CAPE CORAL, Fla. — Many people use the terms "spider veins" and "varicose veins" interchangeably. Both can be signs of a deeper health issue, but do have some differences you should know about.
Spider veins are small, darker veins that show up on the surface of the skin, usually on the legs.
“We have patients come and see us specifically for this, and they have concerns with how their legs look," Dr. Joseph Cipriano with Lumiere Cosmetic Vein Center in Cape Coral, said.
He said a lot of times, you can't even feel that you have spider veins. But that doesn't mean they should be ignored.
“They can bleed, they can get ulcerated, they can have problems with them, so I don't take them lightly. I make sure people understand that there are risks with having spider veins, just like there are with varicose veins," Dr. Cipriano said.
He said varicose veins are much larger and usually protrude from your skin.
"Those can spontaneously rupture, bleed and ulcerate. They can be associated with wound care issues and can cause a lot of problems for patients," Dr. Cipriano said.
He said varicose veins usually come with symptoms.
“They start to feel pressure. They start to feel pain, and have discomfort. It can make it harder to walk and move,” He said.
Dr. Cipriano said spider or varicose veins can be a sign of a deeper health issue. Both can be a sign of venous insufficiency.
"Venous insufficiency is, simply put, the difficulty of blood getting back to your heart from your legs. Literally, the valves have broken in your legs for one reason or another," Dr. Cipriano said.
He said to think of your blood supply as a circuit. It pumps out of your heart, throughout your body, down to your legs, and has to make it's way back up.
"Impediment to that return will have a direct effect on how well the blood gets back, and that reflection can be shown in these different circumstances with spider veins versus varicose veins," he said.
That increased pressure is what causes those varicose veins to protrude. Dr. Cipriano said venous insufficiency can cause ulcers and wounds, mobility issues, or pain and discomfort in your legs.
“If you're having difficulty walking the same distances you used to, if you're having problems breathing as well, your legs feel heavier, lethargic," he said.
He said to remember that even if you don't feel pain, it's important to get your spider or varicose veins checked out.
“No matter how small the problem it may be, it could be a sign of a bigger problem. It doesn't have to have pain. Pain can be one of the last things that you feel,” Dr. Cipriano said.
Dr. Cipriano said because your body is constantly growing and breaking down veins and blood vessels, there's a chance spider veins can resolve on their own. But if they don't, there are multiple ways to treat them.
"Initially, we always talk about conservative management — compression, elevation of their legs, exercise, and that helps with movement of blood. So if we can offload that pressure of blood, make it so blood moves easier, you can have some improvement," he said.
But typically, he said they have to go a step further.
"You can do sclerosant injections, which is just something that irritates the inside of the vein so that way it shuts down. Your body naturally has the ability to grow and destroy veins or vessels. With that, then we can help the body move down that pathway by causing irritation to those vessels," Dr. Cipriano said. “It usually takes about 6-8 weeks for the vessels to shut down altogether and disappear so you can't see them anymore.”
He said treating varicose veins is a little trickier because there is higher pressure on the veins.
"You can treat varicose veins with sclerosants, you can treat varicose veins with sutures and actual removal," he said.
Dr. Cipriano said resolving the venous insufficiency that's causing varicose veins is the best way to resolve them.
"If we get rid of the root — the medical problem venous insufficiency — the rest of the tree falls away, meaning the branches that are the veins then get better. Dealing with the problem rather than dealing with the aftermath," he said.