‘Not in Vein”

The Truth About What Lies Beneath Your Unsightly Spider and Varicose Veins

By Kimberly Moskowitz, MS, MD

Have you been hiding your legs for years or delaying treatment because  you assumed that your unsightly veins were nothing more than a  cosmetic nuisance? More than 80 million Americans suffer from  abnormal leg veins but what lies beneath can often be more serious than  you know. The visual appearance of veins is a useful but not completely  reliable indicator of disease severity. Similarly, symptoms do not always  correlate with the severity of underlying veins.

In its simplest form, there are two branches of the circulatory system: the arteries and the veins. Arteries carry freshly oxygenated blood from the heart and lungs to nourish all of the body’s tissues and cells. Veins do the reverse. They carry “used up” blood from the tissues back to the heart and lungs to be recycled. Veins can accomplish this only because they have tiny valves that open to allow blood flow toward the heart and close to prevent backwards flow down into the feet. Our leg muscles act as pumps for our veins. As they contract, they squeeze the veins, causing the valves to open and the blood to move forward in the direction of the heart. These thread-like valves are fragile and many factors such as genetics, hormones, prolonged standing and trauma cause them to fail over time.

When valves fail, backwards flow causes pooling of blood in the veins. This, called venous insufficiency, causes increased pressure in the veins (venous hypertension) making it even harder to carry blood away from the legs. When veins are not working properly, toxic metabolic waste builds up and essentially poisons our cells and surrounding tissue.

In the early stages, venous insufficiency causes leg fatigue, aching, cramping, discomfort, swelling, and even restless leg syndrome. Symptoms are generally worse at the end of the day and after prolonged standing. As the disease progresses, stasis dermatitis occurs (stasis meaning stagnant or not moving, dermatitis meaning inflammatory changes involving skin). Stasis dermatitis appears as brownish or reddish discoloration on the lower legs and ankles resulting from inflammation and fluid build up under the skin. This excess fluid interferes with the body’s ability to feed the tissue cells and dispose of cellular waste. The poorly nourished tissue becomes thin and fragile over time. Ulcers often form in these areas creating a milieu for infections such as cellulitis. Poor blood flow through abnormal veins also puts patients at risk for deep vein thromboses (blood clots) that can be fatal if they dislodge and embolize to the lungs.

Diagnosing venous insufficiency before disaster strikes is performed easily by a physician specializing in Phlebology. A painless ultrasound exam is performed to determine the size, location, and severity of abnormal veins in the legs. To ensure a safe and effective outcome, it is imperative that this “mapping” of the venous system be performed prior to treatment of leg veins. The marvel of today’s technology is that most vein problems can be treated nonsurgically using endovenous laser techniques such as EVLT. During this procedure, an ultrasound is used to visualize placement of a thin laser fiber into the diseased vein at the exact origin of the problem. The laser energy is then used to seal the vein shut and divert blood flow to the normal healthy veins. The entire procedure takes less than an hour, requires no general anesthesia, and leaves minimal to no scarring. Patients return to normal activities almost immediately. Because venous insufficiency can lead to serious medical problems, treatments are covered by most health insurance plans. Sclerotherapy is the treatment of choice for smaller varicose and spider veins. Sclerotherapy involves a series of tiny injections into the abnormal veins causing them to be painlessly reabsorbed by the body and fade away. As the body reabsorbs the veins it results in improved circulation and symptoms.

Once thought of as merely cosmetic, spider veins may actually be creepier than you think. It is important to understand that the veins on your legs may appear innocent but they could be an indication of serious problems underneath. Most of these problems are the result of stagnant blood flow and the build up of harmful metabolic waste. As with any medical condition, early diagnosis and treatment is important. The best news is that as your veins fade from view, so too does your risk of developing serious complications and a lifetime of hiding.



Posted in: Getting Rid of Varicose Veins, Restless Legs Syndrome

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