Varicose Veins: What Are They?


Varicose veins are damaged, unhealthy veins that cause many health consequences for millions of people each year. These veins are typically located near the surface of the legs, close to or just beneath the skin. As these veins fail, they are no longer able to effectively move blood back up the legs toward the heart. Once the blood stops moving up the legs it will begin to pool in the veins of the affected leg. As the blood begins to pool, abnormal pressures increase within these veins resulting in their becoming enlarged and dilated. They increase in size and lines until they appear as blue-green, worm-like bulges pushing the skin up. They can be painful, cause cramps, heaviness, skin itching, redness, edema (swelling) and skin sores. Varicose veins will get worse with time unless successfully treated.

What Causes Varicose Veins?

As we now know, varicose veins are damaged veins that no longer work properly. These veins frequently develop as the result of a genetically inherited condition that predisposes the one-way valves within superficial veins to eventually stop working properly. This creates a condition where blood is no longer flowing as it should in just one direction: up, but instead reverses flow pushing back down into the veins of the lower leg. As this happens, pressure within these thin-walled veins increases, pushing and stretching the veins to become swollen and dilated.
Other less common causes of varicose veins include history of injury to the affected leg, previous blood clots in the leg veins, and narrowing or blockage of outflow of exiting veins in the upper leg and pelvis.

varicose_vein pic

Varicose veins left untreated will lead to a progressive and worsening condition of the legs known as venous stasis. Some of the signs of this deterioration include pain, swelling, dermatitis (skin itching and redness), blood clots in the veins, skin sores and spontaneous vein rupture resulting in bleeding.

Unfortunately, as time passes valve damage in these veins will worsen and even spread to nearby healthy veins. This happens even faster when the veins are subject to increased stress and pressure. Many factors cause increased pressure on these vein valves including pregnancy, prolonged standing, previous leg injury, sedentary lifestyle, and the normal aging process.

Damaged veins are most commonly treated with the latest and most effective lasers, ultrasound-guided sclerotherapy and micro-phlebectomy. These therapies are some of the most gentle and effective ways to remove the damaged veins. Once the veins are gone, the blood in the area is rerouted to the many healthy veins nearby.

It is important to remember that, once the damaged veins are properly treated, your body will re-route blood flow into nearby stronger, healthier veins, thus, reducing potential vein problems and improving your circulation.
All of the treatments offered at the Austin Vein Institute are performed exclusively by Dr. Brennig himself. Your care will never be passed off to anyone else. You deserve the care and experience of a dedicated board certified vascular surgeon no matter how simple or challenging your case. All procedures are safely performed in the comfort of our AVI office.

Complications from Varicose Veins Venous Ulcers (Sores)

As venous disease progresses and remains untreated, there is a risk for development of permanent skin and soft tissue damage in the lower legs, particularly around the ankles. These changes are permanent and can result in significant open wound problems.

Spider Veins: What are they?

The medical term for spider veins is telangiectasia. These are very small (less than 1 mm in diameter) superficial veins. They typically lie in a superficial layer of the skin called the dermis, so they are easily seen. They usually have a reddish-blue or purple-black color to them. Up to 90% of adults develop spider veins on their legs. They can produce symptoms such as skin discoloration and hyperpigmentation, localized skin burning and itching, as well as feelings of heaviness and muscle fatigue.

Spider veins are known by various names, including spider veins, web veins, reticular networks, and venous stars. These veins can be the normal result of aging. However, they may be related to a more significant underlying vain problem. They can be safely and effectively treated to dramatically decrease their appearance and help restore much of the natural beauty to one’s legs, face and chest.

What Causes Spider Veins?

In some cases, spider veins are an inherited condition, resulting simply in localized skin changes of dilated dermal veins and focal spider vein appearance. In other cases, previous history of trauma, often many years earlier for example, being hit by a softball in the side may lead to local damage of the underlying vessels and the appearance of surface spider veins. Another cause of spider veins is underlying larger vein incompetence and reflux. These may be surface veins feeding into and causing the spider veins. A smaller type of varicose veins, known as reticular veins may also be a source for increased venous blood pressure into the skin veins, thus, resulting in the development of spider veins in that area.

Spider Vein Treatment

The first step in treating spider veins is to determine if there is any larger source of vein failure and reflux pushing into and causing the spider veins. This determination is best accomplished by comprehensive evaluation by an expert. If indicated, a detailed vascular assessment utilizing duplex ultrasonography must be performed. Once larger vein insufficiency has been ruled out or treated, focused treatment of the spider veins can begin.

Sclerotherapy is the treatment of choice for most spider veins, particularly those in the legs. Loupe magnification, targeted lighting, and micro needles are used, along with an FDA approved sclerosing solution to treat and “close down” the spider veins. Once closed, these veins will dissolve through the body’s natural processes. For best results, patients will be asked to wear prescription grade support stockings for a brief period of time following their sclerotherapy treatment. Patients typically undergo two to six treatments to obtain the desired results. The average number of treatments is three to four for most patients. Once the veins are treated and dissolve, those veins will not return. However, new spider veins can form over time and they tend to appear in the areas where one has been prone to developing them.

spider vein before

spider vein after

Surface lasers like the 532nm KTP laser and the 1064nm Nd: YAG laser are sometimes useful for these veins, however, due to the associated heat, pain and slower treatment times with these lasers most experienced experts rely primarily on sclerotherapy for the best results when treating spider veins.

Reticular Veins

Reticular veins, also known as feeder veins, are the medium dilated blue and green veins beneath the skin’s surface. Their size is most easily described as somewhere between that of spider veins and the large bulging grape-like varicose veins. These veins are enlarged due to an abnormal increase in blood pooling and pressure. They often feed into and cause clusters of spider-veins to pop up especially on the outside of the thighs in women. They tend to respond very well to sclerotherapy.


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