Varicose & Spider Veins


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It is estimated that more than 80 million Americans suffer from some form of venous disease. Varicose veins Charlotte are very thin walled, dilated veins that have become elongated and tortuous. Small, congested veins that lie close to the skin and have a web-like appearance are known as spider veins. Larger veins, located more deeply, may appear as bumps or lumpy protrusions under the skin and are green or blue in color. Varicose veins can occur anywhere in the body. Hemorrhoids, for example, are varicose veins of the rectal/anal area. Veins have one-way valves which help channel oxygen-poor blood from body tissues back to the heart. If these valves are not functioning properly, blood flow actually reverses (or refluxes). The great majority of varicose veins in the leg are caused by faulty valves in the groin or behind the knee. When the leg veins cannot adequately pump blood back to the heart, this is referred to as chronic venous insufficiency (CVI). Chronic reflux leads to overfilling of the superficial veins under the skin. Over a period of time, this additional pressure of blood may cause the veins to stretch, bulge and become visible. At the same time, tiny capillary branches of the veins near the skin can also overfill with blood, producing multiple spider veins and purple discoloration.


Vein valvefailure may be due to:

Weakness of the vein walls causing the walls to balloon out, preventing the valves from closing all the way

Direct damage to the valves themselves

Damage to the vein from trauma, blood clot or inflammation which then disrupt the normal flow channel


Heredity seems to play a significant role: 70% of people with varicose veins have a family member with the same problem. It is believed that some people are born with too few valves or have inherited weak vein walls due to decreased amounts of collagen and elastin.Women also have a much higher incidence for developing varicose veins than men, likely due to the effects of the female hormones progesterone and estrogen which relax the vein wall. Also, during pregnancy, this hormonal effect on the vein wall, the enlarging uterus increasing pressure in the lower legs as well as an increase in blood volume all contribute to the development of varicosities.

As you increase in age, the vein wall loses strength (collagen) and elasticity (elastin) predisposing the development of vein disorders. In the US, the incidence of varicose veins for women in their 40’s is 41%; for women in their 60’s the incidence is 72%. For men in their 40’s the incidence is 24%; for men in their 60’s it is 43%.

If you are overweight or very tall, your risk for varicose veins is increased

70% of people with varicose veins have or had occupations that require prolonged standing.

Although this has not been well studied, it is thought that frequent straining such as that seen with chronic constipation or coughing can increase forces transmitted to the leg veins and contribute to the formation of varicose veins


Symptoms range from cosmetic problems to life-threatening and do not necessarily correlate with the size of the varicose veins. Symptoms are often made worse by prolonged standing. Severe varicose veins can compromise the nutrition of the skin and lead to eczema, inflammation or even ulceration of the lower leg.

Mild symptoms include:

  • leg aching and heaviness, often worse at night and after prolonged standing
  • itching
  • swelling
  • restlessness of the legs

More serious problems include:

Bleeding: rarely there can be a large amount of bleeding from a ruptured vein

Superficial thrombophlebitis: pain, redness due to blood clots in inflamed superficial veins. This is different from the clots in the deeper veins, which are life-threatening.

Venous eczema: usually above the ankle. It can be treated short term with steroid-containing creams. Long-term use of these creams can cause the skin to be very thin and fragile. If left untreated, eczema can become very severe with inflammation, scaling, redness

Bronzing of the skin (stasis dermatitis): starting out as light brown patches and then to a darker, shiny brown

“Atrophie Blanche”: is a French term that describes shiny, white patches of skin. It is a sign of advanced damage.

Lipodermatosclerosis: describes damage to the skin and the fatty layer below it. Not only is the skin discolored, shiny and hard, but the fat underneath also becomes hard and shrinks, dimpling the skin above it.

Ulcers: Long-term inflammation skin has broken down, leaving an open sore. These ulcers are often very slow to heal. They may be large or small; painful or painless. Venous disease is the most common cause of ankle ulcers in the Western world.


How can you help yourself? Most preventative measures are common-sense:

If you are overweight, try to lose a few pounds.

Take regular walks. Walking is the best exercise to improve the flow of blood in the legs, but avoid exercises that use weights and high-impact exercises, such as jogging.

Avoid long periods of standing or sitting. If you have to stand/sit in one position for an extended time, do some ankle movements, such as standing on tiptoe to encourage your calf muscles to pump blood out of your leg veins.

Put your feet up whenever you are sitting around at home. This will help the veins to empty and reduce swelling of the feet. Try not to cross your legs or to sit for long periods with your legs bent. On long train or plane journeys, walk around from time to time, and on long car or coach journeys take advantage of any stops to get out and walk for a few minutes.

Avoid falling asleep in a chair. If you are tired, go to bed.

Extract of horse chestnut may help the swelling and aching associated with varicose veins. It can cause nausea in some people. Avoid if you have high blood pressure. Talk with the doctor before trying an herbal/dietary supplement.

Eat a low salt, high fiber diet: too much salt in the diet can lead to water retention and swelling. High fiber foods such as fruits, vegetables, and whole grains reduce the chances of constipation

Wear sunscreen to protect your skin from the sun and limit the spider veins on your face

Avoid high heels – low heels work the calf muscle more. The calf muscle helps pump the blood towards the heart.

Don’t wear tight clothes around your waist or groin girdles, tight belts which restricts circulation


Do I need a consult?

  • Do your legs ache?
  • Do your ankles swell?
  • Do you hate the way your veins look?
  • Have you ever had a blood clot in your veins?
  • Have you ever had phlebitis?

If you answered ‘Yes’ to any of these questions, then you would probably benefit from a consultation.

VNUS, developers of the ClosureFast technique to treat varicose veins, has an excellent patient education website. Click here for a self-assessment test to see whether or not you are at risk for varicose veins:

What happens during a consultation exam?

The first part of a consultation is a complete history and physical exam. We ask patients to bring a pair of shorts because the physicians will want to examine the legs from hip to toe. This gives the physician the first look at what type of treatment may be needed.

The next part of the consultation involves an ultrasound and doppler exam. Vein disorders are not always visible and diagnostic techniques are important tools in determining the cause and severity of the problem. Venous ultrasound is a painless medical test that uses high-frequency sound waves to produce pictures of the veins. There are no needles or radiation. A color Doppler study (a special application of ultrasound) is also included in the examination to measure the flow of blood through the vein, specifically looking for backward flow or reflux. You may actually hear pulse-like sounds that vary as the blood flow is measured.

These tests help confirm any problems that the physician needs to address. If problems are identified, the ultrasound is then used to “map out” the section of the vein that needs to be treated

You will be positioned face-up on the examination table and a clear tact between your body and the ultrasound probe. The doctor will then sweep the probe back and forth over the area being examined.

After completion of the ultrasound and doppler exam, the doctor will discuss the results of the tests and what available treatment options he or she recommends.


Treatment options range from conservative care using compression hose to sclerotherapy to endovenous closure. After an evaluation is done, options will be discussed with you and a plan developed. Click on the links below to find out more information about specific treatments:

Endovenous Closure


Foam Sclerotherapy

Laser Vein Treatment

Compression Stocking

Patient Reviews

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