Spider veins are tiny, red, purple, or blue vessels that also twist & turn. They are visible through the skin and typically visible on the legs and face. They serve no useful purpose in the body. It is estimated that they affect nearly half of adult women in the U.S. If there is significant venous insufficiency present with spider veins, any treatment for the spider or reticular veins is unlikely to provide lasting results. Therefore an experienced physician should carefully examine the patient’s legs before attempting any treatment. Spider veins, without corresponding venous insufficiency, are simply cosmetic issues and are typically treated with sclerotherapy, laser therapy, or lifestyle changes.

Varicose veins are enlarged, twisted and can appear ropey. They are swollen, dark blue or purple blood vessels that you can see and feel beneath the skin. The term commonly refers to the veins on the leg, although they can occur elsewhere too. They form when the valves within a vein weaken and allow some blood to flow backward. The vein can weaken under the strain and balloons outward, which causes the skin to raise. This can cause aching, heaviness, swelling, itching, cramping, restless legs, and discomfort. The right treatment can take care of the discomfort associated with the condition and improve the appearance. If left untreated it can lead to serious circulatory problems and worsen over time.

Understanding Varicose Veins

A varicose vein is a condition that affects 3 in 10 adults. Men are less likely to develop varicose veins than women are. Varicose veins can affect any part of the body, but they commonly occur in the feet and legs, particularly the calves. This is because walking and standing exerts a lot of pressure on the veins in your lower body. This web page seeks to discuss what varicose veins are, types of varicose veins, and how they are diagnosed and treated.

What are Varicose Veins?

Varicose veins are the veins under the skin of your legs, which are twisted or widened. The leg consists of two main veins: the deep veins and the superficial veins. Your leg muscles exert pressure on the deep veins when walking and this carries blood back from the legs to the heart. The superficial veins are under the skin and play a less significant role.

Both the deep veins and superficial veins have valves that prevent blood from flowing down to the legs and instead push it towards the heart. When these one-way valves are damaged, you experience varicose veins. As a result, blood flows down to your legs and causes excessive pressure when standing. The excess pressure causes the veins to expand or widen.

Types of Varicose Veins

  • Trunk varicose veins: In this condition, the veins around the surface of your skin are affected. These veins appear knobbly and thick. They are visible, long, and unpleasant.
  • Reticular varicose veins: Red veins that form a network like pattern.
  • Telangiectasia varicose veins: These are also called spider or thread veins. They are small clusters of red or blue veins that appear on your legs or face. Spider veins are harmless and do not bulge beneath the skin’s surface like trunk varicose veins.

How are Varicose Veins Diagnosed?

To check for varicose veins, your physician will perform a physical exam that includes observing your legs to check whether there is any swelling. Your doctor could also ask you to describe any aching and pain in your legs.

Your physician may also perform an ultrasound test to check whether the valves in your veins are operating normally or whether you have a blood clot. During this exam, a technician passes a hand-held device/ transducer over your skin. The transducer projects images of the veins in your legs to a screen. This way, your physician is able to determine whether you have expanded veins or any kind of swelling.

Treatment of Varicose Veins

In most cases, varicose veins do not require treatment. When treatment is necessary, your physician will recommend up to six months of engaging in regular exercise, using compression stockings, and elevating your leg when resting.

In complicated cases, the most common treatments are:

  • Sclerotherapy- in this procedure, a special foam is used to close your veins
  • Endothermal ablation- in this procedure, the affected veins are sealed by applying heat
  • Ligation and stripping- this is a surgical procedure conducted to remove the problematic veins


These tiny veins are usually caused by the natural aging process of the skin, sun damage, trauma, certain skin disorders such as rosacea, or genetics. The veins can be fine or larger and dark. Visible veins are often considered to be a cosmetic issue. However, they can be found in people with rosacea, liver disease, and more rarely, autoimmune disease. Hormonal changes can also be associated with visible facial veins as well. Our physicians at Virginia Heart & Vascular Institute can help to determine the cause of your visible veins and provide the right cosmetic and medical treatment and prevention plan.

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  • Genetics – The number one risk factor for vein disease is genetics and family history. If you have varicose or spider veins, it’s very likely that someone else in your family also has them. About 80% of patients with vein disease have someone else in their family who has the disease as well.
  • Structural Malfunction – Varicose veins occur when some of the connections between deeper and surface veins of the leg no longer function properly. There are many reasons as to why this happens, but defective and damaged valves within the veins are significant factors.
  • Lifestyle – Pregnancy, jobs that require a lot of standing, as well as a unhealthy lifestyles, can aggravate varicose & spider veins.
  • Making Lifestyle Changes: Losing weight and increasing activity and exercise, and dietary & nutritional plans
    • Preventative Measures: There is no known scientific method for preventing varicose veins, but there are ways of improving your circulation and muscle tone, thereby reducing the risk of developing varicose veins or getting additional ones.
    • Support compression stockings: Provide external graduated counter-pressure to aid in venous blood flow to the heart. They reduce pooling and pressure in the veins and could reduce the risk of forming a deep vein blood clot.
  • Endovenous Laser Treatment (EVL): A breakthrough technology used to treat varicose veins which involves heating the inside of the vein, causing it to seal shut and disappear.
  • Ultrasound-guided Ablation: It’s an alternative to surgical stripping. Used for larger and deeper varicose veins that can’t be treated with the laser for varying reasons, including their visibility, location and morphology. The ultrasound offers your physician the ability to precisely target the exact location to optimize treatment results.
  • Sclerotherapy: Injection treatment used to eliminate small to medium size varicose veins and spider veins. Sclerotherapy is affordable, requires numbing by medication, and there is no downtime associated with this simple procedure. The treatment utilizes a very fine needle to inject a solution, sclerosant, into the varicose or “spider vein”. Most patients compare the discomfort of the needle to an ant bite.
  • Foam Sclerotherapy: Painless procedure that uses a vein light to make veins appear fluorescent in color, after which they are injected with a special foam sclerosant. Treatment of asymptomatic is considered cosmetic and not covered by insurance.

Vein issues can be irritating and even make you feel self conscious because of the cosmetic effects. But it’s important to realize that there are options available to help treat varicose, facial and spider veins. Contact Virginia Heart & Vascular Institute at 703-560-1075 for vein treatment in Fairfax Virginia.