Varicose veins and spider veins are a common medical condition. It is estimated that 15% of males and 25% of females are affected in North America, and prevalence is even higher in Europe. Genetics, hormonal influences and the effects of pregnancy are the most common causes of varicose and spider veins. Other incidences include obesity, and jobs requiring prolonged standing or sitting. Despite the pervasiveness of venous disease, much is still poorly understood.
Veins act as a collecting system throughout the body. A series of one way check valves coupled with the contraction and relaxation calf muscles (calf pump) and breathing, moves blood from the tissues back to the heart. The venous system is redundant. It involves an extensive network of vessels found in multiple layers, much of which lies deep to the surface of the skin and thus invisible to the naked eye. When a vein becomes dilated, one way check valves no longer function properly, and blood begins to flow in reverse, away from the heart. Backwards flow (reflux) leads to elevated pressure in the veins that in turn allow them to become engorged and progressively more dilated. As dilated diseased veins are permitted to persist, the network of diseased veins begins to grow, commonly leading to symptoms of pain and swelling. In severe cases, leg ulcers and phlebitis may develop, prompting urgent need for definitive management.
Despite the widespread prevalence of venous disease and complications from varicose veins, such as bleeding, ulcers or phlebitis, a perpetual myth continues throughout the medical community. The falsehood shared among many primary care physicians suggests that varicose veins and spider veins do not cause symptoms. Frustration is commonly reported by patients as their physicians offer no options for finding symptom relief. A recent scientific study may help shift medical opinion.
In a recent study, sixty-two subjects with isolated spider (telangiectasia) and reticular veins (blue green veins) were randomized to compression stockings or sclerotherapy (injections). Compression therapy consisted of fitted thigh high stockings which were worn daily for six weeks. Quality of life parameters were assessed at the end of the compression trial for comparison. Patients randomized to sclerotherapy received no compression, rather a series of injection sessions using dilute 0.1 – 0.2% SotradecolTM to first manage the blue green veins, and then the spider veins.
Quality of life questionnaires revealed significant reduction of aching, pain, leg cramping and clinical restlessness with compression therapy, while the sclerotherapy arm of the study found incremental global relief of symptoms and appearance over the twelve months of care. The results of this study demonstrate statistically significant reduction of symptoms in patients with isolated refluxing surface vessels, and suggest that reticular veins and telangiectasia are more than merely a cosmetic concern.
This study was sponsored by BSN Medical (Stockings) and Bioniche Pharma (Sclerotherapy), leaders in the field of venous disease.
There are many potential treatments for reticular veins and telangiectasia, yet the only treatments known to offer symptom relief include compression and sclerotherapy as demonstrated in this study. Because of the complexity of the venous system, it is imperative that a thorough ultrasound evaluation be performed before any treatment intervention. Recognize that sclerotherapy is an art and experience matters. Although laser centers report they can successfully eliminate spider veins, results vary. Do the research before seeking treatment, and find an experienced physician with a variety of treatment options and sole practice dedicated to managing varicose and spider veins.
If you are suffering from leg pain, cramping or swelling, varicose veins represent a common potential underlying cause.