Dr. James Laredo: Cause and Treatment for Varicose and Spider Veins - [Video Transcription]
- What are varicose veins and spider veins?
Varicose veins and spider veins fall under the category of varicose veins. Spider veins are the small purplish looking veins that appear on a lot of patient's legs; predominantly women. These are usually asymptomatic and much smaller. Varicose veins are the bigger bulging veins that a lot of people see. They are found on men and women's legs. Those fall under the category of varicose veins. So, you have the asymptomatic spider veins and the varicose veins which can cause symptoms.
- What causes varicose veins?
Thankfully, varicose veins are not life threatening. They are not limb threatening either. A patient won't lose their legs or die from varicose veins. However they can cause significant symptoms and cause a lot of discomfort. In addition, the second condition venous insufficiency can lead to ulcerations of the legs.
- What is venous insufficiency and how can that be serious?
Venous insufficiency is a condition in the veins. Normally blood is returned from the legs back to the heart. There are these one-way valves present in the veins that maintain forward flow. In patients with venous insufficiency, the valves don't work. The blood backs up in the veins and elevates the pressure. The increase in venous pressure can lead to many different complications. It can lead to worsening of varicose veins, leg swelling, and a dark discoloration which is a condition known as hyperpigmentation. In addition, it can lead to hardening of the skin. That is a condition known as lipodermatosclerosis. Furthermore, with the continued inflammation of the skin it can ultimately lead to breakdown of the skin and development of ulcers.
- What's the best way to treat spider veins?
Spider veins usually don't cause symptoms. However, a lot of patients would like them treated. That is basically a cosmetic treatment. There are two ways to treat spider veins. One way is by using a cutaneous laser where laser energy is applied to the spider vein to treat it. Another way is with sclerotherapy. Unfortunately, laser therapy of spider veins doesn't work as well as sclerotherapy. Sclerotherapy is a procedure where a needle is inserted into the spider vein. A medication that destroys the lining of the vein is then injected into the vein. Over the course of 6 to 8 weeks, the veins improve or go away.
- As a patient, what can I expect during my visit?
Initially, we will take a comprehensive history and perform a physical exam. If warranted, we would do an ultrasound of the legs. The ultrasound allows us to visualize the veins and to see if there are any clots in the veins. It can also allow us to make a diagnosis of venous insufficiency if that is present.
- Why should I come to Georgetown University Hospital for my minor or major vein problems?
We have a Georgetown Vein Center. We were one of the first groups in the area to offer the laser ablation procedure. It is a less invasive treatment of underlying venous insufficiency. In addition, we offer the full gamut of treatments of all venous disease not just varicose veins or spider veins. We can treat deep vein thrombosis, which are clots in the deep veins. We can also treat patients with the post thrombotic syndrome which is a condition associated with a deep vein thrombosis. Plus, we can treat patients with all venous disorders. In addition, we can treat patients with congenital vascular malformations. These are vascular conditions that result at birth. The vast majority of these conditions are venous in nature. About 90% of congenital vascular malformations are venous malformations.
