Varicose Veins, Spider Veins and Dilated Capillaries

It is estimated that 40% of women have varicose veins or spider veins. Men also develop them, but with less frequency. Although there are many reasons given for the development of these unsightly veins and capillaries, the most common cause is heredity. Most of these can be easily and safely removed, as described below.

What are Varicose Veins?

Varicose veins are enlarged, non-functional, veins that are more than 2 millimeters in width and may exceed 2 centimeters. They may appear blue or green but often no color is seen. In this latter circumstance, they appear as protruding, tortuous cords that course under the skin. Varicose veins are apparent when standing but often seem to disappear when lying down or with leg elevation. That’s because the incompetent valves – that are characteristic of varicose veins – are unable to prevent blood from flowing backwards as illustrated in the diagram below. Sclerotherapy and Endovenous Ablation are the most effective non-surgical methods for removing varicose veins.

The following are examples of varicose veins that have been successfully treated by sclerotherapy:


What are Spider Veins?

Spider veins are enlarged veins less than 2 millimeters in width. They appear deep red, blue or purple. While often flat, they may protrude, especially when standing. Sclerotherapy remains the most effective non-surgical method for removing spider veins

The following are examples of spider veins that have been successfully treated by sclerotherapy:


What are Dilated Capillaries?

Dilated Capillaries (also referred to as ‘broken capillaries’, or ‘broken blood vessels’) appear as red or pink thread-like lines, usually less than 0.2 millimeters in width. When a large number of capillaries are clustered together they may have the appearance of a red patch or a bruise that never disappears. Besides the legs, dilated capillaries are often seen on the face and nose.

Unlike the slightly larger spider veins, dilated capillaries respond poorly to Sclerotherapy. The safest and most effective treatment is with a Vascular Laser.

The following are examples of dilated capillaries that have been successfully treated by laser and intense pulsed light:

What is the cause of Varicose Veins, Spider Veins and Dilated Capillaries?

The most common cause of these enlarged veins and capillaries is heredity. These can be inherited from the maternal or paternal side of the family. If someone is predisposed these can appear as early as during the teen years, although in most they appear later in life. Even if a person is predisposed, there are additional factors that may enhance the development of varicose veins, spider veins and dilated capillaries. These include pregnancy and injury, such as a contusion or blow to the leg.

What are the symptoms of varicose veins?

Symptoms associated with varicose veins may include aching, cramping, burning, pain and itching along the course of the vein, sometimes with swelling of the leg, ankle or foot. In severe cases, discoloration and induration of skin may occur, which could lead to ulceration.

Is it dangerous to remove Varicose Veins, Spider Veins or Dilated Capillaries?

No. Varicose Veins, Spider Veins and Dilated Capillaries are functionless, incompetent, distended blood vessels into which blood passively pools. They are not functioning vessels and do not assist in the return of blood back to the heart. By the time that they have appeared adjacent, competent veins and capillaries have taken over their function. The circulatory system does not need to form new channels to compensate for their functional absence (i.e. before their removal) or their physical absence (i.e. after their removal).

Should I wait until after I have all of my pregnancies before treating my veins?

No. There is no need to wait until having all of your anticipated pregnancies before beginning treatment. Unfortunately, this is a common misconception. In fact, it is wise to treat varicose veins and spider veins prior to pregnancy so that they are gone and cannot become worse. Of course, new varicose and spider veins can develop during subsequent pregnancies, but at least the previously treated ones would be gone.


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10.32.09: Delegation and Assignment of Performance of Cosmetic Medical Procedures and Use of Cosmetic Medical Devices. This is a Maryland safety regulation which governs who can legally perform medical cosmetic procedures.  Dr. Green administers all injectable treatments (including Botox™, Juvederm™, Voluma™ , Kyblella™ and other fillers & Sclerotherapy) and laser treatments.

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