Reticular veins (bluish-green veins measuring 2-3 mm or more) and spider veins (red or purple veins measuring 1-2 mm) assume their appearance because one way valves within these veins cease to function allowing blood to congest the vein and make it swell. The stagnant blood within these veins is so superficial that nerves within the skin are often irritated causing a stinging or burning sensation. Muscles are also irritated causing aching, cramps, or restlessness.
These veins are usually hereditary and are aggravated by estrogen, pregnancy, and occupations that require standing. Being overweight also aggravates the problem, however, losing weight actually makes the veins look worse.
You have several treatment options. Doing nothing simply allows vein disease to progress. If left untreated, spider veins gradually progress over time as more valves within the veins fail.
Wearing hose can help reduce symptoms if the veins are painful. It will not, however, prevent the progression of vein disease.
Traditional sclerotherapy is the "gold standard" in treatment of reticular and spider vein disease. In sclerotherapy, a nontoxic liquid sclerosant (polidocanol or sodium tetradecylsulfate) is injected with very fine needles into diseased veins. This closes the veins down. The veins are then absorbed by the body. This is the treatment Dr. Douglass uses and recommends. Because the sclerosant acts like a liquid tool reaching the hidden sources of vein disease, it can be effectively used to treat large areas of veins in the least amount of time. There is some mild bruising and swelling immediately after treatment. Wearing of compression stockings is then recommended.
Laser therapy has proved disappointing in the treatment of reticular and spider veins of the leg though it is useful on some facial lesions. This is primarily due to the fact that laser therapy only reaches where the laser is pulsed but does not reach to the rest of the veins feeding into visible veins.
"Despite recent advances in laser technology for treatment of lower extremity telangiectases, sclerotherapy continues to offer superior clinical effect in the majority of cases."
Lupton, Jason, MD, and Patti Romero RN, BSN, Clinical Comparison of Sclerotherapy Versus Long-Pulsed ND:YAG Laser Treatment for Lower Extremity Telangiectases, Dermatological Surgery, 28:8:August 2002.