Varicose veins are enlarged blood vessels caused by weakening vein walls, usually affecting the saphenous vein (the most visible one) that runs the length of the leg. This can happen if the valve that prevents blood from flowing backward as it moves up the legs weakens, allowing blood to pool in the vein and enlarge it.
Spider veins are smaller versions of varicose veins that are close to the skin's surface. They can be red or blue and may look like spiderwebs.
Both varicose and spider veins tend to run in families. The incidence also increases with age and weight. Veins that enlarge during pregnancy tend to improve afterward. Among women, the hormonal changes associated with puberty, pregnancy and menopause can increase the risk of developing varicose or spider veins, as can birth control pills and other drugs containing estrogen and progesterone. If you're fair skinned, you may develop spider veins on the face as a result of sun exposure. Patients with acne rosacea can also experience this.
For most people, varicose or spider veins are a cosmetic problem, although more advanced varicose veins can cause legs to ache or swell.
The most common treatment is sclerotherapy, an office procedure that works for both varicose and spider veins. A saline solution injected into the vein causes its walls to stick together and seal shut. Other veins take over the blood circulation. You may need several treatments depending on how extensive the affected area, but you should be able to resume your normal activities immediately.
Laser light can also be used to collapse and seal larger veins as can radiofrequency energy that heats the affected vein causing it to collapse and seal itself shut. Both techniques are office procedures that require local anesthesia. Very large veins may require surgical removal.
Most of the treatments for varicose and spider veins are very effective, although there's always a chance that new ones will develop over time. To lower your risk, wear sunscreen to protect your face, exercise regularly to improve the strength and circulation of your legs (walking is ideal), lose weight and don't cross your legs when sitting. Avoid either sitting or standing for long periods of time, and try to elevate your legs when resting. If you have to stand or sit for a long time, wear elastic support stockings. A low salt, high fiber diet can help, too (salt can cause water retention and swelling, and insufficient fiber increases the risk of constipation, which can contribute to varicose veins).
In addition, you might try horse chestnut, an herbal extract that strengthens veins and reduces swelling. It comes in an oral form and as a topical cream. I also recommend using antioxidants called oligomeric proanthocyanidins, or OPCs, extracted from grape seeds or pine bark. These compounds are nontoxic free radical scavengers that help support blood vessels.
Andrew Weil, M.D.