What exactly are varicose veins? Spider veins? During Pregnancy ?
In the case of varicose veins (varicosities), you’ll see swollen, ropey veins just beneath the skin which often wind their way across the legs. These veins are often quite large. They have a bluish or purplish color due to the oxygen poor blood trapped within, and while they’re most commonly found on the legs they can actually occur anywhere. Hemorrhoids are an example of varicosities in the rectal area, and many pregnant women experience varicosities around the vagina.
The vast majority of women who have or are prone to vein problems find that they get much worse during pregnancy. While it’s possible that there will be no associated symptoms this isn’t common–many women experience aching, heavy legs that fatigue easily. This is relieved by rest and elevation, but starts again soon after standing. The problem is compounded by pregnant women who must stand for prolonged periods on the job.
Why are varicose veins Pittsburgh made worse by pregnancy?
It’s a question of added weight and added blood volume. As the uterus develops and grows in size, it puts added pressure on the body’s main abdominal vein, the vena cava. This in turn causes a dramatic increase in pressure inside the main leg veins, the great saphenous vein (GSV) and the small saphenous vein (SSV).
Here’s where gravity comes into play. The legs are the lowest point in a person’s body, and since all veins carry blood back to the heart, blood making its way up the legs must overcome the force of gravity. Add to this the added pressure of pregnancy, and it’s little wonder that blood begins to trickle back down these vessels and pool in the legs and feet. Further add the fact that pregnancy hormones (progesterone) cause veins to relax and become more stretchy, and it’s a recipe for vein disease.
How about getting rid of my unwanted veins entirely?
If you don’t achieve the improvement you’d been looking for, or if symptoms of pain, swelling, achiness, heaviness, and fatigue persist, many highly effective modern treatments exist. These options are light years ahead of older stripping procedures and are very minimally invasive. Even if you’re simply unhappy with the appearance of your post pregnancy legs, it’s often worth seeking treatment. Even with full leg treatment, be aware that new vein problems can crop up, especially if you’ve got a bad family history or are carrying around too much excess weight. Then there’s the question of future pregnancies. Talk with your doctor, since it may be best to wait until you’ve finished having children before treatment.
You’ll probably be directed to an outpatient vein clinic, like the Advanced Vein Center, where you’ll be evaluated with Doppler ultrasound. This will determine exactly how bad your problems are, if they’re likely to worsen in the future, and what treatments, if any, will be the most effective. At this point, if you decide to take action, you’ll examine your options and set an appointment.
Now moving on to spider veins. These formations of tiny vessels have a weblike appearance, hence the name, and are most often found on the thighs near the knees and the backs of the calves. Ironically, they’re also commonly found on the face. Much like varicose veins, they’re bluish in color due to the oxygen poor blood trapped inside, and both types of problem veins typically develop together. If you’ve got one type, you’re likely to develop the other.
Spider veins usually don’t cause pain or discomfort, and in the case of pregnant women are more likely to improve after delivery than varicosities.
Are varicose veins preventable or treatable during pregnancy?
It’s unlikely that prone patients can avoid them entirely, but it’s possible to minimize the problem. Here are some suggestions::
Exercise daily. Even just a brisk walk around the block can improve your circulation.
- Stay within the recommended weight range for whatever stage of pregnancy you’re in.
- Exercise daily, especially low impact activities which engage the calf muscles.
- Get off your feet whenever possible. It helps tremendously to elevate your legs 6 to 8 inches above your heart, but if that’s not possible then just putting them up on a stool will still help greatly.
- Avoid sitting for long periods with your legs crossed.
- Don’t sit or stand exclusively for long periods. Mix it up. If your sitting get up and move around, and if you’re standing then sit and rest periodically.
Graduated, prescription compression hose, which provide higher levels of pressure at the ankles and less as they go up the leg, are an excellent idea. They’re not comfortable, but they’re the single best move you can make from a preventative standpoint. This varying pressure helps blood move up the leg–think of them as squeezing blood back towards the heart. They won’t fix any existing problems, but they will provide relief of symptoms and prevent things from getting worse as quickly.
Stockings are available at pharmacies, but prescription stockings which require a patient to be measured for a perfect fit are by far the better option. Tip: get measured in the morning–you haven’t been on your feet all night, so less swelling will be present. Once you have your stockings, make sure to put them on while you’re still lying in bed, which can help prevent swelling before it develops.
It’s possible that you’ve heard that sleeping lying on your left side will prevent vein problems, or at least prevent them from getting worse. This idea stems from the fact that your vena cava, the largest vein in your abdomen, is on the right side of your body, and that sleeping on the left side takes the pressure of the developing fetus off the vein somewhat. There’s no proof that this is so, yet some providers still recommend this technique. Try it for yourself: it may help, and certainly can’t hurt.
Are vein problems associated with pregnancy ever medically serious?
This isn’t likely. They may be quite uncomfortable and even hurt outright, but usually aren’t harmful in the long term. This is one of the reasons why waiting until after pregnancy to seek treatment. It is true, however, that a small minority of pregnant women (or people in general) will go on to develop small blood clots in veins just beneath the surface, known as superficial venous thrombi. These tend to have a hard, ropey feel to them and many patients become alarmed, yet for the most part these are harmless as well. Even when they hurt, which is possible, they’re still not putting you at risk.
Complications are very rare, but possible. These areas sometimes become infected, which manifests as redness, swelling, and tenderness. As with any type of infection prompt treatment is essential, and oral antibiotics are almost always sufficient. Call your doctor’s office if:
- One or both legs becomes swollen over a short period of time.
- Obviously infected sores develop in the overlying area.
- Skin changes, including color changes, happen near the affected vein.
These superficial clots still aren’t generally a serious manner, and they’re not to be confused with deeper clots known as Deep Vein Thrombi (DVTs). As mentioned these clots form in the deep venous system, and have the potential to become lethal. There’s a chance that these clots will break away from the vein wall, travel to the lungs, and become lodged there. While not all patients with varicose veins develop a DVT, risk factors include pregnancy (for a variety of reasons), and the inactivity which can accompany pregnancy. In fact women who take prolonged periods of bed rest, pregnant or not, are at a much higher risk, as do those with clotting disorders.
DVTs can appear with no symptoms, which makes them even more dangerous. However you’re much more likely to experience sudden, severe, and painful swelling in the calf and ankle areas of the affected limb. It’s also likely that this pain will be made worse by flexing the foot upward, or when standing for any length of time. It can’t be overstated–if you’re having these symptoms, it’s time to call 911.
You’ll have an immediate Doppler ultrasound of both legs. If DVTs are found, you’ll likely be hospitalized and put on a course of very strong clot-busting medications.
The problem with DVTs is that they can break loose from the vein wall. Then it’s possible for them to travel through the venous system, eventually becoming lodged in the lungs. This is known as a pulmonary embolism, which is potentially life threatening condition. If you begin to experience labored breathing, an increased heart rate, or a cough which produces blood, call for assistance at once
What treatment options are available after pregnancy?
After delivery, it’s still good to continue wearing support hose. Continue to exercise, rest, and elevate the legs as well. Both the appearance of your legs and any symptoms you may be experiencing are likely to improve somewhat in the months following your pregnancy, it’s entirely possible that they won’t, or at least not improve as much as you’d like. This is especially true if a woman has been pregnant multiple times. What you want to do about your problem is ultimately up to you and how much your legs bother you. If you do choose to get treatment, highly effective, minimally invasive treatments are available.
What about spider veins? What treatments are available?
These smaller cousins of varicose veins generally don’t produce symptoms, but are quite unsightly. First line treatment is usually sclerotherapy. During sclerotherapy, tiny amounts of medications which damage the inner walls of the vein are injected directly into the veins being treated. This causes the vein to scar shut or collapse, and in a matter of weeks become reabsorbed by the body. In a manner of weeks they’re gone altogether.
How can spider veins be effectively treated?
- Lifestyle modification is key. Exercise which involves the legs, especially the calves, can help. Also weight loss can help, if weight is an issue.
- Sclerotherapy as described above.
- Minimally invasive surgery such as endovenous Radiofrequency (RF) ablation.
- More invasive procedures, such as ligation (tying) and stripping (surgical removal).
- Skin resurfacing lasers and Intense Pulsed Light (IPL), which are quickly becoming gold standard treatments.
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Why are spider veins usually blue? What does this mean?
This is largely because oxygen poor blood is trapped inside them. This blue appearance is harmless however: plenty of oxygen rich blood is still circulating throughout the body.
Lifestyle modifications and at-home remedies
- Exercise, especially involving the legs and calves, is critical.
- Maintain a reasonable body weight. Less weight equals less pressure on the veins of your legs while standing.
- Wear sensible footwear: wear heels only when necessary.
- To relieve pressure, elevate the legs throughout the day.
- Avoid both sitting and standing in one position for lengthy periods. Mix it up. Take brief walks throughout the day, and when standing take short sitting breaks.
- To further reduce pressure, avoid sitting with the legs crossed for long periods of time.
lists to effectively realize the patient’s vision of desired vein treatment results.
Two types of visible problem veins exist: spider veins and varicose veins. Here’s what you can do to take action.
Spider veins are both extremely common and unsightly. These are clusters of very small veins directly under the skin, between the outer layer (epidermis) and the deeper layer (dermis). Since the epidermis is somewhat translucent, spider veins are, unfortunately, quite visible, especially among those with thin or fair skin. Their incidence increases with age, so most people who reach the 5th or 6th decade of life will develop them to some extent. It isn’t inevitable, yet it’s extremely likely.
Think of varicose veins as larger, less branching spider veins. They’re also deeper into the skin. This is what happens when veins become stretched out over time–the one-way valves inside these min-large sized veins weaken, blood begins to pool in the lower extremities, and varicosities occur. They’re common: if you don’t have them, you’ve certainly seen them in others. They appear as winding, twisting, bulging veins, usually on the lower thighs and backs of the calves. They usually have a bluish color, but can be flesh colored as well.
Is it possible for scar tissue to form inside a vein after treatment?
It’s possible, and the effects can be damaging. The scar tissue will damage adjacent valves, and often the valves upstream and downstream as well. Worse still is vein blockage–if the scar tissue is extensive enough, the vein is effectively shut down, which can impede blood flow to the heart if this happens in a main leg vein.
Will my varicose veins ever return?
Nothing in medicine is a guarantee, but when a vein is collapsed or removed surgically, it’s gone permanently. It can’t come back because it’s no longer there. However new problem veins can develop, especially when multiple risk factors are present, such as excess body weight and a family history of vein problems. They also frequently occur with pregnancy
Vein treatment especially the initial Doppler Ultrasound is covered by most insurance. To what extent is determined by your signs and symptoms, but in general the diagnostic testing is covered. So call today to have all your questioned answered.