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SPIDER VEINSSpider veins and reticular veins are probably one of the most cosmetically annoying problems that women complain of to their vascular surgeon. However, not all of these problems are cosmetic, despite what insurance companies dictate. There are plenty of instances when patients have genuine symptoms because of these issues.WHAT ARE SPIDER AND RETICULAR VEINS? Spider veins are abnormal skin veins that are enlarged. They typically are red or blue-red, and lie within the skin layer. Reticular veins are the larger, blue veins that lie just underneath the skin layer. These veins all serve to take blood back to the main veins, and from there to the heart. The options to treat these conditions include lasers and injection sclerotherapy. Patients with spider veins and reticular veins might not have any symptoms. However, many of these patients may be used to the chronic symptoms that they do not ascribe their symptoms to their vein problem. Such symptoms include leg heaviness, tenderness over a cluster of veins, itching, or a burning sensation. Sometimes, patients will state that they had a suddent and sharp pain, following which a new cluster of veins developed. The risk factors for these types of enlarged veins is the same as for varicose veins.
TREATMENT OPTIONS The options for treatment are either sclerotherapy or laser. Sclerotherapy involves injecting the veins with a solution known as a sclerosant. Essentially, the solution irritates the inside of the vein, causing it to collapse and close down. There are several solutions that are used for this purpose. Sodium Tetrodecol (Sotradecol) is probably the most commonly used solution for sclerotherapy. It is mixed in a concentration of 0.25% to 1%, depending on the size of the vein, and injected into the vein with a 30 or 27 gauge needle. Sotradecol is FDA approved for sclerotherapy, and works well. However, its main side-effects are staining of the skin. Staining is a result of blood coagulating in the vessel after treatment, leaving a small iron deposit that can take the body several months to reabsorb. Other sclerosants that are used include Polidocanol, which works in a similar fashion. Most clinicians think that Polidocanol leads to less staining. Other solutions that are used included glycerin, and hypertonic saline. Another way of treating spider veins and reticular veins is the laser. There are several different wavelength lasers that can treat these veins, including the 940 nm laser, and the 1064 nm laser. In the vein treatment community, the 1064 nm laser is considered by many to be the best choice. However, most people use the 1064 nm laser as an adjunct to sclerotherapy. Alternative remedies for varicose and spider veins are abundent. these treatments are said to both repair and prevent venous insufficiency. Some of these treatments include herbal supplements and vitamins, and they have been used in Europe far more than in the U.S.
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