There is a difference in approaching and understanding varicose vein disease according to age .

Most of younger people approach vein disease with the desire to improve the aesthetic appearance and are surprised to learn that 75% of them already crossed the line of cosmetic to medical disease . Early vein disease symptoms are easily ignored : leg fatigue , fullness , cramping are vague and not specific to varicose disease . They come for cosmetic and uncover the medical depth of the disease

Older people present with different stages of medical vein disease , or with a complication , such as blood clots ,recurrent cellulitis or leg infections . Initially they are not interested in cosmetic aspect , focusing on treating the serious complications of varicosities and reducing leg swelling or improving walking abilities . Venous medical treatment render significant relief of symptoms , changing the focus of treatment towards cosmetic .

” Since I feel much better why not wear shorts again” is one of the most common sentence heard after successful ablations . They present with a medical problem and after successful treatment , will ask for cosmetics

Spider veins are considered cosmetics , and not covered by insurances since are not associated with a medical condition

Spider veins appear as tiny red or blue lines, usually less than 1 mm in diameter, that look like branches or a spider web just below the surface of your skin. You can see them but not feel them.

Spider veins may give pain , discomfort to touch , bleeding, however do not pose a serious medical threat .

Varicose veins are bulging , twisted blue blood vessels that can be seen and felt right under the surface of the skin. They are larger than spider , and associated with symptoms as well as complications . The key difference is that varicose veins are seen and felt but spider are only seen , not palpable

They are associated with abnormalities of larger superficial veins , saphenous veins , not seen with visible eye but with the ultrasound

Medical symptoms and complications of varicose vein disease

1. Recurrent edema , unresponsive to diuretics
2. Stasis dermatitis , or skin changes , redness , induration , pigmentation, associated with pain, decrease mobility and prone to infections .
3. Cellulitis , or skin infections , recurrent unless venous ablations are performed ; they require hospitalization and weeks of antibiotics
4. Skin ulceration, nonhealing , prone to infections
5. Blood clots , called DVT , which is a serious medical condition with potential fatal complications such as pulmonary embolism
6. Thrombophlebitis when the superficial vein becomes painful, warm to the touch and hard.
7. Bleeding from a visible varicosity when cut or hit triggering a significant amount of bleeding, hard to control .Or, if the skin isn’t broken, there may be large painful bruising

How to remember ?

Spider veins – visible not palpable , cosmetic , not covered by insurance , not triggering serious medical complications , however may be the early stage of venous disease .

Varicose veins – visible and palpable , associated with symptoms and possible serious complications , covered by insurances , progressive course unless treated . If present together with spider veins , always to be treated first , before spider therapy

References

Varicose Veins and Spider Veins, Frequently Asked Questions. U.S. Department of Health and Human Services, Office on Women’s Health. http:/www.womenshealth.gov.

Mayo Clinic. Varicose Veins Overview. http://www.mayoclinic.org/diseases-conditions/varicose-veins/home/ovc-20178078 (updated 1/22/2016, accessed 11/30/2016)

Wittens, C., et al., Editor’s Choice – Management of Chronic Venous Disease, Clinical Practice Guidelines of the European Society for Vascular Surgery. Eur J Vasc Endovasc Surg, 2015. 49: p. 678-737. http://www.ejves.com/article/S1078-5884(15