With cooler temperatures on the way, you’re probably not thinking about shorts and skirts. But if you have spider veins or varicose veins, fall and winter can be good times to get treatment, depending on your needs and plans.

What Are Spider and Varicose Veins?

Spider and varicose veins happen when the valves in your veins do not work properly.

Natalie Sridharan, MD, a vascular surgeon with UPMC, says the major differences between  

varicose veins and spider veins include size, color, and prominence.  

“Varicose veins are those more large, bulging veins that people see on their legs,” says Dr. Sridharan. “Whereas spider veins tend to be smaller, blue-colored, non-bulging veins that people tend be bothered by more cosmetically. However, even spider veins can be present in patients with underlying venous insufficiency.” 

Spider veins are a small type of varicose veins that usually appear as red or blue webs close to your skin. While they can change how your legs look, they don’t usually cause any physical symptoms.

Varicose veins are large, bulging veins that can change how your legs look and feel. Some symptoms can include:

  • Pain
  • Itching
  • Swelling
  • Heaviness or tiredness in the legs
  • Brown skin discoloration
  • Skin ulcers, or wounds that do not heal

Who Gets Spider and Varicose Veins?

While they can affect anyone, they are most common in women, especially women who have had children. You may also have a higher risk of varicose veins if you:

Spider and Varicose Vein Treatment Options

In most cases, spider and varicose vein treatment can be done on an outpatient basis. Depending on your condition and symptoms, treatment may include:

  • Compression stockings, which can help relieve the symptoms of varicose veins but will not treat the underlying cause
  • Sclerotherapy, a series of injections that uses medication to safely close spider and varicose veins
  • Endovenous ablation, a catheter-based procedure that uses heat to safely close varicose veins
  • In severe cases, surgery may be necessary to remove varicose veins

Are There Side Effects?

Most spider and varicose vein treatments can be done quickly and are usually low-risk, but some patients may have side effects.

Sclerotherapy can cause tenderness, redness, or hard lumps at the injection site and along the veins, as well as matting, or a small cluster of thin, red spider veins near the injection site.

Endovenous ablation can cause a pulling sensation, as well as tenderness, along the vein.

Surgery can cause superficial nerve damage, which causes small areas of numbness in the skin.

Other side effects can include:

  • Bruising, scabbing, leg swelling, and rarely, small ulcers
  • Hemosiderin staining, or a light brown discoloration of the skin in the treatment area. This typically fades over time but may take several months to a year.
  • There is a very small risk of deep vein thrombosis, a blood clot in a vein deep below your skin, with any vein treatment.

Many of the patients Dr. Sridharan treats are people with jobs requiring extended periods of standing, she said, such as nurses and restaurant workers.  

The condition usually develops as downward pressure in the veins causes blood to pool in the extremities, which may lead to swelling, bulging veins, pain, edema, itching, bleeding, and inflammation. People with any of these symptoms are encouraged to see a doctor for treatment.  

“I always tell patients that, for the vast majority with venous insufficiency, or varicose veins, if they’re going to have a problem, this is a good problem to have,” says Dr. Sridharan. “Because, for the most part, it’s not terribly dangerous, although it can really affect people’s quality of life. However, there is a very severe spectrum of disease – and we care for those patients as well – that can have such severe venous insufficiency, or such severe pressure in the leg, that they have debilitating swelling, or even to the point that they get venous ulcerations that require special dressing and specialized wound care, which we certainly help take care of.”  

When Is the Best Time to Get Treatment for Spider Veins or Varicose Veins?

Depending on your symptoms and plans, your doctor may recommend treatment several months before you’ll wear clothing that shows your legs, like shorts, skirts, or dresses. For example, if you have a beach trip planned for next summer, it may be better to get treatment in the fall or winter than to wait for the spring or shortly before you leave on your vacation.

In many cases, fall and winter can be good times to receive treatment, because cosmetic side effects may resolve before you’ll be back in your shorts.

To learn more about the options for spider and varicose vein treatment, call the Vein Center of the UPMC Heart and Vascular Institute at 412-802-3333.

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