February 2011

Varicose veins—ugh! We all instantly recognize them and we all wish to hide them or eliminate them. They appear as little spider veins on the face, such as the cheeks and nose, or they can be large worm-type discolorations that plump up primarily on the thighs and lower leg. But what causes them and what can you do about them?

Why Varicose Veins Develop

Your age, weight, gender, genetics and other factors can influence your tendency toward developing these unattractive veins. Blood circulates down the legs through your arteries to your feet and then returns back to the heart through your veins. Contraction of the leg muscles pumps the blood back up to the heart, even when you are standing. Also, the veins have one-way valves to prevent the blood from flowing backwards down the leg. Varicose veins develop when this system breaks down and allows some blood to pool in the leg veins instead of being pumped back up the body.

First, aging is a factor. Since the same veins sustain wear and tear over decades, the valves in the veins essentially become tired out over time, allowing blood to flow backwards and pool. This blood then collects and becomes visible on the surface over time.

Weight is also a cause of varicose veins. Those who weigh more than they should develop varicose veins as the fat applies higher pressure in the legs.

Women suffer more than men with varicose veins. This is likely due to hormones during pregnancy and menopause, which cause the vein linings to weaken.

Blood clots lead to varicose veins as well. These can develop in the superficial veins, causing them to become inflamed, which damages the valves. This allows the blood to flow backwards, causing a pooling effect.

The most common cause is a lack of movement. Sitting or standing for long periods of time can cause the muscles to contract less often. This results in pooling. Over time, this pressure leads to bulging of the veins, resulting in the twisted, bumpy characteristic that we identify as a varicose vein.

Treating Varicose Veins

Anyone can develop varicose veins but there are treatments to help. Although pressure stockings can be worn (these should be fitted to you personally at the drug store, as ill-fitting pressure stockings can apply too little or too much pressure), most of our patients opt for either laser vein treatments or sclerotherapy.

Laser treatments involve the use of a special medical laser that can nonsurgically distribute a precise measure of energy to each vein through a laser handpiece. The light energy causes heat in the blood vessel (but not the tissues surrounding the vessel) to coagulate the blood. This is not painful and generally requires 2-3 treatments spaced 4-6 weeks apart, after which you can resume your normal schedule. Eventually the appearance will improve, as the vein is no longer bulging. The photos at left illustrate the power of laser vein therapy for facial and leg veins.

Sclerotherapy is another option. Sclerotherapy involves injecting a solution through a very tiny needle into the vein. The solution causes the vein to waste away and disappear over a few weeks. It’s very simple and involves only minor discomfort.

There’s no reason to suffer with embarrassing leg or facial veins. You have time, now before the summer comes, when a desire to wear shorts or a swimsuit will come along with the warmer weather!

To your health & beauty,

Gregory Chernoff, MD