Veins carry oxygen-depleted blood back to the heart. If the walls of the blood vessels weaken or if there is increased backward pressure in the vessel, then blood can back up, or pool, inside the vein. This results in gradual distension of the vein, causing the development of reticular veins and varicose veins—enlarged, dilated blood vessels, purplish or bluish in colour, which may bulge above the surface of the skin and are commonly seen in the legs. They commonly or eventually cause discomfort, swelling or even pain in the affected area. Patients with varicose veins of the lower extremities are at greater risk for clots forming in the legs (deep vein thrombosis) that can dislodge into the main circulation and cause clots in the lungs or brain.
Factors that may contribute to the development of varicose, reticular and spider veins (very small vessels) appearing on the lower extremities include heredity, age, pregnancy, previous trauma to the extremity, obesity, heart disease, chronic diseases and standing or sitting for long periods of time, particularly with the legs crossed.
Chronic moderate or severe vein disease of the lower extremities significantly reduces mobility and results in a condition called stasis dermatitis in addition to putting the patient at risk for infections, ulcers and poor wound healing.
Patients with dilated reticular veins or varicose veins often benefit from wearing compression stockings to improve the venous return from the lower extremities.
Dermatologists are specialists trained to diagnose and treat the different types of vein disease. A consultation with a dermatologist can help to diagnose the particular type of vein disease a patient might have, to educate the patient as to what can be done to minimize the damage moving forward, and to review the different treatment options available.
The treatment of varicose and reticular veins can be for medical or cosmetic reasons (often commonly both). It is important to remember that varicose veins and damaged reticular veins are a medical concern, particularly if left untreated, as they will usually worsen over time and contribute to increased patient morbidity. As well as causing pain and discomfort, they can cause swelling, skin rashes, redness, sores and be a source for infections. Severe varicose veins may lead to deep vein thrombosis (DVT) that is a serious medical condition and requires immediate medical attention. Early diagnosis and treatment by a dermatologist trained in vein disease such as Dr. Lubitz will promote improved skin and vein health and contribute to greater mobility later in life.
Large varicose veins, particularly those located high in the thigh and groin, can be treated by surgical stripping (an older technique but still applicable in some situations) that is often associated with significant recovery time. Today, these large vessels are commonly treated safely and effectively with less downtime using a laser (YAG or EVLA – endovenous laser ablation) or ultrasound guided foam sclerotherapy.
Today the most common treatment for the majority of dilated reticular veins and varicose veins is sclerotherapy. Sclerotherapy of these larger vessels is usually done with a slightly larger needle (still very small), with the stronger solution injected being either a liquid or foam (known as foam sclerotherapy).
Laser Vein Therapy
Laser vein therapy using a YAG for reticular veins or Endovenous Laser Ablation (EVLA) for varicose veins are also safe and effective treatment options, that offer a minimally invasive laser treatments to seal off damaged veins, diverting blood flow to healthy veins.
Spider Veins or Spider Vessels
Spider veins or spider vessels (also called telangiectasia) are small, dilated blood vessels (veins or capillaries) that appear close to the skin’s surface, mostly on the legs, face, chest and hands. They cause no discomfort and are primarily of cosmetic concern. They can bleed significantly if traumatized.
Sclerotherapy of these smaller vessels involves injecting a very small amount of solution with a very fine needle directly into the diseased vein. This damages the vein wall and causes it to collapse and be eventually reabsorbed by the body. Sclerotherapy is not recommended by the majority of dermatologists for treating blood vessels on the face.
Spider veins in addition to small reticular veins on the legs may also be treated in many cases with excellent results using lasers. Lasers are the treatment of choice for spider veins on the face.
Dr. Lubitz is well trained and experienced in treating different blood vessel conditions including varicose veins, dilated veins and spider veins, and offers a variety of advanced treatment options including laser therapy, sclerotherapy and surgical removal. Dr. Lubitz offers a specialized Vein Clinic for patients with vein problems localized to the lower extremites. If you are concerned about blood vessels, and want to learn more about your treatment options, request a consultation in our either our Vein Clinic (lower extremity veins) or our Cosmetic Clinic (Veins located on all other parts of the body).