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  When very small vessels at the surface of the skin become enlarged, they can form webs of blue, purple, and red spider veins.  The medical term for these malformations is telangiectasia.  The more common term is spider veins.  They can occur in males and females; however, they are more common in women and may be related to the presence of female hormones.  

They are usually of cosmetic concern; however, on occasion they may signal a more serious venous disorder especially if they are prominent below the ankle, a condition known as corona phlebectasia.  Generally spider veins do not pose a risk, however in rare cases the can bleed and be more than a nuisance.

Spider veins are most effectively treated with sclerotherapy.  Laser therapy can also be used; however, it is associated with a higher recurrence rate and has been shown to be not as effective and lasting.

These veins are the bulging types seen usually in the lower thigh and calf area.  The underlying problem is the lack of competent valves in the vein.  Under normal conditions, valves located about every six inches in the veins prevent the blood from flowing backwards, down the leg. When the valves do not work, blood goes down the vein, increasing the pressure and causing pain and distension or enlargement of the veins in the lower leg.  

This is a medical condition and left untreated can result in significant problems, such as pain, discoloration, ulceration of the skin, edema or swelling of the legs and an increased risk of blood clots.  

This condition is readily diagnosed with color flow Doppler ultrasound.  This noninvasive painless ultrasound exam is done in our office and is used to evaluate patients with symptoms suspicious for venous insufficiency.

Venous ulcers can form in the ankle area and lower calf when longstanding venous insufficiency leads to very high venous pressures in the lower leg.  The superficial tissues in the lower leg cannot properly perfuse with arterial blood, and thus the skin and subcutaneous tissue suffer.  This leads to death of the tissue and open non-healing sores known as venous ulcers.  

The treatment for this disabling and pathological condition starts with an accurate evaluation of the veins involved.  Oftentimes incompetent perforating veins in the calf area are identified as the cause. Once the pathological veins have been identified and properly mapped treatment can begin. 

Effective treatments include ligation and division of incompetent perforating veins, and foam sclerotherapy.  The modality of treatment will be determined by the venous abnormalities that are causing the ulcer.  Often the ulcer will heal within weeks of treatment. 

 Spider veins can be treated using a procedure called sclerotherapy. Sclerotherapy consists of injecting a vein with a solution which causes it to collapse or no longer carry blood flow.  

This treatment is performed in a short office visit and is relatively painless. You may require several sessions for different parts of the leg.  However, many veins can be treated in one session.  Most of the time there is little or no pain, although some patients feel a slight burning or stinging sensation during the procedure.  

Normal activities can be resumed afterwards with the exception of no hot baths for 72 hours.  

 Varicose Veins and some reticular veins are treated using microphlebectomy. This is the preferred method for treating very superficial bulging veins of the saphenous system or its tributaries. It is very effective and safe. 

This procedure is performed painlessly under local anesthesia.  No stitches are required.  Some bruising may occur, but this usually resolves in a few weeks.  

Compression stockings area worn for 48 hours, and the patient may return to full activities immediately.  When the local anesthesia wears off, most patients experience no pain whatsoever.

 Venous ulcers can be treated using endo-venous ablation. This is a painless and minimally invasive procedure which uses heat to destroy the saphenous vein.  This technique uses needle punctures to access and treat the vein.  Patients can resume normal activities immediately afterwards. 

 You may eat prior to the procedure and drive yourself to and from the office as no sedation is required.  Pain is controlled with a local anesthetic which usually lasts 4-5 hours.

We insist that patients remain active after this procedure with frequent walking.  Gone are the days of bed rest or downtime associated with vein procedures; being active and mobile is the rule!