Varicose Veins

Is There a Difference Between Spider Veins and Varicose Veins?

legs (1)Though spider veins and varicose veins are both classified as vein disorders, there are some distinct differences between them.

What do They Look Like?

Spider veins are small, wispy, web-like veins on the skin surface, usually less than one millimeter in diameter. They may be purple or red, and often appear in clusters or nests, which may look like a bruise. Varicose veins are larger veins, which often have a blue color and generally bulge under the skin. Both types of veins are visible and one of the primary treatment goals is an improvement in cosmetic appearance.

What Causes Spider Veins and Varicose Veins?

Spider veins are usually inherited. Obesity, female hormones and prolonged sitting or standing are also contributing factors. Varicose veins are most often a result of valves that function incorrectly. Normal valves allow blood to flow in only one direction—out of the leg and towards the heart. Faulty valves allow blood to flow backward into the leg, increasing pressure in the veins. This increased pressure dilates and elongates the vein, causing it to protrude and appear curved or twisted.

Do These Veins Cause Problems?

Spider veins do not usually cause symptoms, and are primarily treated to improve appearance. Varicose veins often cause heaviness, aching or pressure. They can also cause fatigue, and sometimes restless or jittery legs and itching. Swelling may be a result of vein insufficiency, but, often involves malfunctioning veins deep in the leg as well. Relief of discomfort is the reason most varicose veins are treated.

How Are Varicose Veins Treated?

Varicose veins are almost always treated in the office with minimally invasive techniques. Sclerotherapy—the injection of a dilute solution into the vein, shutting it down—can be used to treat smaller veins, while larger veins may also be treated with sclerotherapy, ablation of faulty veins and excision or mini-phlebectomy (removal) are also commonly performed treatments. The goal is to divert blood from abnormal veins into nearby normal veins, which easily accommodate the extra load. These procedures involve minimal pain and little or no down time. If you are interested in treating your spider or varicose veins, please call the Emory Vein Center for treatment by a board certified vascular surgeon.

About Dr. Rheudasil

rheudasil-j-mark (1)J. Mark Rheudasil, MD, graduated magna cum laude from Abilene Christian University in Texas and he earned his medical degree from the University of Texas Southwestern Medical School in Dallas in 1983. He completed a general surgery internship and residency program at Emory University in Atlanta, Georgia and also completed a fellowship in vascular surgery at Emory University in 1989.

Dr. Rheudasil is a board certified vascular surgeon. He is a Fellow of the American College of Surgeons and a member of the Society for Vascular Surgery and the American Venous Forum. He is also a member the Southern Association for Vascular Surgery and is a past President of the Georgia Vascular Society and the Atlanta Vascular Society.

Your Aching Legs: Minimizing Varicose Vein Pain and When It’s Time to Consider Treatment

vv2-calloutThough they may not be preventable, there are ways to reduce the likelihood that you will develop varicose veins. If you already have them, treatment can almost always be performed in the office with minimally invasive techniques with very little discomfort or down time.

Join us Tuesday, September 8, at 12:00 p.m. for a live, interactive web chat about “Your Aching Legs: Minimizing Varicose Vein Pain and When It’s Time to Consider Treatment”.

Dr. Rheudasil will be available to answer questions and discuss various topics about varicose vein pain prevention and treatment options. During this interactive web chat, you’ll be able to ask questions and get real-time answers from our Emory Healthcare professional.

Register now for our September 8 chat.

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rheudasil-j-mark (1)About Dr. Rheudasil

Mark Rheudasil, MD, graduated magna cum laude from Abilene Christian University in Texas and he earned his medical degree from the University of Texas Southwestern Medical School in Dallas in 1983. He completed a general surgery internship and residency program at Emory University in Atlanta, Georgia and also completed a fellowship in vascular surgery at Emory University in 1989.

Dr. Rheudasil is a board certified vascular surgeon. He is a Fellow of the American College of Surgeons and a member of the Society for Vascular Surgery and the American Venous Forum. He is also a member the Southern Association for Vascular Surgery and is a past President of the Georgia Vascular Society and the Atlanta Vascular Society.

Can I Inherit Varicose Veins?

vein_ 7-29Varicose veins are large, abnormal blood vessels visible on the skin surface. They almost always affect the legs, and often appear as bulging, twisted blue veins. Many theories exist for why varicosities occur in veins, but the consensus is that weak vein walls and valves are the main cause. Inside your larger veins are valves that allow blood to flow toward the heart, but, open to prevent backward flow of blood toward the feet (reflux).

If the valves don’t function properly, excess blood will remain in the veins, raising the pressure and causing them to swell and distend. Some veins will enlarge enough to weaken the walls and become varicose. Though rarely dangerous, varicose veins can often cause symptoms of aching, weakness or heaviness.

The Role of Genetics

Heredity is one of the most important risk factors for developing varicose veins and spider veins. Your risk of developing varicose veins is increased if a close family member has the condition, suggesting a relationship between genetics and the onset of varicose veins.

So just how do genetics affect your veins?

• Some people can inherit problems such as having too few valves or valves that do not function properly.

• Some people may be born with abnormalities of the vein wall. The resulting weakness may predispose the valves to separate and become leaky.

Some groups of people can be easily identified as inheriting varicose veins. Varicose veins during pregnancy are more likely to affect women who have a family history of varicose veins. Varicose veins that occur in younger patients (20s or even younger) are also believed to be inherited in most cases.

Prevention

If you know that close family members have had varicose veins and that you already have a strong genetic predisposition for varicose veins, you can take steps to prevent their onset.

• Lifestyle changes – Take measures to keep your legs strong and in good shape. Walking and exercising helps promote venous circulation by pumping the blood out of your legs and back up to your heart. Adopting a healthy diet can be helpful in keeping weight off and preventing varicose veins. Eating a low-salt diet helps reduce water retention and swelling.

• Compression stockings – Wearing medium, graduated-compression stockings daily, especially if you spend a lot of time on your feet, will do wonders at preventing the development and/or progression of varicose veins.

• See your doctor and get treatment – Get an evaluation to see if you have venous insufficiency. Endovenous ablation is a minimally invasive office-based treatment that is very effective in relieving superficial venous insufficiency. You can check out my recent blog on The Latest in Vein Treatment Technology for more information.

About Dr. Rheudasil

rheudasil-j-markJ. Mark Rheudasil, MD, graduated magna cum laude from Abilene Christian University in Texas and he earned his medical degree from the University of Texas Southwestern Medical School in Dallas in 1983. He completed a general surgery internship and residency program at Emory University in Atlanta, Georgia and also completed a fellowship in vascular surgery at Emory University in 1989.

Dr. Rheudasil is a board certified vascular surgeon. He is a Fellow of the American College of Surgeons and a member of the Society for Vascular Surgery and the American Venous Forum. He is also a member the Southern Association for Vascular Surgery and is a past President of the Georgia Vascular Society and the Atlanta Vascular Society.

Dr. Rheudasil has published articles in several medical journals including The Journal of Vascular Surgery, American Surgeon and The Journal of the Medical Association of Georgia. He has lectured at the regional and national level on a variety of topics in vascular surgery.

The Latest in Vein Treatment Technology

Varicose Vein TreatmentVein problems are incredibly common. The National Institutes of Health estimates that 60% of all men and women suffer from some form of vein disorder. Specifically, 80 million Americans suffer from varicose veins and/or spider veins. A number of factors contribute to vein problems, including genetics, being overweight, female, pregnant and/or spending a lot of time on your feet.

The fact that modern-day treatment is relatively simple is great news to the millions of Americans who suffer from varicose veins. Veins are designed to return blood from the legs back to the heart. When veins become varicose or enlarged, blood will pool in these superficial veins rather than efficiently emptying out of the legs. This excess blood, and the pressure that results, stretches and dilates the veins and often leads to symptoms of aching, heaviness and fatigue.

Treatment for vein problems has become much less invasive over the last 10 years. In the past, treatment meant surgery: incisions, anesthesia, pain, and a long recovery. Now, vein issues can be treated using more effective and less invasive procedures.

One interesting new treatment for varicose veins is known as sclerotherapy, which involves injecting a small volume of liquid into the diseased vein. The sclerosing solution causes the abnormal vein to close. This procedure uses a very fine needle that is nearly pain-free, and extremely effective in treating varicose veins.

Another interesting treatment is known as endovenous laser ablation therapy (EVLT). In EVLT, a thin laser fiber is inserted into the diseased vein. Laser energy is then delivered through a fiber, causing the vein to close. The loss of the diseased vein does not compromise the circulatory system, since blood will flow through other healthy veins after the procedure.

The best part about these new technologies? There is no down time with sclerotherapy or ablation therapy. A compression stocking may be required for a few days, but, normal activity is encourag

If you have bothersome veins and would like evaluation by one of our board-certified vascular surgeons, please contact the Emory Vein Center for a consultation. Your legs will thank you!

Call 404-778-VEIN or request an appointment online today!

About Dr. Rheudasil

Mark Rheudasil, MDMark Rheudasil, MD, graduated magna cum laude from Abilene Christian University in Texas and he earned his medical degree from the University of Texas Southwestern Medical School in Dallas in 1983. He completed a general surgery internship and residency program at Emory University in Atlanta, Georgia and also completed a fellowship in vascular surgery at Emory University in 1989.

Dr. Rheudasil is a board certified vascular surgeon. He is a Fellow of the American College of Surgeons and a member of the Society for Vascular Surgery and the American Venous Forum. He is also a member the Southern Association for Vascular Surgery and is a past President of the Georgia Vascular Society and the Atlanta Vascular Society.

Dr. Rheudasil has published articles in several medical journals including The Journal of Vascular Surgery, American Surgeon and The Journal of the Medical Association of Georgia. He has lectured at the regional and national level on a variety of topics in vascular surgery.

Takeaways from Dr. Rheudasil’s Vein Live Chat

Varicose Vein ChatThanks to everyone who joined us Tuesday, April 14 for the live online chat entitled “What causes varicose veins or spider veins?,” hosted by Emory Vein Center physician J. Mark Rheudasil, MD.

While it’s important to look your best, it’s also important to feel your best. Males, females, the young and the old. Varicose veins can affect anyone. So have you ever wondered what causes those unsightly bulges and twists to appear on your legs? Check out the conversation by viewing the chat transcript! Here are just a few highlights from the chat:

Question: How helpful are compression stockings for preventing and/or slowing down development of varicose veins?

Mark Rheudasil, MDDr. Rheudasil: Great question! Compression stockings are helpful in minimizing the progression of varicose veins. They do not in most cases, however, prevent varicose veins from developing. They are helpful in reducing the symptoms associated with varicose veins. I recently published a blog on this very topic. You can check it out here.

 

Question: I am 4 months pregnant with my first child. My mother has warned me about the spider veins she developed when carrying my brother and me. Is there anything I can do now to lessen my risk for spider veins during and after pregnancy?

Mark Rheudasil, MDDr. Rheudasil: Compression stockings or support hose and frequent leg elevation during pregnancy are the mainstays of treatment. Veins may well worsen during pregnancy and may require prescription stockings. While we usually try to avoid vein treatment during pregnancy, we can help you get in the correct stockings and advise regarding symptom relief, etc . Feel free to call 404-778-VEIN to make an appointment.

Question: For several months, I have had pretty bad pain my my legs and sometimes they even swell. I haven’t talked to my doctor about it yet. Should I start with my PCP or see a vascular surgeon to determine the cause?

Mark Rheudasil, MDDr. Rheudasil: Good question, Junior. If you don’t have obvious/visible varicose veins, then swelling could be from multiple sources. A general medical evaluation by your PCP would be a great place to start.

 

Question: I am 22 and have spider veins. They are not lumpy but are very obvious. They are on the backs of my legs and mainly on the left leg. I am so worried that because I am only 22 they are going to get really bad. Am I too young to seek treatment?

Mark Rheudasil, MDDr. Rheudasil: You’re never too young to be evaluated for veins that bother you. We’re happy to see you and make recommendations for treatment! Here’s our online appointment request form.

 

If you missed this chat, be sure to check out the full list of questions and answers on the web transcript. For more information or to request an appointment with a vascular surgeon, visit emoryhealthcare.org/veincenter.

If you have additional questions for Dr. Rheudasil, feel free to leave a comment in our comments area below.

 

 

 

Did Crossing My Legs Cause These Veins?

Varicose Veins Leg Crossing“Did crossing my legs cause these veins?” This is one of the most common questions I hear when I evaluate patients with varicose veins. The simple answer is NO! In most cases, varicose veins are inherited. Being overweight, female, pregnant and/or spending a lot of time on your feet are common risk factors. Veins are designed to return blood from the legs back to the heart. When veins become varicose or enlarged, blood will pool in these superficial veins rather than efficiently emptying out of the legs. This excess blood, and the pressure that results, stretches and dilates the veins and often leads to symptoms of aching, heaviness and fatigue.

Early treatment should include:

  • Leg elevation and compression stockings
  • Exercise – something as simple as walking may help symptoms considerably

When symptoms become more severe, your doctor may recommend more specific treatment. Minor procedures used to treat varicose veins are almost always performed in the office with little or no recovery time. The goal is to close the abnormal vein and relieve the pressure, and often the unsightly appearance of the varicose veins.

If you have bothersome veins and would like evaluation by one of our board-certified vascular surgeons, please contact the Emory Vein Center for a consultation. Your legs will thank you!

Call 404-778-VEIN or request an appointment online today!

About Dr. Rheudasil

Mark Rheudasil, MDMark Rheudasil, MD,  graduated magna cum laude from Abilene Christian University in Texas and he earned his medical degree from the University of Texas Southwestern Medical School in Dallas in 1983. He completed a general surgery internship and residency program at Emory University in Atlanta, Georgia. Dr. Rheudasil also completed a fellowship in vascular surgery at Emory University in 1989.

Dr. Rheudasil is a diplomat of the American Board of Surgery and is a board certified vascular surgeon. He is a Fellow of the American College of Surgeons and a member of the International Society for Cardiovascular and Endovascular Surgery, and the North American chapter of the International Society for Cardiovascular Surgery. He is also a member of the Peripheral Vascular Surgery Society, the Southern Association for Vascular Surgery, the Emory Association of Vascular Surgery, the Atlanta Vascular Society, and the Georgia Surgical Society. He is also a member of the Medical Association of Georgia, the Medical Association of Atlanta, and the Atlanta Clinical Society. He is also certified as a Registered Vascular Technologist.

Dr. Rheudasil has published articles in several medical journals including The Journal of Vascular Surgery, American Surgeon and The Journal of the Medical Association of Georgia. He has lectured at the regional and national level on a variety of topics including current reviews of vascular surgery.

What Causes Varicose Veins or Spider Veins? – Join Us for a Live Web Chat!

Varicose Spider VeinsWhile it’s important to look your best, it’s also important to feel your best. Males, females, the young and the old. Varicose veins can affect anyone. So have you ever wondered what causes those unsightly bulges and twists to appear on your legs?

Join us on Tuesday, April 14, at 12:00 p.m. for an interactive web chat discussing the causes of varicose veins and spider veins. Dr. Rheudasil will be available to answer questions and discuss various topics, including the causes, prevention and treatment of varicose veins.

During this interactive web chat, you’ll be able to ask questions and get real-time answers from our Emory Healthcare professional.

REGISTER NOW for our April 14 chat at emoryhealthcare.org/mdchats.

About Dr. Rheudasil

Mark Rheudasil, MDMark Rheudasil, MD, graduated magna cum laude from Abilene Christian University in Texas and he earned his medical degree from the University of Texas Southwestern Medical School in Dallas in 1983. He completed a general surgery internship and residency program at Emory University in Atlanta, Georgia. Dr. Rheudasil also completed a fellowship in vascular surgery at Emory University in 1989.

Dr. Rheudasil is a diplomat of the American Board of Surgery and is a board certified vascular surgeon. He is a Fellow of the American College of Surgeons and a member of the International Society for Cardiovascular and Endovascular Surgery, and the North American chapter of the International Society for Cardiovascular Surgery. He is also a member of the Peripheral Vascular Surgery Society, the Southern Association for Vascular Surgery, the Emory Association of Vascular Surgery, the Atlanta Vascular Society, and the Georgia Surgical Society. He is also a member of the Medical Association of Georgia, the Medical Association of Atlanta, and the Atlanta Clinical Society. He is also certified as a Registered Vascular Technologist.

Dr. Rheudasil has published articles in several medical journals including The Journal of Vascular Surgery, American Surgeon and The Journal of the Medical Association of Georgia. He has lectured at the regional and national level on a variety of topics including current reviews of vascular surgery.

Will Exercise Hurt My Varicose Veins?

exercise varicose veinVaricose veins are commonly associated with prolonged standing or sitting, pregnancy, a family history of vein problems, and with being overweight. Regular exercise and staying fit is helpful in preventing varicose veins, but what if you already have them? While some exercises are helpful, others may not be so beneficial and may even cause veins to worsen.

Running or high-impact exercises may make symptoms worse and aggravate varicose vein swelling. If you are an avid runner, try running on grass or on a softer surface like a synthetic track to reduce the stress on your joints and feet, and the strain on your legs. If possible, wear compression stockings when you run.

Weightlifting can increase abdominal pressure and straining during heavy exercise can reduce the flow of blood out of your legs returning to your heart. Blood can then pool and increase pressure in your leg veins leading to vein dilation and possible damage to delicate valves in your veins. If you do lift weights, consider higher reps with less weight. Try and exercise with your legs at the same level or above your heart. Don’t hold your breath when lifting—exhale when lifting and inhale when lowering weights. Other exercises which may worsen varicose veins include: sit ups, squats, lunges and crunches. The increased abdominal pressure during these exercises may increase pressure in the leg veins and contribute to varicose vein enlargement.

What are good exercises for your veins?

  1. Walking- The single BEST exercise for your lower extremity circulation. This low-impact activity will keep you fit while stretching and strengthening your calf muscles. This will help pump the blood out of your veins and improve blood return back to the heart.
  2. Cycling or using a stationary bike- These exercises also work the calf muscles and improve flow in the leg veins without putting too much stress on your bones and joints.
  3. Elliptical- Designed to mimic running motion and reduce joint stress.
  4. Swimming- An excellent activity for patients with varicose veins because the legs are horizontal, the muscles are exercising, and the external pressure of the water in the pool may even help your legs feel better.

What if I can’t exercise due to pain from my varicose veins?

  1. Rotate your ankles and rock your feet back and forth on the ground. This simple activity will increase the blood flow in your calf veins and reduce the risk of clotting. It is especially helpful when sitting for extended periods of time or on an airplane.
  2. Wear compression stockings. The external pressure on your legs reduces blood pooling in your calf veins. Knee high stockings are generally sufficient and are also quite beneficial during periods of prolonged standing or sitting, and during pregnancy.
  3. Limit wearing high heels as much as possible. The position of the foot in heels reduces calf muscle activity and impairs vein flow.
  4. Get rid of a few excess pounds. Extra weight puts additional pressure on your veins, increasing the size and symptoms of varicose veins.

In summary, patients with varicose veins can often improve the symptoms of their veins and reduce the likelihood of worsening with a few simple steps. Stay active. Begin a low-impact exercise program (such as walking or swimming) and lose a few pounds. Work your leg muscles occasionally when sitting or standing and wear compression stockings when you reasonably can. If symptoms persist, or if your veins are getting worse, give us a call and let us evaluate your leg veins and discuss treatment options.

Call 404-778-VEIN or visit www.emoryhealthcare.org/veincenter to request an appointment!

About Dr. Rheudasil

Mark Rheudasil, MDMark Rheudasil, MD,  graduated magna cum laude from Abilene Christian University in Texas and he earned his medical degree from the University of Texas Southwestern Medical School in Dallas in 1983. He completed a general surgery internship and residency program at Emory University in Atlanta, Georgia. Dr. Rheudasil also completed a fellowship in vascular surgery at Emory University in 1989.

Dr. Rheudasil is a diplomat of the American Board of Surgery and is a board certified vascular surgeon. He is a Fellow of the American College of Surgeons and a member of the International Society for Cardiovascular and Endovascular Surgery, and the North American chapter of the International Society for Cardiovascular Surgery. He is also a member of the Peripheral Vascular Surgery Society, the Southern Association for Vascular Surgery, the Emory Association of Vascular Surgery, the Atlanta Vascular Society, and the Georgia Surgical Society. He is also a member of the Medical Association of Georgia, the Medical Association of Atlanta, and the Atlanta Clinical Society. He is also certified as a Registered Vascular Technologist.

Dr. Rheudasil has published articles in several medical journals including The Journal of Vascular Surgery, American Surgeon and The Journal of the Medical Association of Georgia. He has lectured at the regional and national level on a variety of topics including current reviews of vascular surgery.

Will Compression Stockings Help My Varicose Veins?

Compression SocksCompression stockings are a mainstay of conservative management for varicose veins that are large enough to cause symptoms.

What Do Compression Stockings Do?

  • Compression stockings exert external pressure on the legs, reducing the pooling of blood in varicose veins and improving the vein circulation.
  • The pressure is highest at the ankle/foot and gradually loosens higher on the leg.
  • Stockings often improve symptoms of varicose veins and may slow progression.
  • Some insurance companies require a trial of compression stockings and conservative management before they approve more definitive therapy.

What Will Compression Stockings Not Do?

  • Eliminate or cure varicose veins. They will still be visible when you remove the stockings. Getting rid of your veins will require corrective treatment.
  • They will not be easy to get on and off, and they will be more uncomfortable to wear in the warm weather months.

Does Everyone With Varicose Veins Need Compression Stockings?

  • No. Small varicose veins that are not causing symptoms do not need stockings.
  • For mild symptoms, over-the-counter stockings or panty hose may be fine, and may offer relief for aching or heaviness.
  • Prescription stockings, though considerably more expensive, are often recommended for more severe veins or to help reduce swelling.

When Do I Wear Compression Stockings? How High Should They Go?

  • Stockings should generally be worn when you are standing or sitting. They do not need to be worn while sleeping or when you are able to elevate your legs.
  • Some patients feel better wearing stockings during exercise. Many athletes now routinely wear elastic support while training or competing.
  • Knee high stockings are adequate for most patients, unless there are large veins or significant symptoms higher on the leg.

So, if you have varicose veins, give stockings a try. They may make your legs feel much better. If they don’t relieve enough of your symptoms or if you want more definitive treatment, consult a vascular surgeon at Emory Vein Center. Call 404-778-VEIN or visit emoryhealthcare.org/veincenter to request an appointment.

About Dr. Rheudasil

Mark Rheudasil, MDMark Rheudasil, MD,  graduated magna cum laude from Abilene Christian University in Texas and he earned his medical degree from the University of Texas Southwestern Medical School in Dallas in 1983. He completed a general surgery internship and residency program at Emory University in Atlanta, Georgia. Dr. Rheudasil also completed a fellowship in vascular surgery at Emory University in 1989.

Dr. Rheudasil is a diplomat of the American Board of Surgery and is a board certified vascular surgeon. He is a Fellow of the American College of Surgeons and a member of the International Society for Cardiovascular and Endovascular Surgery, and the North American chapter of the International Society for Cardiovascular Surgery. He is also a member of the Peripheral Vascular Surgery Society, the Southern Association for Vascular Surgery, the Emory Association of Vascular Surgery, the Atlanta Vascular Society, and the Georgia Surgical Society. He is also a member of the Medical Association of Georgia, the Medical Association of Atlanta, and the Atlanta Clinical Society. He is also certified as a Registered Vascular Technologist.

Dr. Rheudasil has published articles in several medical journals including The Journal of Vascular Surgery, American Surgeon and The Journal of the Medical Association of Georgia. He has lectured at the regional and national level on a variety of topics including current reviews of vascular surgery.

Free Vein Screenings

Free Vein ScreeingDo you have trouble with varicose or spider veins? The Emory Vein Center is hosting a free vein screening event on February 6! Join us for an individualized consultation with a board-certified vascular surgeon and find out if vein treatment is right for you. In most cases, treatment is covered by insurance.

Event Details

  • WHEN: Friday, February 6, 1 p.m. – 4 p.m.
  • WHERE:  Emory Clinic, Vascular Surgery Department
    Building A, 3rd Floor
    1365 Clifton Road NE
    Atlanta, GA 30322

For more information, call 404-778-VEIN. RSVPs are encouraged, but not required.