Aditi Pai

Spider Veins: How to Treat This Condition? Spider veins or telangectasias is a condition where the small veins of the face and legs (sometimes other body parts) get damaged. The veins may be red, blue, or purple. They can form widespread patterns that resemble trees, starbursts, or even a spider web (the common term ‘spider veins’). This is the earliest indicator of venous disease. Spider veins occur more frequently in women than men. The frequency increases with age. According to some estimates, up to 15% of older women have this condition. What Causes Spider Veins? Damaged or weak valves are the biggest contributor to spider veins. In the human body, arteries and veins form a highway for our blood. The arteries are responsible for transporting oxygenated blood from the heart to all the organs and tissues. The veins return the deoxygenated back to the heart. Veins in the legs must work extra hard because they’re fighting gravity to transport this blood. Muscle contractions in the lower legs along with the elasticity of the vein walls help to carry this blood to the heart. As the blood is passing through these veins, small valves open to push the blood up and then close up to prevent backward leakage from happening. If the valves of your leg veins are damaged or weak, this blood might flow back and pool. This causes twisting and stretching of the veins, giving them their characteristic spider-like appearance. What are the risk factors for developing spider veins? There are multiple risk factors that can increase your chances of developing this condition such as: -         Age -         Family history -         Gender -         Sitting or standing for extended periods of time -         Pregnancy Spider veins do not cause any discomfort but they can make the person feel embarrassed or self-conscious. Fortunately, there are several treatment options that can remove the veins and manage them in the long run. These range from non-surgical to surgical procedures. Typically, spider veins are removed for cosmetic reasons. The following blog discusses these options in further detail. Spider Vein Treatment Options Without Venous Disease Listed below, are telangectasias or spider vein treatments for patients who do not have underlying venous disease. Hypertonic Saline This procedure is the oldest method for treating spider veins. However, it is also out of favor amongst many vein specialists. To apply this treatment, the doctor will inject a concentrated salt water solution (saline) directly into the spider vein. This causes the vein to shrink and eventually fade. Even though hypertonic saline has a good record of efficacy it can cause substantial discomfort and pain. It’s the least used treatment option now because more modern options are favored by doctors. Sclerotherapy using Polidocanol This is a minimally invasive procedure that is also the most effective at treating tiny varicose and spider veins. In the procedure, the doctor or vein specialist will inject a special polidocanol solution directly into the affected area (much like the saline solution mentioned earlier). This forces the vein walls to fuse, shrink, and fade away. They literally disappear from the skin’s surface. Sclerotherapy is the preferred method of treating spider veins in patients without venous disease. The procedure is very short, usually thirty minutes with no recovery time. The patient remains comfortable and pain-free throughout the session and even when they go home. Patients are able to see positive improvements within three weeks after the treatment. Laser The use of laser for treating spider veins is only applicable on the feet and face. In the procedure, the doctor points the light laser straight at the spider vein cluster. This forces them to shrink and die. The veins are eventually absorbed back into the body. With laser, the patient may require multiple sessions to see noticeable results. Laser treatments can be sought and vein clinics or medical spas and not necessarily through licensed doctors. However, this treatment option is the least effective because it often results in a re-occurrence of the spider veins. Compression Stockings If your doctor has diagnosed you with spider veins, he or she may prescribe medical compression stockings. These are special socks that deliver controlled pressure on your legs. The compression is highest at the ankle and decreases as it goes up the leg. It works by gently squeezing the walls of the veins together. In return, the venous pressure drops and it eases the blood flow to the heart. When worn regularly, compression stocking may prevent new spider veins from forming. They also minimize known symptoms of spider veins like leg swelling. Overall, patients experience a significant improvement in blood circulation. Spider Vein Treatment Options With Venous Disease If you have venous disease, your doctor may recommend the following treatments to remove spider veins: Radio-frequency Ablation (RF) This is the leading method for spider veins treatment in patients with venous disease. In the procedure, the doctor begins by administering a local anesthetic to numb the area. A small incision is created on the skin surface through which the doctor inserts a tiny catheter. This device is then directed into the unhealthy spider veins using ultrasound for guidance. Once the device is inserted into the unhealthy vein, a protected fluid is infused to surround it. Sound waves are delivered to heat up the vein walls causing it to eventually collapse. The pooled blood is rerouted back to the health veins. This results in smooth circulation. Radio-frequency ablation is one of the most effective treatment options available for both varicose and spider veins. According to a meta analyses study conducted in 2009, it has a success rate of 88%. The procedure has a respectable track record. It finishes within twenty minutes and causes next-to-no discomfort or pain. Radio-frequency ablation has an insignificant risk for complications. There’s also no downtime so patients can resume their regular routine. In addition, most insurance plans provide coverage for this procedure. Endovenous Laser Ablation EVLT or endovenous laser ablation is quite similar to RF in many ways. A small incision is made on the skin’s surface, through which a cannula or tiny needle is inserted into the unhealthy vein. This is performed using ultrasound. The diseased vein is heated up, causing the vein walls to collapse. The gathered blood is rerouted to healthy veins. There is only one major differentiator between the two procedures- the method of heat. RF relies on sound waves whereas EVLT uses laser energy. The latter is far hotter. As a result, EVLT may cause slightly more discomfort after the procedure compared to radio frequency ablation. Once the effects of the anesthesia diminishes, the patient may experience some discomfort or pain. This is a direct result of the laser energy. This is perhaps the only drawback of EVLT, otherwise it is equally helpful as RF ablation. EVLT has a near perfect record, with minor risk of side effects or complications. The procedure is completed within 60 minutes and no recovery time. It is also covered by many insurance plans. Sclerotherapy Using Varithena Sometimes called Foam Sclerotherapy, this method uses a premixed solution that contains foam. During the process, the dermatologist will inject this premixed solution along with a nitrogen infusion into the spider veins. While the foam solution closes off the unhealthy saphenous vein, the nitrogen will catalyze or expedite the process to make it an effective procedure. This treatment option is successful at treating varicose veins, spider veins, and venous insufficiency. Sclerotherapy using varithena is minimally invasive. The patient experiences negligible discomfort and complications. The recovery time is faster than many other treatments. In fact, studies have shown that patients achieved the best results when they combined sclerotherapy using varithena and compression stockings. These garments must be worn for up to 10 days post treatment. Clari-Vein or Chemical Ablation This method relies on a cutting-edge tool for chemically ablating the unhealthy saphenous vein. The device has a 360-degree tip that rotates while simultaneously delivering a special vein solution directly into the vein walls. The procedure does not use thermal or laser energy. This forces the unhealthy vein to close off or fuse. The pooled blood is rerouted via healthy veins. The ClariVein method is effective in patients with tangled, twisted, or knotted spider veins. However, this is a comfortable and relatively painless procedure with a minimal chance of complications. There are no side effects and now downtime is required. The only drawback of the procedure is that it requires more time and it may not be covered by the patient’s insurance coverage. This treatment is often considered only if the other options are not suitable for the patient. Vena Seal Vena seal is a type of vein glue. It is a medical grade paste that has received FDA approval in the treatment of venous insufficiency. During the Vena seal treatment, the doctor will inject the vein adhesive directly into the unhealthy vein. This causes the vein walls to fuse and eventually collapse. The accrued blood is rerouted via healthy veins. The Vena Seal method is comfortable and relatively pain-free. It also has a high success rate. There’s no incision involved. Most patients respond well with only one injection. The only negative drawback is that it’s a fairly new method. Studies are needed to determine its long term effects, if any. It may not be covered by most insurance plans as well. Conclusion         Although spider veins are not a life-threatening condition, they can cause significant emotional discomfort. Patients opt to have them removed for cosmetic purposes. Depending on whether you have underlying venous insufficiency or not, there are several surgical and non surgical treatment options that can treat spider veins. Keep in mind, that even the diseased veins are removed, they may return. But rest assured, this is usually not noticeable. Most patients try to keep the condition at bay by doing maintenance appointments using the procedures mentioned above.