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Varicose and Spider Veins

Types of Veins








Nearly 40 million Americans, mostly women, suffer from varicose and spider veins causing pain, discomfort, and cosmetic concerns.


While arteries transport blood from the heart to the extremities, it is the function of veins to return blood to the heart. When a vein loses its capacity to return blood to the heart, it is labeled incompetent, becoming enlarged due to congestion and pooling of the blood, collecting in the veins below. Spider veins are congested smaller veins within the skin.


Symptoms include pain, heaviness, burning, throbbing, itching, tingling, cramping, swelling, and restlessness of legs. These may worsen during the menstrual cycle.





Deep Veins

They account for 90% of the total venous return power of the legs. These veins usually become incompetent or diseased after a blood clot has affected them.


Main Superficial Veins

They consist of the great and short saphenous veins. They run approximately one half inch under the skin, but are visible when varicose. These are usually the main culprits when one develops varicose veins.


Reticular or Feeder Veins

These are small blueish-greenish veins seen through the skin. They "feed" spider veins, so their elimination is important in the treatment of these.


Spider Veins or Telangiectasia

Fed by the reticular veins, they are a major cosmetic concern in women. Due to hormonal factors, these are rarely seen in men.


Perforator Veins

These veins connect the superficial veins with the deep veins. When incompetent, they play an important role in the development of varicose veins. Most cases of recurrence are due to failure by the clinician to accurately diagnose and treat them.






It is the most frequent contributing factor. If one has a strong family history of venous disease, it is very likely varicose veins will develop. Early detection and treatment of incompetent veins under the skin can prevent or retard the progression of the disease.


Hormonal Factors



Sometimes the first sign of pregnancy is not a missed period, but rather pain in legs due to a rapid rise in female hormone levels. For unknown reasons, they usually develop with the second pregnancy, but some or most of them may disappear after delivery when hormone levels drop. There is also a mechanical factor when the enlarged uterus compresses or obstructs veins in the pelvic area.


Birth Control Pills

Increased levels of female hormones will create a predisposition for the development of varicose and spider veins.


Hormone Replacement Therapy

Same principle as with birth control pills when progesterone is part of the regimen.



If one's job entails prolonged standing or sitting, there is an increased risk of developing varicose veins due to the weight of gravity increasing the pressure in the veins causing them to dilate and fill with blood.



The incidence of varicose and spider veins peaks between the age of 50 and 60. It can start at any age, but mainly between 30 and 45 years of age.


Leg Injuries

Trauma to veins can damage their internal valves causing the veins to become incompetent. This usually happens when a deep vein is affected.





1. Avoid prolonged standing and sitting (more than 30 minutes). On long airplane and automobile trips, walk for five minutes every hour. Periodically flex your ankles to pump the blood out of your legs while sitting.


2. Avoid constricting bands on the leg that would leave an indentation.


3. Wear support compression stockings when standing for prolonged periods of time, when flying, and during pregnancy.


4. Walk or bicycle frequently to boost circulation in the legs.


5. Avoid heavy weight-lifting in legs. More repetition with less weight is better.


6. Maintain your ideal body weight.


7. Elevate your legs whenever possible.


8. Protect yourself from the sun to reduce the number of unwanted vessels on the face.





Bi-directional continuous wave hand-held Doppler (the stethoscope of the phlebologist), is provided at your initial consultation. It determines the existence of blood flow and its direction in your main superficial and deep veins. Be weary of any vein specialist who doesn't examine you with this device. It is the equivalent of a Cardiologist not listening to your heart.


Venous Duplex Ultrasound is the gold standard for the accurate diagnosis of vein disease. Non-invasive, without injection of contrast material, it allows us to map your incompetent or diseased veins corroborating and complimenting the hand-held Doppler exam. This is provided at all of our facilities, if warranted, based on your physical and hand-held Doppler examinations.








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