Varicose Veins FAQ

About Varicose & Spider Veins

What are varicose veins?

Varicose veins are enlarged veins that can be blue, red, or flesh colored. They often look like cords and appear twisted and bulging. They can be swollen and raised above the surface of the skin. Varicose veins are often found on the thighs, backs of the calves, or the inside of the leg. Although less common, varicose veins can occur in other areas of the body and they are not always visible. Pain or cramp-like symptoms can also be an indication of varicose veins.

What are spider veins?

Spider veins are like varicose veins but smaller. They also are closer to the surface of the skin than varicose veins. Often, they are red, purple, or blue. They can look like tree branches or spiderwebs with their short, jagged lines. They can be found anywhere on the legs and can cover either a very small or very large area of skin.

How common are varicose and spider veins?

Varicose and spider veins are very common and affect 1 out of every 3 adults. About 50 to 55 percent of women and 40 to 45 percent of men in the United States suffer from some type of vein problem. Varicose veins affect half of people 50 years and older.

What causes varicose veins?

Any condition that puts excessive pressure on the legs or abdomen can lead to varicose veins. The most common pressure inducers are pregnancy, obesity, and standing for long periods of time. Being sedentary may also contribute to varicose veins. The likelihood of forming varicose veins also increases as veins weaken with age. A previous leg injury may damage the valves in a vein which can result in varicosity. Genetics also plays a role, so if other family members have varicose veins there is a greater chance you will, too. Contrary to popular belief, sitting with crossed legs will not cause varicose veins, although it can aggravate an existing condition. The most common reason for the development of varicose veins is from vein reflux disease.

What causes spider veins?

Spider veins can be caused when blood pools in veins near the surface of the skin. They can also be caused by hormone changes, exposure to the sun, injuries, pregnancy, heredity, weight gain, and standing or sitting for long periods of time.

What is vein reflux disease? What is venous insufficiency?

Vein reflux disease, also known as venous insufficiency, is a medical condition affecting the circulation of blood in the legs. Arteries are blood vessels that carry oxygen-rich blood from the heart down to the legs. The “used” blood then returns up the legs to the heart through separate blood vessels called veins. When standing, the blood in the veins will flow up the leg against gravity. Veins have valves inside them that act as one-way flaps to prevent blood from flowing backward. If the valves break down or become damaged, the blood will flow backward on itself. Essentially, the blood will then get “backed up” in the vein and all the branches draining into this vein will also get backed up. Over time, more and more of the blood then “pools” in the veins and its branches causing the veins to stretch and enlarge. The veins closest to the skin are the ones we see as varicose veins. Vein reflux disease is the most common cause of varicose veins. Vein reflux disease is a progressive medical condition and may cause your symptoms to worsen.

What are the signs and symptoms of varicose veins?

Varicose veins can often be seen under the skin. Some other common symptoms of varicose veins in the legs include:
Aching pain that may get worse after sitting or standing for a long time
Cramping (particularly at night)
Rash that’s itchy or irritated
Restless legs
Darkening of the skin (in severe cases)

Are varicose veins and spider veins dangerous?

Varicose veins are usually not dangerous, and may not cause any problems, however, they may cause aching pain, throbbing, and discomfort. In some cases, varicose veins can lead to more serious health problems. These include:

Sores or skin ulcers. Due to chronic (long-term) backing up of blood, these sores or ulcers are painful and hard to heal. Sometimes they cannot heal until the backward blood flow in the vein is repaired.

Bleeding. The skin over the veins becomes thin and easily injured. When an injury occurs, there can be significant blood loss.

Phlebitis. A blood clot that forms in a vein just below the skin. Symptoms include skin redness; a firm, tender, warm vein; and sometimes pain and swelling.

Deep vein thrombosis. A blood clot that forms in a deeper vein. It can cause a “pulling” feeling in the calf, pain, warmth, redness, and swelling. However, sometimes it causes no significant symptoms. If the blood clot travels to the lungs, it can be fatal.

Spider veins are rarely a serious health problem, but they can cause uncomfortable feelings in the legs. If there are symptoms from spider veins, most often they will be itching or burning. Less often, spider veins can be a sign of blood backup deeper inside that you can’t see on the skin. If so, you could have the same symptoms you would have with varicose veins. Rarely, larger spider veins can bleed if scratched or bumped.

Are varicose veins hereditary?

Many times, yes. Heredity is a primary factor in over 80% of varicose vein cases. Other contributing factors may include pregnancy, obesity, hormone therapy, standing or sitting for long periods of time and injury.

Do men get varicose veins?

Although women are affected at a higher percentage than men, men can also be troubled with varicose veins and their associated symptoms (and benefit from treatment). As many as 45% of men will get varicose veins at some point in their lifetime.

Why do I need an ultrasound examination of my legs?

A patient with symptoms may or may not have visible varicose veins in their legs. An ultrasound examination of the major veins inside the leg is essential to assess for vein reflux disease or detect varicose veins present beneath the skin. This is the most common cause or source for varicose veins as well as the associated symptoms. Any treatment of varicose veins and its associated symptoms must begin with addressing the source. Getting an ultrasound is non-invasive and painless.

What is a free vein screening?

Any person who (suspects they have) has varicose or spider veins in their legs can call or make an appointment for a free vein screening. The appointment involves a quick non-invasive ultrasound of your legs, and a meeting with a vascular specialist to discuss the results of the ultrasound. Afterward, a vascular specialist will discuss and review potential treatment options with you.


Can varicose veins be prevented?

Not all varicose and spider veins can be prevented, but there are some steps you can take to reduce your chances of getting new varicose and spider veins. These same things can help ease discomfort from the ones you already have:

Exercise regularly to improve your leg strength, circulation, and vein strength. Focus on exercises that work your legs, such as walking or running.

Control your weight to avoid placing too much pressure on your legs.

Eat a low-salt diet rich in high-fiber foods. Eating fiber reduces the chances of constipation, which can contribute to varicose veins. High-fiber foods include fresh fruits and vegetables and whole grains, like bran. Eating less salt can help with the swelling that comes with varicose veins.

Avoid wearing high heels for long periods of time. Lower-heeled shoes can help tone your calf muscles to help blood move through your veins.

Elevate your legs when resting as much as possible.

Don’t stand or sit for long periods of time. If you must stand for a long time, shift your weight from one leg to the other every few minutes. If you must sit for long periods of time, stand up and move around or take a short walk every 30 minutes.

Wear elastic support stockings and avoid tight clothing that constricts your waist, groin, or legs.

What factors increase my risk for varicose veins and spider veins?

Many factors increase a person’s chances of developing varicose or spider veins. These include:

Increasing age. As you get older, the valves in your veins may weaken and not work as well.

Medical history. Being born with weak vein valves increases your risk. Having family members with vein problems also increases your risk. About half of all people who have varicose veins have a family member who has them too.

Hormonal changes. These occur during puberty, pregnancy, and menopause. Taking birth control pills and other medicines containing estrogen and progesterone also may contribute to the forming of varicose or spider veins.

Pregnancy. During pregnancy, there is a large increase in the amount of blood in the body. This can cause veins to enlarge. The growing uterus also puts pressure on the veins. Varicose veins usually improve within three months after delivery. More varicose veins and spider veins usually appear with each additional pregnancy.

Body Mass Index. Being overweight or obese can put extra pressure on your veins. This can lead to varicose veins.

Lack of movement. Sitting or standing for a long time may force your veins to work harder to pump blood to your heart.

Should I see a doctor about varicose veins?

You should see a doctor about varicose veins if:

You develop symptoms of varicose veins including heaviness, tiredness, or swelling in the legs, or itching or burning in the lower extremities

The vein has become swollen, red, or very tender or warm to the touch

There are sores or a rash on the leg or near the ankle

The skin on the ankle and calf becomes thick and changes color

A varicose vein begins to bleed

Your varicose vein symptoms are interfering with daily activities including sleep

The appearance of your veins is causing you distress

If you’re having pain associated with varicose or spider veins, even if it’s just a dull ache, don’t hesitate to get help.


What is the treatment for varicose veins and spider veins?

To relieve the discomfort that may be associated with varicose veins, your doctor may recommend conservative measures including compression stockings and/or over-the-counter anti-inflammatory medications like ibuprofen and aspirin. Over time, the varicose veins can grow and extend throughout the legs and often are associated with symptoms such as burning, throbbing, aching, heaviness, cramping, and restlessness. Swelling of the lower legs and ankles can develop. Often, conservative measures are not enough or fail to alleviate the symptoms and medical, Clinic-based procedures can then be performed.

After a discussion of the patient’s symptoms and a physical examination of the legs, an ultrasound is performed to study the major veins in the legs assessing for any functional or structural abnormalities in determining a possible cause for the varicose veins and symptoms. Vein disease is a progressive medical condition and the signs and symptoms associated can worsen over time. People can present at different stages of the disease process and therefore treatment plans may vary, and a customized and comprehensive Clinic-based treatment plan will be made and discussed with the patient. Treatment options for varicose veins include VenaSeal or The ClosureFast™ Procedure, and for spider veins, Sclerotherapy.

What is VenaSeal?

VenaSeal™ is a permanent solution for varicose veins that Works by injection of a medical grade adhesive that closes off the affected veins and the blood is then rerouted to healthy veins.

What is The ClosureFast™ Procedure?

The ClosureFast™ procedure uses a patented radio frequency ablation (microwave) to deliver uniform heat to treat and close affected veins, and the blood is then rerouted to healthy veins. To learn about The ClosureFast™ Procedure varicose vein treatment, please click here

What is Sclerotherapy?

Sclerotherapy is a treatment for spider veins where a liquid injection is introduced directly into the veins that causes the veins to become absorbed by the body and the blood is then rerouted to healthy veins. To learn more about Sclerotherapy, please click here

Do you offer Laser vein treatment?

Our practice offers the VenaSeal™ and ClosureFast procedures which are the latest technology to treat varicose veins. VenaSeal works better than Laser vein treatment as it involves only a single injection of local anesthesia, does not require postoperative compression stockings, causes less discomfort and bruising, and allows patients to return to their day-to-day activities including work and exercise on the same day as treatment. The ClosureFast Procedure also works better than Laser vein treatment as normal laser treatments do not offer the patented heat device that The ClosureFast Procedure provides where the heat that is delivered to the vein is delivered in a uniform method so that no portion of the vein becomes hotter than any other.

Can varicose veins and spider veins return even after treatment?

It is rare for varicose veins and spider veins to return after treatment. Current treatments for varicose veins and spider veins have very high success rates compared to traditional surgical treatments. Over a period of years, however, more abnormal veins can develop because there is no cure for weak vein valves. Unfortunately, no treatment can prevent new veins from becoming varicose. Occasionally, patients who are in an occupation where they are required to stand for long periods of time may develop some recurrence of varicose veins that may require additional treatment.

What treatment would you recommend?

Once you undergo an ultrasound study, our vascular specialist can determine which treatment would work best.

What is the recovery time after treatment?

There is virtually no recovery time from our procedures. You can drive, return to work, and resume day-to-day activities immediately after the procedure.

How long does it take to perform a VenaSeal™ treatment?

You can expect to be in the Clinic for approximately 45 minutes to one hour on the day of your treatment. The actual vein treatment itself will take approximately 20 minutes.

How long will it take to complete treatment?

Once you undergo an ultrasound study, our vascular specialists can determine how many veins in the lower extremities need to be treated. We will then schedule treatments and can generally complete all your vein treatments within 1 to 2 weeks.

How long will the results last after treatment?

For most, it will last for a lifetime.

What are my restrictions after treatment?

We encourage you to be active immediately after the procedure and you can resume all of your day-to-day activities including driving and working immediately. We ask that you do not enter a pool or a spa for 1 week.

Do I need to take time off from work for recovery?

It is not necessary to take time off from work for recovery. The procedures are performed in our Clinic, require one shot of local anesthesia, are minimally invasive, and take approximately 20 minutes to perform.

Do you treat spider veins of the face or hands?

We do not treat spider veins of the face or hands. We recommend that you speak with your primary care physician to receive a referral to a physician that treats face and hand spider veins.

Will I receive treatment the same day as my vein screening?

The complementary vein screening is an excellent way to determine whether you have a venous disease or not. If you have evidence of venous disease, we then schedule a formal ultrasound study for a future date that examines the vein in much greater detail, after which you will have a 30-minute consultation with a vascular specialist to discuss a treatment plan.

If I get a procedure done, will I need someone to drive me?

No, you don’t need anyone to drive you. You can drive yourself to and from the procedure.

What is your success rate for VenaSeal™ treatments? For ClosureFast™?

The success rate for VenaSeal™ and ClosureFast fast is over 97%.

Does it hurt to get the VenaSeal treatment or the ClosureFast treatment?

The VenaSeal and ClosureFast treatments are minimally invasive and virtually painless. The procedure takes less than 20 minutes to complete and involves a single injection of local anesthesia, similar to receiving a flu shot or having your blood drawn.

Is it safe to get treatment if I am pregnant?

While our treatments are very safe, we ask that you wait until after breastfeeding has concluded before moving forward with any treatments.

Can I wait to get my varicose vein treatment until later?

New technologies developed over the past 20 years have dramatically improved the treatment of varicose veins. Our treatments utilize the newest FDA approved technology, are safe, virtually pain-free, take only 20 minutes, and you can return to your normal activities the same day. While it is ultimately your choice as to when you should treat your varicose veins, letting your varicose veins go untreated can increase your risk of phlebitis which means clots can develop in the superficial veins in the legs, as the blood is pooling in the legs and not circulating through the vascular system properly. You should seek the advice of your primary care physician or speak to one of our vascular surgeons to determine your individual prognosis and potential treatment plan.

Cost and Insurance

Will my insurance plan cover treatment of my varicose veins and spider veins?

Vein reflux disease along with varicose veins and associated symptoms is a medical condition. Most insurance plans, Medicare, and IEHP recognize vein reflux disease as a legitimate, covered medical expense and will cover treatment for patients whose signs and symptoms are significant and after conservative management, including a trial of compression stockings, has failed. If you are experiencing any symptoms of vein disease it is worth finding out if your insurance provider will cover the cost of treatment.

Our practice will complete a consultation and an in-Clinic venous ultrasound test. If you test positive for vein disease, Medicare and most insurance companies will cover the cost of the consultation, venous reflux test, and varicose vein treatments. However, as with many other medical treatments, some insurance companies have specific requirements that must be followed which we will work with you to develop.

Why Empire Vein Specialists?

There are many doctors who treat varicose veins. Why should I come to Empire Vein Specialists to have my veins evaluated and treated?

We are the nation-wide leader of the VenaSeal™ procedure, having completed over 19,000 VenaSeal™ procedures and tens of thousands of vein procedures overall. All of our specialists are board-certified vascular surgeons which means they have undergone years of specialized training in vascular diseases and disorders and our state-of-the-art facilities have accredited vascular labs on site. We offer the most recent advancements for the treatment of varicose and spider veins. After thorough discussion and a complete diagnostic evaluation, we will offer a comprehensive treatment plan to perfectly suit your needs and we are committed to providing you with the best treatment options and highest quality, individualized patient care.