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What treatment is recommended for varicose and spider veins?

This question was asked in Manhattan, New York and has 7 answer(s) as of 01/20/2014.
Is it possible to have varicose veins and spider veins too on the same leg? I know that I have spider veins on my legs. I think I have varicose veins too, could that be possible? The spider veins are red and itchy. Is there a treatment that can cure both of these conditions at once?


Doctors Answers (7)

The first step is to obtain an ultrasound to determine if you have underlying varicose veins. If you have a problem with these deeper veins, then we will close those veins first through a procedure called endovenous radio frequency ablation. This procedure is a one time office treatment and will close your damaged varicose vein. After that treatment, we can inject your spider veins with a liquid that will close the veins over time. This procedure is called sclerotherapy and usually requires 3-4 sessions which are done monthly.

It is possible to have only one type of vein problem such as spider veins or varicose veins and often you may have any combination of different sized veins that are causing problems. Spider veins are small red surface veins that often have no significant symptoms but may itch or burn in some patients. The larger varicose veins may have no symptoms in some patients or may be very uncomfortable affecting normal activities and producing pain, spontaneous bleeding, phlebitis (superficial blood clots), skin changes, including eczema and ulcerations. Different types of veins on the legs can often be treated at the same time but with significant vein problems it is best to treat the worst vein problems first.

Yes a person may have both on the same leg. Varicose veins are larger and bulge above the surface of the leg. They are typically blue/green in appearance and larger than about 3mm or larger and can be symptomatic of deeper problems such as venous insufficiency. These are best removed using microphlebectomy (through small punctures under local anesthetic). Sclerotherapy can result in areas of trapped blood which needs to be removed, multiple treatments and higher incidence of pigmentation over the veins. Smaller flatter veins are called reticular veins and can be treated successfully with sclerotherapy injections. The red/blue spider veins which are much finer are treated with sclerotherapy (the gold standard) and/or topical laser. The "feeding reticular" veins below these should also be treated for long term clearing. In my practice I would address the larger veins first, let the limb settle to see if some spider veins fade and then treat the surface spider veins.

It is very common to have both on the same leg. Sometimes, treating the varicose veins that are in the vicinity of your spider veins, especially with sclerotherapy injections, the medication can enter the smaller veins and they will faint or disappear, but this is not the rule.

No treatment can cure veins completely. It is possible to have both varicose veins and spider veins on the same leg. The spider veins can be a consequence of the varicose vein. Varicose veins occur because of backward blood flow in a vein deeper down. The best thing for you to do to determine your treatment options is to first have a thorough ultrasound to evaluate the veins deeper down. You may be a candidate for endovenous ablation with laser or radiofrequency closure. You do not want to treat your spider veins until the underlying vein issue is addressed.

Yes, spider veins and varicose veins coexist. A complete evaluation will allow us to develop a treatment plan to take care of both. If you are symptomatic, then insurance will likely cover the treatment.

Spider veins and varicose veins are inherited separately but often coexist in the same patient. Usually the treatments are different for each, but no treatment is curative. Your individual case should be discussed after consultation with a vein specialist.

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