Varicose Vein FAQ's

The Facts

What are varicose veins and spider veins?
Varicose veins are enlarged veins that can be blue, red, or flesh-colored. They often look like cords and appear twisted and bulging. They can be swollen and raised above the surface of the skin. Varicose veins are often found on the thighs, backs of the calves, or the inside of the leg.

Spider veins are like varicose veins but smaller. They also are closer to the surface of the skin than varicose veins. Often, they are red, purple, or blue. They can look like tree branches or spiderwebs with short, jagged lines. They can be found anywhere on the legs and can cover either a very small or very large area of skin

How common are varicose and spider veins?
About 50 to 55 percent of women and 40 to 45 percent of men in the United States suffer from some type of vein problem. Varicose veins affect half of the people 50 years and older.
What causes varicose veins and spider veins?

Any condition that puts excessive pressure on the legs or abdomen can lead to varicose veins. The most common pressure inducers are pregnancy, obesity, and standing for long periods. Being sedentary also may contribute to varicose veins, because muscles that are out of condition offer poor blood-pumping action. The likelihood of forming varicose veins also increases as veins weaken with age. A previous leg injury may damage the valves in a vein which can result in a varicosity. Genetics also plays a role, so if other family members have varicose veins there is a greater chance you will, too. Contrary to popular belief, sitting with crossed legs will not cause varicose veins, although it can aggravate an existing condition.

Spider veins can be caused by the backup of blood. They can also be caused by hormone changes, exposure to the sun, injuries, pregnancy, heredity, weight gain and standing or sitting for long periods of time.

The most common reason for the development of Varicose veins is from Vein Reflux disease.

What is Vein Reflux disease? What is Venous insufficiency?

Vein reflux disease, also known as venous insufficiency, is a medical condition affecting the circulation of blood in the legs. The circulation in the leg is comprised of the arteries and veins. The arteries are blood vessels that bring oxygen-rich blood from the heart down to the legs. The “used” blood then returns up the legs to the heart through separate blood vessels called veins. When standing, the blood in the veins will flow up the leg against gravity. As your leg muscles squeeze, they push blood back to the heart against the flow of gravity. Veins have valves inside them that act as one-way flaps, or check valves, to prevent blood from flowing backward. If the valves break down or become damaged, the blood will fall back on itself. Essentially, the blood will then get “backed up” in the vein and all the branches draining into this vein will also get backed up. Over time, more and more of the blood then “pools” in the veins and its branches causing the veins to stretch and enlarge. The veins closest to the skin are the ones we see as varicose veins. Vein reflux disease is the most common cause of varicose veins. Vein reflux disease is a progressive medical condition and may cause your symptoms to worsen.

What are the signs and symptoms of varicose veins?

Varicose veins can often be seen on the skin. Some other common symptoms of varicose veins in the legs include:

  • Aching pain that may get worse after sitting or standing for a long time
  • Throbbing
  • Cramping (particularly at night)
  • Heaviness
  • Swelling
  • Rash that’s itchy or irritated
  • Darkening of the skin (in severe cases)
  • Restless legs
Are varicose veins and spider veins dangerous?

Spider veins rarely are a serious health problem, but they can cause uncomfortable feelings in the legs. If there are symptoms from spider veins, most often they will be itching or burning. Less often, spider veins can be a sign of blood backup deeper inside that you can’t see on the skin. If so, you could have the same symptoms you would have with varicose veins. Rarely, larger spider veins can bleed if scratched or bumped.

Varicose veins may not cause any problems, or they may cause aching pain, throbbing, and discomfort. In some cases, varicose veins can lead to more serious health problems. These include:

  • Sores or skin ulcers due to chronic (long-term) backing up of blood. These sores or ulcers are painful and hard to heal. Sometimes they cannot heal until the backward blood flow in the vein is repaired.
  • Bleeding. The skin over the veins becomes thin and easily injured. When an injury occurs, there can be significant blood loss.
  • Superficial thrombophlebitis which is a blood clot that forms in a vein just below the skin. Symptoms include skin redness; a firm, tender, warm vein; and sometimes pain and swelling.
  • Deep vein thrombosis, which is a blood clot in a deeper vein. It can cause a “pulling” feeling in the calf, pain, warmth, redness, and swelling. However, sometimes it causes no significant symptoms. If the blood clot travels to the lungs, it can be fatal.
Are varicose veins hereditary?

Heredity is a primary factor in over 80% of varicose vein cases. Other contributing factors may include pregnancy, obesity, hormone therapy, standing or sitting for long periods of time and injury.

Do men get varicose veins?

Although women are affected at a higher percentage than men, men can also be troubled with varicose veins and their associated symptoms (and benefit from treatment).

Why do I need an ultrasound examination of my legs?

A patient with symptoms may or may not have visible varicose veins in their legs. An ultrasound examination of the major veins inside the leg is essential to assess for vein reflux disease. This is the most common cause or source for varicose veins as well as the associated symptoms. Any treatment of varicose veins and its associated symptoms must begin with addressing the source.

What is a vein screening at St. Augustine Vein Center?
Any person who has varicose or spider veins in their legs can call or make an appointment online for a free 15 minute vein screening. Empire Vein Specialists holds a monthly free vein screening day for those unable to come in during the week (appointments are required). You will meet one of their board certified vascular nurse practitioners to discuss your concerns and answer all of your questions. You will undergo a painless, noninvasive screening ultrasound of the legs to assess for vein reflux disease. If appropriate, you will then be set up for a full consultation with one of their Board certified vascular surgeons along with undergoing a formal ultrasound examination of your legs.


Can varicose veins be prevented?

Not all varicose and spider veins can be prevented but there are some steps you can take to reduce your chances of getting new varicose and spider veins. These same things can help ease discomfort from the ones you already have:

  • Wear sunscreen to protect your skin from the sun and to limit spider veins on the face.
  • Exercise regularly to improve your leg strength, circulation, and vein strength. Focus on exercises that work your legs, such as walking or running.
  • Control your weight to avoid placing too much pressure on your legs.
  • Don’t cross your legs for long times when sitting. It’s possible to injure your legs that way, and even a minor injury can increase the risk of varicose veins.
  • Elevate your legs when resting as much as possible.
  • Don’t stand or sit for long periods of time. If you must stand for a long time, shift your weight from one leg to the other every few minutes. If you must sit for long periods of time, stand up and move around or take a short walk every 30 minutes.
  • Wear elastic support stockings and avoid tight clothing that constricts your waist, groin, or legs.
  • Avoid wearing high heels for long periods of time. Lower-heeled shoes can help tone your calf muscles to help blood move through your veins.
  • Eat a low-salt diet rich in high-fiber foods. Eating fiber reduces the chances of constipation, which can contribute to varicose veins. High-fiber foods include fresh fruits and vegetables and whole grains, like bran. Eating less salt can help with the swelling that comes with varicose veins.
What factors increase my risk for varicose veins and spider veins?

Many factors increase a person’s chances of developing varicose or spider veins. These include:

  • Increasing age. As you get older, the valves in your veins may weaken and not work as well.
  • Medical history. Being born with weak vein valves increases your risk. Having family members with vein problems also increases your risk. About half of all people who have varicose veins have a family member who has them too.
  • Hormonal changes. These occur during puberty, pregnancy, and menopause. Taking birth control pills and other medicines containing estrogen and progesterone also may contribute to the forming of varicose or spider veins.
  • Pregnancy. During pregnancy, there is a huge increase in the amount of blood in the body. This can cause veins to enlarge. The growing uterus also puts pressure on the veins. Varicose veins usually improve within three months after delivery. More varicose veins and spider veins usually appear with each additional pregnancy.
  • Obesity. Being overweight or obese can put extra pressure on your veins. This can lead to varicose veins.
  • Lack of movement. Sitting or standing for a long time may force your veins to work harder to pump blood to your heart. This may be a bigger problem if you sit with your legs bent or crossed.
  • Sun exposure. This can cause spider veins on the cheeks or nose of a fair-skinned person.


What is the treatment of varicose veins and spider veins?

Varicose veins normally do not require medical attention, but they should not be ignored. To relieve the discomfort that may be associated with varicose veins, your doctor may recommend conservative measures including compression stockings and/or over-the-counter anti-inflammatory medications like ibuprofen and aspirin. Over time, the varicose veins can grow and extend throughout the legs and often are associated with symptoms such as burning, throbbing, aching, heaviness, cramping, and restlessness. Swelling of the lower legs and ankles can develop. Often, conservative measures are not enough or fail to alleviate the symptoms and medical, office-based procedures can then be performed.

After a discussion of the patient’s symptoms and a physical examination of the legs, an ultrasound is performed to study the major veins in the legs assessing for any functional or structural abnormalities in determining a possible cause for the varicose veins and symptoms. Vein disease is a progressive medical condition and the signs and symptoms associated can worsen over time. People can present at different stages of the disease process and therefore, the treatment plan may vary. At Empire Vein Specialists, a customized and comprehensive office-based treatment plan will be made and discussed with the patient. These can include VenaSeal, Radiofrequency ablation, sclerotherapy, and phlebectomy.

Will my insurance plan cover treatment of my varicose veins and spider veins?

Vein reflux disease along with its associated signs including varicose veins and swelling along with its symptoms is a medical condition. Most insurance plans, Medicare, and IEHP recognize vein disease as a legitimate, covered medical expense and will cover treatment for patients whose signs and symptoms are significant and after conservative management, including a trial of compression stockings, has failed. If you are experiencing any symptoms of vein disease it is worth finding out if your insurance provider will cover the cost of treatment.

Empire Vein Specialists will provide a consultation and an in-office venous ultrasound test. If you test positive for vein disease, Medicare and most insurance companies will cover the cost of the consultation, venous reflux test and varicose vein treatments. However, most insurance companies require a 6-week to 3-month period of “conservative management” before any procedure can be scheduled. We will work with you to develop a conservative management plan which may include elevating your legs, minimizing prolonged periods of standing or sitting and wearing compression stockings.

There are many doctors who treat varicose veins. Why should I choose St. Augustine Vein Center to be evaluated and treated?

At St. Augustine Vein Center, Board-Certified Vascular Surgeons will evaluate and treat your varicose veins and vein disease. Vascular Surgeons are specialists who are highly trained to treat diseases of the vascular system. Your blood vessels –arteries carrying oxygen-rich blood and veins carrying blood back to the heart — are the roadways of your circulatory system. Without smoothly flowing blood, your body cannot function. Conditions such as varicose veins and vein disease are an important part of the Vascular Surgeon’s area of expertise.

The team at Empire Vein Specialists have performed tens of thousands of vein procedures yet treat each patient as an individual. They offer the most recent advancements for treatment of varicose veins, spider veins, and leg pain in addition to treatment for therapeutic and cosmetic vein problems. Their board certified surgeons are nationally recognized vein specialists and together are the leading providers of VenasealTM, the latest, breakthrough treatment. After thorough discussion and a complete diagnostic evaluation, they will offer a comprehensive treatment plan to meet your needs. Empire Vein Specialists is committed to providing you with the best treatment options and highest quality, individualized patient care.

Can varicose veins and spider veins return even after treatment?
Current treatments for varicose veins and spider veins have very high success rates compared to traditional surgical treatments. Over a period of years, however, more abnormal veins can develop because there is no cure for weak vein valves. Unfortunately, no treatment can prevent new veins from becoming varicose. An Ultrasound can be used to keep track of how badly the valves are leaking (venous insufficiency). Ongoing treatment can help keep this problem under control.

The single most important thing you can do to slow down the development of new varicose veins is to wear compression support stockings as much as possible during the day.

VeneSeal Closure System

“St. Augustine Vein Center feels like family.  The people here are amazing, super nice and answered all of my questions.  I wasn’t sure what to expect, and my treatment was a big investment in myself, but I am so glad that I did.  You will not be disappointed with the results.”

Joanna I.

Hilton Head, SC