Varicose Veins and Spider Veins: Do You Need Treatment?

Updated on: November 28, 2018

Varicose veins are usually associated with the middle-aged and the elderly. When they appear on your legs, they automatically age you, and they can be embarrassing and unsightly. As unpleasant as they are, varicose and spider veins are often harmless; but sometimes they can signal a more serious problem called venous insufficiency, which requires treatment.

What is venous insufficiency?

Venous insufficiency is a condition where your veins don’t work to their full potential. Under normal circumstances, your veins keep your blood flowing in the right direction toward the heart with a series of valves in the vein system. With venous insufficiency, these valves don’t close properly, allowing blood to flow backward along the vein and pool in your lower extremities.

That backed up or pooled blood causes the vein to swell and, over time, the vein can remain enlarged. In this situation, smaller veins become spider veins and larger veins become thick, ropy, varicose veins.

Why is venous insufficiency a problem?

To understand why venous insufficiency is a problem, you need to understand how your cardiovascular system works:

  • Your heart pumps blood out to your body through a large artery called the aorta
  • The blood travels through your arteries to carry oxygen and nutrients throughout your body
  • The veins and arteries are connected to each other inside all of your tissues and organs
  • Your tissues and organs use the nutrients in the blood, which then flows back into the veins and on to the heart

Your blood must flow in one continuous direction, otherwise old, used up blood mixes with new blood and your tissues don’t get the nutrients they need. Additionally, if blood is allowed to pool or flow backwards, it never gets fully renewed in the heart and lungs. Venous insufficiency prevents blood from continuously flowing in one direction.

Symptoms of venous insufficiency

Not all varicose veins are a sign of venous insufficiency. In many cases they no cause for concern, though they are unsightly. However, if you have varicose veins and any of the following symptoms, you should consult your physician:

  • Swollen legs or ankles
  • Leg throbbing or pain that gets worse when you stand and gets better when you elevate your legs
  • Frequent leg cramps
  • Thickened skin on your legs or ankles
  • Weakness in your legs
  • Itchy skin or sores on your legs that don’t heal
  • Skin discoloration, especially around the ankles

When to get treatment

If you have varicose veins without venous insufficiency, whether or not you get treatment is up to you. There are several treatments that can reduce the appearance of your veins and smooth out your skin. If you do have venous insufficiency, you will need to discuss your treatment options with your doctor.

Treatments for venous insufficiency include:

  • Compression garments to exert pressure on the veins, keeping blood flowing in the right direction
  • Sclerotherapy to harden the faulty veins causing, them to shrink
  • Laser therapy to cauterize the faulty veins, causing them to shrink
  • Endovenous therapy using a catheter to manually close off the vein, causing it to shrink
  • Surgery, in more severe cases, to remove the faulty veins

In addition to one or more of these treatments, your doctor might prescribe diet, exercise and medication to prevent more varicose veins from appearing.

Reviewed February 10, 2017

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