Varicose veins are large swollen, twisted veins that appear like a rope and make the skin bulge out. They are blue or purple in color and are often seen on thighs and calves.

Spider veins, also known as telangiectasia, are veins that surround the varicose veins and are red, blue, or purple wriggly lines, often branching out from a central locus resulting in a spider-like appearance.

How Do Varicose and Spider Veins Develop?

Although the condition mentions veins, varicosity can occur in arteries as well. The heart pumps oxygenated blood to the entire body through arteries, and it brings back the deoxygenated blood through veins. The veins have one-way valves; if these valves do not close properly, blood can leak back into the lower part of the vein rather than flowing towards the heart. Over time, more blood gets pooled in the veins, making them larger and weaker by stretching their walls. This is how varicose veins develop.

Spider veins arise from varicose veins. It is believed that the pool of deoxygenated blood collected in the varicose veins causes a state of anoxia (complete absence of oxygen), which triggers the production of vascular endothelial growth (VEGF)- a signaling molecule that triggers vascular neogenesis (formation of new blood vessels). This causes small vessels to bulge and branch out from the varicose veins, giving them a spider-like appearance.

Who Can Get Affected With Varicose and Spider Veins?

It is estimated that nearly ⅓ rd of the population develop varicose or spider veins at some point in their life, usually between the age of 30 and 50. Certain factors predispose the chances of developing them; they are -

Gender - Females are four times more likely to develop varicose and spider veins due to certain hormones, which stretch the walls of the veins.
Family History - Genetics and ethnicity play an important role in the development of varicose veins; it is reported that 90% of people suffering from spider veins have a positive family history, and non-Hispanic whites were at a higher risk compared to other ethnicities.
Lifestyle - People in jobs that require them to stand or sit for long periods of time develop this condition. They are also common in patients suffering from morbid obesity and tobacco addiction.
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Pregnancy - During pregnancy, the body goes through extreme hormonal fluctuations; along with this, the developing uterus also puts extra pressure on the veins, which often causes temporary varicosity. It usually goes away within a few months after childbirth.

Why Are Varicose and Spider Veins Commonly Seen on Legs?

Veins collect deoxygenated blood from the heart from all over the body, technically speaking, varicose veins can develop anywhere, but they are often seen in the legs because blood from the legs flows to the heart against gravity for a very long distance compared to other organs. This, combined with incompetent valves, increases the chances of varicose and spider veins in the legs.

When Is the Appropriate Time to Consult the Doctor?

Varicose and spider veins are usually not dangerous; most often, they are a cosmetic concern; however, one should reach out to a clinician if the following symptoms occur-

If the vein is painful to touch, it can be a sign of a blood clot.
The sudden appearance of soreness or rashes on the leg.
Change in skin color at the location of varicosity.
If there is bleeding at the site of the varicose vein.

How Are Varicose Veins and Spider Veins Diagnosed?

Physical examination is sufficient for initial diagnosis; this will be followed with any of the below-mentioned investigations -

Ultrasound - It helps to see the structures beneath the skin surface. Ultrasound combines the Doppler effect to get the images of blood vessels, determine the velocity of blood and identify any blocks or leaky valves that will obstruct blood flow.
Venogram- This is another technique to view the blood vessels; the radiologist will inject a special dye into the vein that will show up on the X-ray. This is done because a conventional X-ray only shows defects in the bones; the special dye will mimic the radiopaque nature of the bone and reflect any blood clots, blockages, and other vascular problems.

How Are Varicose or Spider Veins Treated?

Different treatments are available for varicose and spider veins; the clinician will decide after careful evaluation. Some of the options available are -

Sclerotherapy - The clinician will inject a solution into the vein, which will make the veins become more fibrous over time; the vessels fade and get reabsorbed in the body.
Laser Therapy - Also known as endovenous thermal ablation, the surgeon will use a catheter and a laser to cut off the damaged vein.
Microphlebectomy - The damaged portion of the vein is extracted by making minute skin incisions.
Thermocoagulation - A small needle is inserted into the damaged vein, and heat is generated through it with a high-frequency pulse that occludes the veins by thermocoagulation. The vessel resorbs and eventually fades away.

Is the Treatment for Varicose and Spider Veins Permanent?

The damaged vein seals off after surgery, but over time new varicose veins will develop if the underlying cause is not addressed. Genetics and family history cannot be controlled, but lifestyle changes and a few home remedies can reduce the development of new varicose veins.

What Are the Home Remedies for Varicose and Spider Veins?

Although the below-mentioned suggestions may not completely prevent varicose veins, they can help to some extent -

Do not sit or stand for a long time. Instead, take a 5 minutes break for every 30 minutes of sitting/standing; this will help with blood circulation.
Elevate your legs. It will help the blood in your legs to flow back to the heart.
Stay active and lose weight. This will improve blood circulation and reduce the excess pressure on the veins while pumping blood back to the heart.
Wear compression stockings. These help to compress the veins, thereby improving blood circulation.

What Are the Complications of Varicose Veins?

The most common complication of untreated varicose veins is blood clots. Occasionally, these blood clots get lodged at different locations and can cause life-threatening conditions. Based on the location, there are different types of clotting disorders; they are -

Superficial Thrombophlebitis - Blood clots within the varicose veins are called superficial thrombophlebitis; they are treatable and not dangerous.
Deep Vein Thrombosis - When a blood clot happens in a vein deep inside the body, it is known as deep vein thrombosis.
Pulmonary Embolism - When the blood clot travels into the lungs, it causes pulmonary embolism and is often life-threatening.

Conclusion:

Most varicose and spider veins are not harmful; they are more of an aesthetic concern. Home remedies and lifestyle changes often help in controlling them. However, if any of the symptoms mentioned earlier are observed, it is always best to contact the healthcare provider for further guidance.