Varicose and Spider Veins
What are Varicose Veins?
Varicose veins are large bulging veins seen immediately under the skin. These veins result from malfunctioning valves that create high pressure and pooling of blood. The great saphenous vein is the most common culprit. This vein runs from the foot to the groin along the inner part of the thigh.
The great saphenous vein is usually not visible. However, high pressure and flow reversal in this vein can damage normally small tributary veins and cause them to bulge. This causes the characteristic appearance and symptoms of varicose veins. Left untreated, varicose veins can lead to disfigurement, pain, and disability.
What are Spider Veins?
Spider veins (or telangiectasias) are small red or blue veins that appear on the skin. These veins are usually caused by small abnormal veins under the skin. These veins are usually not visible, and may develop even when the major leg veins are normal. Spider veins are usually a cosmetic concern. However, large clusters are sometimes associated with pain, itching, and stinging.
Patients with vein disease seek treatment due to either cosmetic concerns or physical complaints. The development of symptoms related to vein disease is often very slow. Because of this insidious course, many patients do not realize the full impact of their problem until after treatment.
Symptoms may include leg heaviness, pain, tenderness over the course of a vein, itching, burning, restless legs, night cramps, swelling, skin discoloration, and numbness and tingling. In more advanced cases, skin breakdown may occur with resulting ulceration.
Leg pain related to venous disease should be differentiated from pain associated with arterial disease. Typically, walking or leg elevation will improve the pain associated with venous disease. In arterial disease, leg pain is typically made worse by walking or elevation.
Consequences of Varicose Veins and Spider Veins
Varicose veins are a significant cosmetic concern. However, the underlying venous insufficiency that causes varicose veins may lead to serious medical problems. The abnormal flow and blood pooling that result from the valvular malfunction can cause thrombophlebitis (painful, inflamed, thrombosed veins) and leg swelling. As the severity of the disease process increases, bleeding can develop from superficial varicosities.
The high venous pressure, . particularly at the level of the ankle, may cause a problem known as chronic venous insufficiency. This may result in inflammation that causes skin thickening and discoloration. In more severe cases, skin breakdown and ulceration may result. Venous stasis ulcers require aggressive treatment to avoid enlargement and infection. Ultimately, the underlying abnormal veins must be treated to allow adequate healing.