Spider veins are those little red and blue veins that pop up on you legs which some people mistake for a bruise or injury.  Although sometimes they can arise as a result of an injury, usually they are a result of standing on your feet and your heritage. People can have spider veins and also have varicose veins or you can just have spider veins. Varicose veins are those larger, ropier, blue veins that bulge when you stand and often cause burning or tired sensation of the legs. The symptoms of both spider veins and varicose veins can be improved by wearing either supports knee-highs or hose, but the stockings will not prevent either of them from occurring. 

Over the years, several treatments have been used to treat spider and varicose veins. Strong saline solutions were used to inject the spider veins to fade them. Although these injections worked well, they burned and, for some people, were painful. Varicose vein treatments included “stripping” and open ligation; again these treatments worked, but often left multiple scars and were uncomfortable. As time has passed, new technologies have developed which allow for treatment of these unsightly and painful veins with minimal discomfort and almost no scarring. Modern sclerotherapy uses sclerosing agents to shrink spider veins with almost no burning sensation and new ways of “foaming” these agents allow for more veins to be treated with less punctures. The treatments are done every six weeks until the problem spider veins have faded from sight. Most people require two to three treatments unless they have a lot of “spiders,” then they may desire to have more treatments. Maintenance treatments can be done once or twice a year. During the treatment most people chat or relax, after the treatment some people report a temporary mosquito bite like sensation. Support stockings worn after the treatment seem to maximize the result, but in the summer time support stockings can be almost as painful as the spider veins. At first the veins will look darker before they start improving as the few red blood cells trapped in it fade like a bruise. Most people who have this done are realistic and are not looking for “Tina Turner” legs, but want to feel comfortable wearing shorts and bathing suits without having a road map of veins visible for comment. 

Varicose veins are the “big brother” of spider veins. Most people with varicose veins also have spider veins, but it is the varicose veins that are causing most of the symptoms of heaviness, tiredness, swelling and burning. As we discussed, older methods included vein stripping, vein ligation (tying it off) and the “roter-ruter” technique in which the vein is mechanically shredded. All of these methods left scars and the recovery was significant. Current techniques use very slender, hair like filaments which are threaded up the problematic vein from a puncture site to a precise point and then energy is transmitted to the interior of the veins resulting in its and it immediately ceases to function. After care involves wearing a support stocking for three days and stopping all blood-thinners for two weeks before and two weeks after the procedure. Often many of the spider veins associated with the varicose vein will resolve once the feeder vein is treated. If not, then some additional sclerotherapy can be used to treat the remainder of the little spider veins. 

It is estimated that 25 million people have varicose veins and now that there is a procedure that involves very little discomfort and essentially no recovery time, there is no reason not to have your varicose veins evaluated. Insurance recognizes that if left untreated varicose veins and severe venous disease can lead to leg wounds, ulcers and severe disability. Thus it is considered a functional disease that is covered by many insurance companies. Spider veins are not covered by insurance, as they are not a functional issue, just unsightly. The good news is that there are now even better treatments for both spider and varicose veins. So as we leave fall and enter into winter, wearing longer pants, consider having your “spiders” and varicose veins evaluated and even treated.