I hear this from patients all the time. You used to wear shorts in the summer to stay cool, and then you developed unsightly veins. Ever since these veins appeared, you are too embarrassed to wear shorts, and you wear long pants even on the hottest day in summer. At Missouri Vein Care, we understand how bulging or unsightly veins can drag your self image into the basement and prevent you from enjoying your life. In this blog I describe how varicose veins or visible veins develop and explain the difference between them.
What is a Varicose Vein?
A varicose vein is an abnormally dilated and enlarged vein. This is due to abnormal flow in the vein allowing the blood to pool under high pressure rather than flow normally. This tends to cause local aching or pain as the vein distends under pressure. Once they start to form, they always get larger and more uncomfortable each year, and new ones tend to pop up as well. Most of the time a varicose or bulging vein is the same color as the skin, but they can also appear purple or blue in color. Occasionally the surrounding skin is red due to inflammation. One important point is that only 20% of people with a vein condition have varicose veins - most who have abnormal veins under the skin have normal looking legs that ache.
The increased pressure inside the vein causes the vein wall to stretch and this results in dilation (causing the bulge) and elongation (causing the curvy pathway). Unless it is treated, each year the appearance and symptoms get worse.
What are Prominent or Visible Veins?
A prominent vein, also known as a reticular vein, can be healthy or abnormal. They are always blue and rarely bulge. How well you can see visible veins depends on three factors: your skin pigment, your weight and whether abnormal blood flow is present. Pale skin, low in melanin, allows blue veins to become very visible. For most people with fair, pale skin, this is completely normal. Dark skinned people hide reticular veins much better.
As your weight goes down, there is less fat in the skin layer and this allows the reticular veins to become more visible. If you have bulging varicose veins, as you lose weight these veins also tend to become more prominent.
These veins usually have straight segments with a zig zag course. When they are under pressure they become more prominent and develop more branches and a curvy appearance. They can be associated with clusters of prominent spider veins called teleangiectasias. These visible blue veins or clusters of spider veins often occur on the outside of the thigh or inside of the knee or calf. These can be easily treated with sclerotherapy. Sclerotherapy at our clinic involves using a numbing spray for comfort and injecting solution into the veins to close them down and make them go away. After treatment, veins fade away over the next few weeks to months depending on their size. Often additional treatments are needed if you have especially prominent or large numbers of these veins.
If you have treatment only for unsightly veins, insurance companies consider this cosmetic and won’t provide coverage. If you have leg symptoms and abnormal veins, insurance will often provide coverage for treatments.
Schedule Your Free Vein Screening Today
Some people have visible bulging or blue veins, but most people with a vein condition do not. Your legs may ache, throb or feel heavy, and you thought you were just getting old. You may feel helpless because you think there is nothing which can help. These symptoms are often indications that you may have a treatable vein condition. Leg cramps, swelling, throbbing, itching near the veins, and restless legs are also common symptoms of a vein condition, even if you don’t have visible bulging or blue veins. Treatments can definitely help with the symptoms as well as the appearance.
If you notice any of these symptoms or the appearance of your legs bothers you, a free vein screening with Missouri Vein Care can help sort this out. Contact us to set up a virtual or in office screening so you can get your questions about your legs answered.
