The body’s veins are responsible for carrying deoxygenated blood back to the heart, running both through the muscles and superficially beneath the skin. These veins have one-way valves inside of them, which are supposed to prevent blood from traveling backward in areas such as the legs where the muscles must fight against gravity to get the blood back to the heart.
When these valves begin to fail, blood can wind up pooling in the superficial veins beneath the skin, giving them a knobbly, distended, blue appearance. This condition is known as varicose veins, or, when the veins are smaller and closer to the surface, spider veins.
There is currently no accepted scientific explanation for the formation of varicose and spider veins, but in many cases, they tend to run in the family and most patients who suffer from them are women. There is some speculation that changes in estrogen levels may be partially responsible for the development of these damaged veins. Other risk factors include obesity, lack of exercise, and prolonged periods of immobility.
In addition to the obvious tips of maintaining a healthy weight and getting regular exercise, there are several other steps that patients can take to help prevent the formation of varicose and spider veins. These include wearing support stockings and avoiding high heels, which have a negative impact on the functioning of the body’s larger veins.
Smaller varicose and spider veins can usually be treated with sclerotherapy, a procedure in which a doctor injects chemical irritants into the vein, prompting it to spasm and close shut. Over time, the walls of the vein will heal together, sealing it so that it can no longer carry blood. It usually takes between two and six months to see the effects of sclerotherapy.
Some larger veins do not respond as well to sclerotherapy as smaller spider veins. When this is the case, a doctor may recommend that his or her patient look into surgical alternatives. There are two types of surgery often recommended for varicose and spider veins, known as ligation and stripping and phlebectomy.
During a ligation and stripping procedure, the surgeon will cut the vein and tie it off, or perform ligation upon it, then strip the vein by removing it through a small incision. During a phlebectomy, the surgeon simply makes many small incisions and removes the patient’s affected veins using a specialized instrument that looks like a hook. It’s important for patients to discuss the risks and benefits of each of these different types of procedures with their doctors prior to deciding upon a treatment plan, as not all patients are ideal candidates for surgery.