Vein disease is extremely common in the U.S and world-wide. The spectrum of disease is classified on a CEAP scale of 0 to 6:
- C-0: No visible veins (but symptoms may be present)
- C-1: Spider veins
- C-2: Varicose veins
- C-3: Leg swelling
- C-4: Skin discoloration/thickening
- C-5 & 6: Healed or active skin ulcers
Generally speaking, spider veins are isolated nuisances at the surface of the skin. If symptoms are present and/or as a patient moves down the spectrum of disease, there is a higher likelihood that underlying problems in the superficial venous system…specifically the Saphenous Veins…may be present.
The superficial venous system in the lower extremities have 2 main jobs:
- Return flow back to the heart: It does so with the help of the calf muscles which act as a “peripheral heart”, pumping flow upwards with each contraction as we walk. What keeps flow going one-way…up & out…are a series of valves within the veins.
- Store extra flow while the body is at rest. Veins are naturally a bit stretchy and can accommodate holding extra flow when needed.
If either of these two jobs are impaired, problems may occur over time:
- Valve malfunction: This allows wrong-way, downward flow with gravity and leads to pooling of blood in leg veins. This is known as venous insufficiency or reflux.
- As veins are ordinarily stretchy, things that lead to increased stretchiness or increased pressure can lead to veins that become bulgy and twisty over time. Such factors include
- Genetic factors
- Jobs that require prolonged standing or sitting in place.
How to treat vein disease?
No matter the underlying cause of vein disease, the first step is assessing the extent of disease and planning a tailored approach to vein treatment. When appropriate, this is done by an ultrasound exam during your consultation visit.