causes the veins to close, turn into scar tissue, and, eventually, disappear.

Post-op, the patient’s leg is wrapped in a compression stocking to aid the healing process and prevent blood clots. Priced at an average of $3,000, the treatment effectively leads to the regression of visible varicose veins — but sclerotherapy or laser therapy is usually recommended to prevent the condition from recurring.

Endoscopic Vein Surgery

Recommended for those dealing with severe cases of varicose veins that could lead to skin ulcers, the surgery involves closing the vein using a small tube with a camera. The doctor will make a minor incision and insert the camera-bearing tool into the vein for viewing while a harmonic scalpel is used to simultaneously cut and cauterize it. The procedure typically costs between $1,500 and $3,000 and lasts 30 to 60 minutes. Patients can resume normal activities in one to two weeks.

Vein Removal Procedures

Ambulatory Phlebectomy

An ambulatory phlebectomy procedure is reserved for the treatment of larger varicose veins that are close to the surface of the skin. Local anesthesia is administered and small incisions are made to remove the affected vein — segment by segment. Patients go home on the same day and may experience mild postoperative pain, swelling, or bruising. The treatment typically costs an average of $1,000 per leg.

Vein Stripping and Ligation

Performed under general anesthesia, vein stripping and ligation is the most invasive treatment option of the bunch. The surgical procedure is used to treat the most serious cases of varicose veins (think: the kind that result in swelling, skin changes, pain, and ulceration).

Surgeons cut into the skin and tie off the veins before removing them. Most providers will try to leave the saphenous vein (i.e. the longest vein in the body that runs the length of the leg — from the foot to the thigh) in case it is ever needed for grafting during a heart bypass surgery. The vein removal relieves symptoms associated with varicose veins and costs anywhere from $1,500 to $3,000. Full recovery may take up to a month.

How To Prevent Varicose Veins and Spider Veins

Ultimately, as Dr. Jaber says, “the best treatment for varicose veins is prevention.” Lifestyle changes like losing weight (for overweight and obese patients), exercising regularly (to increase muscle tone), refraining from sitting or standing for too long, and not spending too much time in high heels or tight clothing can all help mitigate the chances of developing varicose and spider veins. Keeping legs elevated and wearing compression stockings can also help those who are at risk of developing venous disorders. Finally, maintaining a healthy diet is also recommended.