You've noticed blue, red or protruding veins on your legs…. what goes on inside the body to lead to the formation of these veins and can and how are they treated?
 
What's happening below the skin that can't be seen to the naked eye?

Your body continually works hard to ensure optimal blood circulation - this keeps  your body running smoothly. Arteries circulate oxygen-rich blood from your lungs around the rest of your body, it's the veins which push the blood back to your heart against gravity using a network of one-way valves and surrounding muscles. As you walk the calf muscles act like a pump and compresses the deep veins pushing the blood back up the leg. Superficial veins rely entirely on the ability of the valves to prevent backflow to your feet. This is where people with varicose veins have a problem.

How does this create varicose or spider veins?

In varicose veins the valves, which are supposed to open and close consecutively, do not work properly.  When the valves do not function properly, the blood begins to pool in the vein, which makes it difficult for the muscles to push the blood up for legs. Instead of flowing consecutively from one valve to the next, the blood continues to pool in the vein, increasing arterial venous pressure and the increasing likelihood of congestion while causing the vein to bulge and twist. Because superficial veins have less muscle support than deep veins, they are more likely to become varicose or spider.

What’s the difference between varicose and spider veins?

While both Spider and Varicose veins occur mostly on the legs, their appearance is the easiest way to tell them apart.

Spider veins (Telangectasias) are smaller in comparison to varicose veins. They have a diameter between 1 mm to 3 mm and generally appear in small areas just underneath the surface of the skin. They are usually purple, blue or red in colour and have an appearance like a spider’s web or even a linear pattern. Spider veins are often caused by the backup of blood, hormone changes, exposure to the sun, and injury.

Varicose veins on the other hand are much larger due to the pooling of blood in the vein. They are also very bulky in appearance, often similar to thick ropes that protrude and bulge pushing the surface of the skin upwards.

Will I get spider or varicose veins?

There are many factors that presidpose a person to varicose veins and spider veins. Varicose and spider veins are seen more often in women than in men. Some of the more common factors that induce varicose veins include:

  • Genetics . Family history is one of the most common reason for weak vein valves which can inevitably increase your risk. Approximately half of all people who have varicose veins have a family member who has also had them.

  • Weight Gain. Excess weight and obesity can put extra pressure on your veins which may lead to varicose veins.

  • Hormones. During puberty, pregnancy, and menopause women often develop varicose veins due to changes in the production of progesterone and other key hormones. Find out more about these changes during pregnancy and menopause.

  • Immobility. Sitting or standing for a long time may force your veins to work harder to pump blood to your heart. This can be a bigger problem if you sit with your legs bent or crossed.

  • Age. Often the older you are the more common the condition, over time the valves in your veins may weaken and not work as well.

  • Sun exposure. This can cause spider veins on particularly on the face of those with fair skin.

An Ultrasound examination is always performed at the clinic on all patients to assess the competency of all the superficial and deep veins in your leg due to the is a close relationship between the development of spider veins and varicose veins. Up to twenty percent of people with spider veins have underlying incompetent Saphenous veins and ultrasound allows us to detect this. Failure to detect underlying incompetence of superficial veins or saphenous veins leads to much greater complication rates in the treatment of surface veins

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AuthorNicholas Kemp

Horse chestnut, grape seed, Ginko biloba, coumarins and flavonoids. Pills, lotions and even skin wraps for those unsightly vascular marks and promises to make your legs healthy again ot give you your best legs ever! 

There seems to be any number of herbal and home remedies which are available for the treatment and removal of spider veins and varicose veins they can be found online and in the chemist.  Some of these products are cheap and others not so cheap but all seem to guarantee pain free removal of your veins with quick results.

These products are termed Veno-active drugs (VAD) or Phlebotonic drugs.  They are mostly derived from plant extracts.

Such groups include:

·         Benzopyrones (Coumarine, Flavonoids, Oxerutin, Rutin, Rutosides, Diosmine)

·         Saponins (Horse chestnut and Butcher’s extract)

·         Other plant extracts (Gingko Biloba, Maritime Pine extract, grape seed)

·         Synthetic products or the Quinons ( naftazone and calcium dobesilate)

·         Xanthine derivatives (Pentoxifylline )

There seem to be various modes of action depending on the individual drug.  Beneficial effects include reduction in capillary leakage and anti-inflammatory effects by scavenging free radicals. Improvements in venous tone and on the lymphatic system have been proposed.

But what is the level of scientific evidence?

At a recent International Phlebology conference that I attended, Veno-Active Drugs (VAD) were one of the topics of discussion.

Pentoxifylline, Sulodoxine and micronized purified flavonoid fraction (Daflon®) have demonstrated some benefit to patients with Chronic Venous Disease in a few trials.

However “strong recommendations with Level 1 evidence” cannot be made about the use of any of the wide range of Veno-active drugs available in the treatment of Chronic Venous Disease at the moment.

Until more evidence is gathered sclerotherapy and Endothermal ablation remain the most successful and proven methods of removing varicose veins and spider veins. 

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AuthorNicholas Kemp
CategoriesVaricose Veins


Varicose veins are twisted, enlarged and swollen veins that are often visible underneath the skin’s surface. They usually appear in the legs or ankles, and are often red or blue in colour. There are numerous remedies (both medical and non-medical) which are used for treating varicose veins, including laser therapy. Lasers are typically used for treating severe cases of varicose veins, where the veins have become excessively swollen, painful and are causing blood clots.

A laser is basically a highly focused beam of light. In the treatment of varicose veins, lasers are used to heat the veins to the point of scarring. This scarring damages the targeted vein and causes it to wither, collapse and close. The closed vein then loses its source of blood and
dies. With time, this vein disappears and is no longer visible underneath the skin’s surface. There are two major types of laser treatments for varicose veins: simple laser treatment and EndoVenous Laser Treatment.

Simple Laser Treatment

Simple laser treatment can be used for treating tiny varicose veins and spider veins (spider veins are extremely minute varicose veins), and for treating veins close to the surface of the skin. To treat the targeted vein, a mild laser is applied from outside the skin and a laser charge applied on the skin over which the varicose vein, or veins, is visible. The objective is to scar the vein without affecting the skin.

To achieve optimum results, the treatment is usually carried out over a number of sessions, and usually scheduled every 6 to 12 weeks. In each session, the affected area is subjected to a laser discharge. The collective subjection causes the varicose vein to dry-up and close. The spacing is to minimise the effects of the lasers on the skin by giving it enough time to heal. 

EndoVenous Laser Treatment

EndoVenous Laser Treatment is used for treating larger varicose veins, especially those that are buried deep beneath the skin surface. Using this method, an incision is made by a doctor on the skin through which a thin tube (catheter) is inserted. The doctor then uses an ultrasound to guide the catheter until it enters the varicose vein and is in the correct position. Once in position, a laser is passed through the catheter and into the varicose vein.

The laser then delivers short bursts of heat energy into the vein. The heat burns up the vein, causing it to shrivel, dry up and close. Using the ultra-scan to guide the process, the entire length of the vein is traversed and the process repeated. The treatment ends when every inch of the varicose vein has been closed. The catheter is then withdrawn and the incision sewn up.

EndoVenous Laser Treatment is usually carried out using either local anaesthesia or a mild sedative. After the procedure, the patient usually feels a little tightness around the area. Sometimes, mild pains or bruises occur, but these usually wear off within a very short time. The procedure is known to have a 94% success rate in closing varicose veins. In most cases, simple laser treatment is used to close up the remaining 6% of the varicose veins.

On the whole, both types of laser treatments are much more effective and carry fewer risks than other treatment options, like the surgical removal of varicose veins. A patient is usually able to resume their normal life within minutes of completing a laser treatment session. Even then, the mild burns and pains associated with laser treatments can be a source of discomfort. As such, it is usually advisable to speak to one’s doctor about the various options available. Generally, laser treatment is recommended for varicose veins which cannot be treated using other non-medical options, like exercise and wearing compression stockings.

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AuthorNicholas Kemp