the quest to stay eternally ageless, it helps to pay attention
to your veins. Tens of millions of women and men in the U.S.
experience varicose and spider veins in their legsand
face an often confusing variety of remedies to choose from:
Laser treatment? Injections? Surgery? To find out what works
best, The Sheet headed to Cornell Vascular and spoke
with renowned venous expert Dr. Robert Min.
Q: What are
varicose and spider veins?
A: Spider veins are small
red or blue veins located just below the surface of the skin.
They can have a linear or web-like appearancehence the
term spider vein. Varicose veins are larger, located deeper
underneath the skin. They can protrude from the skin surface
in a rope-like appearance.
Q: What determines if you get varicose
and spider veins?
Hereditary factors play the most important role. Women are
more likely to have varicose or spider veins due to hormonal
factors, including pregnancy, birth control pills, or hormone
Q: Do these veins cause other health
Most spider veins are nothing more than a cosmetic nuisance.
Although varicose veins can also be unattractive, they're
often associated with symptoms such as leg pain, cramps, fatigue,
heaviness, or swelling.
Q: What treatments are available?
The treatment of choice for the majority of varicose veins
and nearly all spider veins on your legs is compression sclerotherapy.
In some cases, additional intervention such as surgery, ultrasound-guided
sclerotherapy, or endovenous laser treatment is necessary.
Q: What's compression sclerotherapy?
Sclerotherapy is an in-office procedure involving a series
of injections. A tiny needle is used to administer small amounts
of a sclerosing solution into the vein. This irritates the
vein's inner lining, causing it to collapse and ultimately
Q: Does sclerotherapy hurt?
Most people report little if any discomfort. Occasionally
you may feel mild burning at the injection site for a few
Q: How many treatments will I need?
This varies according to the severity and number of veins
that need to be treated. Although most people notice some
improvement after the first treatment, most areas need to
be treated approximately three times for optimal results.
Q: Is surgery needed to treat severe
cases of varicose veins? A: Occasionally, patients
with varicose veins need more than just sclerotherapy. In
the past, surgical ligation and stripping was the only treatment
available for these cases. Today, minimally invasive in-office
methods are available and may offer good alternatives to surgery.
Q: What are some of the latest advances
in varicose vein treatment?
In recent years, some exciting advances in the treatment of
veins have been made. These newer, less invasive treatments
include: ultrasound-guided sclerotherapy, radiofrequency heat
closure, and most recently, endovenous laser treatment. Endovenous
laser treatment is a minimally invasive technique performed
in the doctor's office. It doesn't require general anesthesia,
doesn't cause scarring, has fewer risks, lower costs, and
a shortened recovery period compared to surgery.
Q: How do I know which is the best
treatment for me?
The first step is to find a physician with experience and
expertise in phlebology, the field of medicine dealing with
disorders of the venous system. A focused medical history,
physical exam, and diagnostic testing will determine the cause,
severity, and best treatment options available for your particular
J. Min, M.D., is director of Cornell
Vascular, Assistant Professor and Attending Physician in Vascular
Interventional Radiology at New York-Weill Cornell Medical
Center. He's specialized in the treatment of varicose and
spider veins for the past decade and serves on the board of
directors of the American College of Phlebology. Dr. Min and
his staff at Cornell Vascular will be happy to answer any
of your questions at (212) 752-7999.