4 rarely asked questions about spider veins

In the words of Albert Einstein,“The important thing is not to stop questioning.”

As a practicing Vascular Surgeon with 31 years of experience in management of varicose veins and spider veins, I find myself constantly answering my patients’ questions and concerns. Some questions, however, are rarely asked and hold much significance. Here are 4 rarely asked questions about spider veins and their answers:

1. In terms of Spider Veins (aka thread veins, telangiectasia), why are some red in color, others purple, and others blue?

Answer: The degree of oxygen saturation of the hemoglobin molecule of the blood in the vein determines the color of the vein (red –highest; blue lowest). So the closer the surface a spider vein the more red it is. Also size matters with the bigger veins being on the blue end of the spectrum.

2. Doesn’t my body need these veins that the doctor is destroying (with sclerotherapy or any other technique)?

Answer: Not if the vein is damaged as in the case of varicose veins and not in the case of veins acquired late in life such as spider veins. Actually, varicose veins are bad passageways for blood that offer little resistance to blood and the blood pools in them ( increasing the  risk of blood clots), so removing them will redirect the blood to healthier routes.

3. Why do men get varicose veins less than women?

Answer: Estrogen & Estrogen progesterone fluctuations which are mainly women’s traits weaken vein walls, which is the main reason for the prevalence of spider veins in women. These circumstances are amplified during pregnancy, where the weight of the baby in the womb puts further strain on the veins.

4. Why do I rarely notice varicose veins in arms, do they only affect legs?

Answer: This is a valid and perplexing question since the primary reason for varicose veins is the weakness of vein walls – a trait that is often inherited. You are right; Primary varicose veins of the upper extremity are extremely rare. This is even more perplexing when we consider that increased hydrostatic pressure that promotes and increases the prevalence of varicose veins of the legs (such as prolonged standing) are present in in the upper extremity in certain group of people (weight lifters and heavy laborers).

The definitive answer remains a mystery.

Albert Einstein said it best, “If you can’t explain it simply, you do not understand it well enough.” 

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