Broadly speaking, superficial veins on the legs fall into 2 categories:

“Subcuticular” (spider and blue veins) and “subcutaneous’ (varicose-bulging veins).

The very tiny-almost hair thin purple/reddish veins you see on your legs are called ‘telangiectasia’ – it’s a cool word but we’ve decided to call them “spider” veins to keep it simple. Because, let’s be honest, they look a bit like spiders. They are the most superficial and live just below the surface of the skin.

These veins are completely harmless and will never develop into bulging (varicose) veins. However they can be quite unsightly and can be eliminated with sclerotherapy injections. This usually takes 2 or 3 injections (2 weeks apart) and is quite effective.

The blue, (not bulging) veins you often see just under the skin are called reticular veins. We all have a greater or lesser degree of these veins. They are more visible in light skinned people and more visible in females than males. They are also harmless but are usually the underlying source of the overlying spider veins. They are also best treated with sclerotherapy (liquid or foam).

The last category are the varicose veins. These are the veins you see bulging on the skin. These veins are generally larger and have a problem with the valves within them that control the flow of blood.

The bulging portions on the skin are just the branches and “low lying fruit” or rather… just the “ tip of the iceberg.” The real problem is below the skin in the trunk of these veins. These veins can be a problem-functionally and pose significant cosmetic undesirability. The state-of-the-art treatment for these veins is the endovenous laser procedure. (EVLA or EVLT) Microphlebectomy is also useful in removing some of these veins that the laser can’t reach.

The reality is that most patients have a combination of all of these veins and they can all be successfully treated.

Sclerotherapy is just a fancy word for a procedure that involves injecting a substance into a vein which causes it to shrink up and eventually disappear. The substance we inject is called a “sclerosant”. There are many on the market but the most sophisticated, regulated and most commonly used substance is called sodium tetradecyl sulfate (Tromboject) – it’s been around since 1940. Once injected into very small veins this substance causes the vein to get inflamed ( this is why the spider veins often look more red for a bit after treatment) then shrink and eventually be dissolved by your own body over 3-4 weeks. Another substance we use is called Sclerodex. It is basically a mixture of sugar and salt. Both of these substances are very safe.They can occasionally cause a temporary skin reaction but this is uncommon. Sometimes a bit of light brown pigment will form over the vein. This too is uncommon and will resolve 95% of the time.

Sclerotherapy has been around for about a hundred years. It’s important to remember that spider and reticular ( blue, non bulging ) veins often need multiple treatments to fully disappear. This is not a marketing scheme just a reflection of our bodies rich and overabundant blood supply. But rest assured, these tiny (but often very prominent) veins serve no known, useful purpose and can safely and permanently be eliminated.

Spring is coming. It’s time to get “sclerosing”. Love your shorts again!

No…and yes.

In general varicose (bulging) veins that aren’t working will create problems, but they don’t generally create a “health risk”. By that I mean they don’t put you at risk for life threatening problems. People with varicose veins do; however, have a very slightly increased (10% over the general population) chance of developing a Deep Venous Thrombosis (clot) – this is a clot in the deep venous system of your leg. (Remember the deep system, which you can’t see, carries most of the blood from your leg back to your heart) DVT’s, if left untreated, can dislodge, travel in your blood and cause strokes. When these clots are detected we treat patients with blood thinners for up to 3 months until the clot resolves.

So what does happen to untreated varicose veins?

Clots may form in the bulging superficial veins – this is called “thrombophlebitis” and will cause warmth and tenderness over the vein, but will not cause strokes or other problems.

Varicose veins can eventually cause lower leg swelling (edema), skin breakdown (ulceration) and skin pigmentation (stasis dermatitis). Varicose veins may also bleed briskly if cut or scraped. All nasty stuff.

Come see us at Durham Vein and Laser Centre and let us tailor a treatment for you.

Love Your Shorts Again.!

Don’t I need those ugly veins?

Actually -no.  Any of the veins you can see in your leg are part of the “superficial system” of veins in your legs. This includes the spider-like clusters of veins (telangiectasia) embedded in the skin, the deeper blue (reticular) veins and even the bulging (varicose) veins you see on your legs. Basically any vein you can see – you can do without, so removing varicose veins is fine because you don’t need those veins. Your legs are endowed with an over abundance of veins – the deeper system of veins in your leg (which you can’t see) is more than capable of delivering venous blood back to your heart.

In fact, shutting down (with laser or sclerotherapy) these visible veins will redistribute the blood from veins that aren’t working and shift it into veins that are working well. This actually helps your circulation.

Picture a beautiful tree or plant that has some branches that aren’t thriving at its perimeter. By pruning those branches,  we help the healthy parts of the plant to do even better.

So, as summer approaches come see us at Durham Vein and Laser Centre. Let us help you love wearing shorts again!

Like most problems in life, vein problems present in various shapes and sizes.

Let’s make one thing straight – vein problems are not your fault. Just as you inherited the unique shape of your nose and outgoing personality from your parents, you also inherited their predisposition to have faulty veins.

It’s all in your genes.

You can make them worse by spending a lot of time standing around, but you didn’t cause those veins to bulge or look like little spiders on your skin anymore than you caused your hair to be brown or your eyes to be blue.

Vein abnormalities come in all shapes and sizes so we have learnt to treat them in all sorts of different ways. The basic underlying problem is the same. Veins look abnormal when the blood flowing through them is disrupted, turbulent or slow. This causes them to bulge (varicose veins) look like blue spaghetti  just under your skin (reticular veins) or just stand out like thin purple/ blue strands of “spider ” like clusters on your skin (spider telangiectasia) .

Laser treatment (EVLA) is usually reserved for the varicose veins that start high in your groin and extend down to below your knees. We often don’t see the trouble at the skin level and therefore need an ultrasound (Venous Doppler) of your leg veins to better understand what’s going on. The blue veins and the spider veins are usually best treated with Sclerotherapy (this is a fancy word for injecting a very small amount of a sclerosing agent into these veins causing them to get inflamed, close off which redirects the blood into better working veins). Sometimes you might need a combination of laser treatment AND sclerotherapy. In some cases, all that is needed is to make a super small incision and take the vein out. This is called Microphlebectomy.

My job as a vein surgeon is to figure out how much or how little of each of these 3 vein problems you have and tailor the right vein treatment for you.

Legs are to be celebrated. Love your shorts again!