Last updated: Jul 23, 2008
If you suffer from bulging (and painful!) varicose veins, you have company: Up to 25 percent of women have them, and many more are prone to spider veins. Robert Weiss, MD, director of the Maryland Laser, Skin, and Vein Institute, runs through the causes and high-tech solutions.


Q: What causes varicose veins—and can they be prevented?
A: The valves in the venous system are designed to prevent blood from traveling backward down the legs. But when those valves fail, the blood backs up, and that pressure causes veins to expand and bulge. Because they dont expand uniformly, the veins take on an irregular, bumpy shape. Family history plays a role, too. And, for anyone genetically prone to varicose veins, a job that requires standing for long periods of time can make things worse. (Many women also develop varicose veins during pregnancy.) What can you do to prevent them? Exercise regularly and stay at a healthy weight. Also, if youre going to be on your feet for a while, wear support hose; they can put pressure on the veins to help minimize expansion.

Q: Is it dangerous to get rid of varicose veins?
A: We have a thousand more veins than we need, and a damaged vein is counterproductive—like a leaky pipe. Getting rid of it reroutes blood through the veins that are working. To explore that option, talk to a dermatologist or plastic surgeon about minimally invasive techniques that can seal off varicose veins from the inside. The VNUS Closure treatment uses radio-frequency energy and the CoolTouch CTEV is a laser treatment. Both are inserted through a small puncture (usually around the knee) and guided via ultrasound to the vein. The vein then shrivels up and, when the body detects its no longer functioning, is actually digested. Within a few months, youll barely be able to tell where it was. Theres very little pain and rarely any bruising. Some insurance plans cover the cost, typically starting at about $2,500 and up for both legs.

Q: How about spider veins?
A: They can also result from pres­sure but are often caused by sun exposure. Ultraviolet rays damage the collagen, which causes the veins to expand and become visible. Luckily, small areas can be spot-treated with a laser. You can also have your spider veins injected with a solution that causes the vein to close, during a procedure called sclerotherapy. The cost: $400 to $500 for a complete treatment.