Varicose, reticular, and spider veins are permanent dilations of small superficial blood vessels on the legs. Spider veins are the smallest dilations whereas varicose veins are the largest and reticular veins are in between. When we see a varicose vein, we presume there is damage to one of the larger one-way valves higher up in the thigh. This is often assess using ultrasound.
Heredity may be the main reason leg veins develop but hormones, trauma, high impact exercise, and long periods of standing are contributing factors.
Advances in laser technology are improving so that the smaller leg veins can safely be treated using laser light in our clinic without leaving a scar. When the dilated blood vessels are hit by the laser light they are sealed so the blood can no longer flow into the vessel. In many cases sclerotherapy is a less expensive and better option for treating smaller dilated vessels than the use of a laser.
For varicose veins, laser and simple sclerotherapy are often insufficient to close these dilated vessels because the damage to a large one-way valve creates so much back pressure that the vessels often fail to close or reopen quickly as a result of the pressure. In these cases, the valve needs to be closed. This can be done surgically by a vascular surgeon of through an endovascular procedure where a probe is inserted into the vessel and the valve can be closed from within the vessel. This is known as endovenous ablation and can be accomplished using laser or radiofrequency. We do not perform endovenous ablation in our clinic but our dermatologist can send you to the right person if he decides that is the best treatment for you.