Like Varicose Veins, Spider Veins are heriditary. Beyond heridity, there are four predominant causes: age, gender, pregnancy and lifestyle/occupation.

Age: Spider Veins may develop at any age, but generally occur between the ages of 18 and 35, peaking between 50 and 60.

Gender: Woman are much more likely to develop spider veins, by a factor of four to one.

Pregnancy: Changes in hormone levels and increased weight cause an increase in blood volume, which can cause veins to malfunction causing spider veins.

Lifestyle/Occupation: Prolonged sitting or standing on a regular basis can increase the risk of developing spider veins. The lack of movement can cause blood to pool in the legs, which may lead to valves malfunctioning, leading in turn to vein distention.

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There’s a pretty cool video on youtube about varicose vein procedures. It does contain some graphic medical images.

Dr. Gerant Rivera, Associate Professor of Radiology at UCSD describes how new minimaly invasive techniques in interventional radiology are being used to treat a variety of conditions from aortic aneurysms to varicose veins.

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I thought this was interesting. It’s from the National Heart Lung and Blood Institute.

How Are Varicose Veins Diagnosed?
Doctors often diagnose varicose veins based on a physical exam alone. Sometimes tests or procedures are done to find out the extent of the problem and to rule out other disorders.

Specialists Involved
If you have varicose veins, you may see a vascular medicine specialist or vascular surgeon. These are doctors who specialize in blood vessel conditions. You also may see a dermatologist. This is a doctor who specializes in skin conditions.

Physical Exam
To check for varicose veins in your legs, your doctor will look at your legs while you’re standing or sitting with your legs dangling. He or she may ask you about your signs and symptoms, including any pain you’re having.

Diagnostic Tests and Procedures
Doppler Ultrasound
Your doctor may recommend a Doppler ultrasound to check blood flow in your veins and to look for blood clots. A Doppler ultrasound uses sound waves to create pictures of structures in your body.

During this test, a handheld device will be placed on your body and passed back and forth over the affected area. A computer will convert the sound waves into a picture of the blood flow in your arteries and veins.

Angiogram
Although rare, your doctor may order an angiogram to get a more detailed look at the blood flow through your blood vessels. For this procedure, dye is injected into your veins. The dye outlines your veins on x-ray images.

An angiogram can help your doctor confirm whether you have varicose veins or another problem.

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Medical compression stockings provide graduated compression to the leg (meaning it is highest at the ankle and gradually decreases going up the leg), helping to decrease the swelling or pooling of fluids. These stockings are worn daily and come in a variety of styles and colors.

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What are the treatment options for varicose and spider veins?
A variety of treatments are available to manage each vein condition. Determination of the appropriate treatment is best achieved by a trained vein specialitst. Current treatments available are:

Compression Stockings – Helps to reduce the swelling and increases circulation.

Sclerotherapy – A chemical solution is injected directly into the vein to close it down.

Endovenous Laser Treatments (EVLT) – Laser or radio waves are used to close off the vein so the body can clear it away like a scab or a bruise.

Vein Surgery – Rarely used except in certain cases where removal of the vein is the best solution.

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The most common symptom of varicose veins is the appearance of twisted and bulging veins. In some people they can also cause the following:

Pain
A heavy feeling in the legs
Swelling and throbbing of the feet and ankles
Itching around the affected area
Sore or ulcers around the veins.

If you have any of these symptoms use our find a varicose vein specialist tool to have your veins evaluated.

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Many women first develop varicose veins or find that they get worse during pregnancy. First, your progesterone levels rise, causing the walls of your blood vessels to relax. Secondly, as your uterus grows, it puts pressure on the large vein on the right side of your body (the inferior vena cava), which in turn increases pressure in the leg veins. (Veins are the blood vessels that return blood from your extremities to your heart, so the blood in your leg veins is already working against gravity.) The amount of blood in your body increases when you’re pregnant, adding to the burden on your veins. Up to 40% of all women develop varicose veins during pregnancy.

There are valves in the veins which prevent the back flow of blood back into the legs. When these valves become damaged or defective, the blood flows backwards and causes swelling and enlargement of the veins. In addition, during pregnancy, there is a gain of weight and volume which causes the baby in utero to compress some parts of the pelvis (lower abdomen) and lead to an engorgement of the veins in the vulva/vagina.

Varicose veins commonly occur on the legs and thighs but may also occur in the vulva or vagina. If a female has varicose veins of the vulva during pregnancy, she will always have varicose veins in the legs.

There are three main causes for the development of varicose veins during pregnancy:

* The principal cause is the hormonal changes that occur during pregnancy. Increased levels of the hormone progesterone cause blood vessels to relax. This may allow the two halves of the valves in the vein to separate slightly, so that they don’t meet to block the back-flow of blood.
* The enlarged uterus (the organ that holds a developing fetus), pressing against the major veins in the pelvic region, tends to add to the overall problem. The result is an increase in the pressure in the leg veins that are subject to becoming varicose.
* A family history of varicose veins tends to increase the likelihood of varicose veins developing during pregnancy.

Unfortunately, in the majority of cases, the varicose veins of the legs worsen with time. The varicose veins start to become more prominent and swell and with time, the veins become engorged with blood and cause localized pain and itching. Once the leg veins become prominent, it is very unlikely that they will spontaneously resolve without any treatment. However, varicose veins on the vulva/vagina often do get better once the baby has been delivered. The majority of women who do develop varicose veins in the legs will retain these varicosities after pregnancy.

You may or may not be able to prevent varicose veins during pregnancy. Fortunately you can take steps to minimize the severity of varicose veins and treat the veins you do have during pregnancy. If one starts early in pregnancy, varicose veins can be prevented. Here are some simple steps for treating and minimizing varicose veins during pregnancy:

* The major preventive measure is to exercise and walk to stimulate the muscles which can push the blood away from the leg.
* Elevation of the legs at all times is also recommended.
* During pregnancy, one should always lie on the left side with the legs elevated on a pillow. This prevents the fetus from pressing on the leg veins and decreases the chance of developing varicosities.
* Don’t cross your legs when sitting down.
* Avoid standing or sitting still for long periods of time. Take frequent breaks to stretch while at your desk and shift your weight while standing. This can help decrease the amount of pressure on your legs and help keep your circulation moving. Wiggle your toes regularly and flex your muscles to also promote better circulation in your legs.
* Buy some pregnancy support hose that provide graduated compression. This will not only help reduce bulging but will also help reduce any swelling you experience in your extremities during pregnancy. You can get these online or from a medical supply store or pharmacy. These stockings unlike normal pantyhose are quite thick and help maintain blood circulation. They can also help prevent blood from pooling in your legs if you put them on first thing in the morning.
* Be sure to gain an appropriate amount of weight. Carrying too much weight can contribute to varicose veins.
* Avoid tight clothing that can compress the waist or groin.
* Eat a low-salt diet (salt does have the ability to retain water).

For many women varicose veins become much less severe after pregnancy. For others they may find they are still uncomfortable after pregnancy. A small number of women are more at risk for developing blood clots in their veins. This condition should be monitored by a doctor. In some cases a clot may need to be treated.
If you do find your varicose veins are problematic after delivery, you can consult with a qualified surgeon to help decide the best course of treatment. Many veins can be minimized or eliminated using modern treatment methods. If you do decide to have your veins treated you should probably wait until after you are done having children, otherwise you may develop new varicose veins in subsequent pregnancies.

Varicose veins during pregnancy

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If you do not have either varicose veins or spider veins, you are in the minority as nearly 70% of American women and more than 40% of American men will encounter varicose and spider vein issues before they reach retirement age. As these percentages continue to grow more individuals will likely encounter a venous condition – either spider veins or varicose veins – at some point in your lifetime.
While no one knows the exact cause of spider veins and varicose veins. Several risk factors can cause a person to be more likely to spider veins and varicose vein issues. The following risk factors increase your chances of developing the condition but do not always guarantee you will develop spider veins or varicose veins. Conversely, the absence of all of the following risk factors does not ensure you will never develop the condition either.
Risk factors for Developing Varicose and Spider Vein Issues:
The following factors may put one at an increased risk of developing varicose or spider veins:

Heredity – If someone in your family has had varicose veins, there is an increased possibility that you will develop them as well. Statistics show that approximately 50% of the people who have varicose veins have a family history of them.

Gender – Women tend to get varicose veins and spider veins about twice as often as men. Hormonal changes that occur during puberty, pregnancy, menopause, or with the use of birth control pills may raise a woman’s chances of developing vein conditions. Female hormones tend to relax the vein walls, causing the valves to separate and become ineffective in stopping the backflow of blood in the veins. Hormone replacement therapy may also lead to an increased risk.

Age – The possibility of developing spider veins or vericose veins increases as you age, with most cases being reported in patients between the ages of 40 and 70. Aging causes wear and tear on the veins, increasing the possibility that veins and/or valves will have a failure.

Obesity – Excessive weight puts added pressure on your entire circulatory system, including your veins and will cause your heart to work harder to push the blood through the aggravated veins.

Pregnancy – During pregnancy, a growing fetus puts extra demands on the circulatory system and extra pressure on your veins as well. Varicose veins may appear for the first time or existing ones may worsen. (See PREGNANCY) Often, varicose veins that appear for the first time may actually get better within 3 to 12 months after the delivery.

Lifestyle – Standing or sitting for an extended period of time, especially with your legs bent or crossed, may raise your risk for varicose or spider veins. Staying in one position for a long time may weaken the walls of your veins and aggravate existing inflamed veins. People that lead a more sedentary lifestyle or have an occupation that involves a lot of sitting or standing may be more at an increased risk to vein disorders.

Injury – An injury, especially to the leg, could damage veins or valves and increase the risk of varicose veins or spider veins.

Risk Factors at www.1800varicose.com

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I thought this was an interesting article:

If you have varicose veins, special support stockings may ease some of your symptoms, such as aching legs.

There are two types of support stockings for varicose veins.

* If you have varicose veins in your lower leg, you can wear short stockings that cover your leg from your ankle to your knee.
* If your varicose veins are in your upper leg (along the front of your thigh for instance), you can wear the longer type of stockings. These cover your whole leg. Some have open toes and some have closed toes.

All support stockings for varicose veins are tighter at the ankle than at the top. This means they apply more pressure at the bottom of your leg, which helps to squeeze blood upwards towards your heart.

Here are some tips on using support stockings for varicose veins.

* Support stockings come in different sizes, and some are more elastic than others. Larger, more uncomfortable veins need tighter stockings. Your doctor or pharmacist can help you get the right size and fit.
* It’s best to put the stockings on in the morning before you get out of bed. This is because your varicose veins are least likely to be full of blood and swollen after you’ve been lying down. As soon as you stand up, the blood pools in these veins. This makes it harder for the stockings to keep your veins from bulging.
* The stockings gradually get less elastic the more you wash them, so you’ll need to get new ones every few months.

Some people find that their legs feel better if they wear support stockings and look better when they take them off. However, there is no good-quality research to show that stockings help with symptoms or improve the way your legs look.

Source:

http://www.guardian.co.uk/lifeandstyle/besttreatments/varicose-veins-things-to-know-about-support-stockings

Ellis H, Taylor P. Elastic stockings. Greenwich Medical Media. 1999; 50-51.
© BMJ Publishing Group Limited (”BMJ Group”) 2009

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The following is excerpted from the NIH’s excellent page describing how varicose veins are treated.

Medical Procedures
Medical procedures are done either to remove varicose veins or to close them. Removing or closing varicose veins usually doesn’t cause problems with blood flow because the blood starts moving through other veins.

You may be treated with one or more of the procedures listed below. Common side effects right after most of these procedures include bruising, swelling, skin discoloration, and slight pain.

The side effects are most severe with vein stripping and ligation (li-GA-shun). Although rare, this procedure can cause severe pain, infection, blood clots, and scarring.

Sclerotherapy
Sclerotherapy (SKLER-o-ther-a-pe) uses a liquid chemical to close off a varicose vein. The chemical is injected into the vein to cause irritation and scarring inside the vein. The irritation and scarring cause the vein to close off, and it fades away.

This procedure often is used to treat smaller varicose veins and spider veins. It can be done in your doctor’s office, while you stand. You may need several treatments to completely close off a vein.

Treatments are typically done every 4 to 6 weeks. Following treatments, your legs will be wrapped in elastic bandaging to help healing and decrease swelling.

Microsclerotherapy
Microsclerotherapy (MI-kro-SKLER-o-ther-a-pe) is used to treat spider veins and other very small varicose veins.

A small amount of liquid chemical is injected into a vein using a very fine needle. The chemical scars the inner lining of the vein, causing it to close off.

Laser Surgery
This procedure applies light energy from a laser onto a varicose vein. The laser light makes the vein fade away.

Laser surgery is mostly used to treat smaller varicose veins. No cutting or injection of chemicals is involved.

Endovenous Ablation Therapy
Endovenous ablation (ab-LA-shun) therapy uses lasers or radiowaves to create heat to close off a varicose vein.

Your doctor makes a tiny cut in your skin near the varicose vein. He or she then inserts a small tube called a catheter into the vein. A device at the tip of the tube heats up the inside of the vein and closes it off.

You will be awake during this procedure, but your doctor will numb the area around the vein. You usually can go home the same day as the procedure.

Endoscopic Vein Surgery
For endoscopic (en-do-SKOP-ik) vein surgery, your doctor will make a small cut in your skin near a varicose vein. He or she then uses a tiny camera at the end of a thin tube to move through the vein. A surgical device at the end of the camera is used to close the vein.

Endoscopic vein surgery usually is used only in severe cases when varicose veins are causing skin ulcers. After the procedure, you usually can return to your normal activities within a few weeks.

Ambulatory Phlebectomy
For ambulatory phlebectomy (fle-BEK-to-me), your doctor will make small cuts in your skin to remove small varicose veins. This procedure usually is done to remove the varicose veins closest to the surface of your skin.

You will be awake during the procedure, but your doctor will numb the area around the vein. Usually, you can go home the same day that the procedure is done.

Vein Stripping and Ligation
Vein stripping and ligation typically is done only for severe cases of varicose veins. The procedure involves tying shut and removing the veins through small cuts in your skin.

You will be given medicine to temporarily put you to sleep so you don’t feel any pain during the procedure.

Vein stripping and ligation usually is done as an outpatient procedure. The recovery time from the procedure is about 1 to 4 weeks.

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