Dr. Oz Show on Varicose and Spider Veins – A Vein Surgeon’s Perspective
Written by Dallas Vein Specialists on January 16, 2015
Recently Dr. Oz discussed varicose veins and spider veins of the leg on his afternoon television show. This was complete with video simulation of veins and a discussion of treatment. A woman with typical leg spider (thread) veins demonstrated their appearance and discussed her cosmetic concerns. Then Dr. Oz discussed the difference between varicose veins and spider veins. A visiting dermatologist demonstrated laser treatment of spider veins on a patient’s leg. Finally Dr. Oz discussed treatment of venous insufficiency with “Butcher’s Broom” tea.
These demonstrations require considerably more explanation than was provided on this short TV segment. I will take the points one at a time and clarify each.
Firstly varicose and spider veins are 2 very different problems but may be related. Varicose veins are large bulging veins easily seen on the surface of the leg. They appear to be at least 3-4mm in diameter and often appear to be in a twisting or coiling pattern. They occur because of failure of the valves inside the veins that course up and down the leg between the skin and the muscle, i. e. in the fat layer beneath the skin. When the valves fail, blood pools from the pull of gravity in the veins when the patient stands or sits. This is venous incompetence or venous insufficiency. The blood pooling causes pressure inside the veins in the leg to rise. This pressure is transmitted to smaller veins that course near the skin. Over time these thin walled veins enlarge and get longer producing the typical ropy bulging veins of the thigh, calf, ankle and foot. The process tends to be progressive and can involve large areas of the leg in advanced cases.
Spider veins are much smaller and occur on the surface of the skin. In Great Britain they are called thread veins, which may be a more descriptive term. These veins occur usually in clusters and may occur in a variety of sites on the leg. Spider or thread veins are often present with no underlying venous insufficiency and have a strong genetic causation in many patients. Spider veins may also result from venous insufficiency and coexist with varicose veins.
Secondly the treatment of varicose veins is different from the treatment of spider veins. Suffice it to say that the best treatment of varicose veins involves a minimally invasive surgical procedure that is safe and effective. I have discussed this in detail in prior blogs and on my website. I invite anyone interested to go to dallasveinspecialists.com to learn more.
Now as to “Butchers Broom” tea for healthier veins. One study that was well designed showed that patients with venous insufficiency who took this herbal extract had less swelling of the legs as compared to those with venous insufficiency who took a placebo. It did not show any improvement in the varicosities. This was one study only and has not been duplicated. Certainly such herbal extracts will not reverse varicose veins. Likewise there is no evidence that such measures will slow the development of varicose veins.
Lastly the discussion of sclerotherapy and the demonstration of the laser application for spider veins of the leg require some explanation. Sclerotherapy is the needle injection of a chemical solution into the tiny spider veins that results in damage to the vein walls leading to their disappearance over ensuing weeks. It has been the accepted best treatment for spider veins. The laser treatment demonstrated direct light energy damage to the spider veins again leading to their resolution. What was not discussed is that both treatments, sclerotherapy and laser, have high rates of failure and recurrence. Some vein specialists, I among them, believe that these failures and recurrences are most times the result of not treating the so called “feeder veins”. Feeder veins are larger veins located nearby or beneath the spider veins that are connected to the spider veins. Unless these feeder veins are targeted and treated, it is difficult to eradicate the spider veins, and if eradicated, they will frequently recur.
Using augmented reality viewing with infrared imaging of the feeder veins beneath the skin, treatment of the feeder veins using both transdermal laser and sclerotherapy is possible. The combination of feeder vein treatment and overlying spider vein treatment with both laser and slcerotherapy will provide better initial removal and less recurrence of the spider veins. At Dallas Vein Specialists the CLaCS (Cryo Laser Cryo Sclerotherapy) treatment is exactly that. Our results are superior to conventional sclerotherapy alone or laser alone. CLaCS, developed and widely used in Brazil, is new to the United States. Dr. Oz is not yet advised. Check out the complete history and explanation of CLaCS and view before and after photographs .