Varicose Veins: Why Treating Visible Veins Alone May Not Solve The Real Problem
Professor Kittipan Rerkasem
Many patients assume that spider veins and varicose veins are simply cosmetic issues affecting the skin surface. As a result, treatment is often focused only on the veins that are visible. However, visible veins are frequently a symptom of a deeper underlying condition known as Saphenous Vein Reflux.
The great saphenous vein is one of the main veins responsible for returning blood from the legs back to the heart. When the valves inside this vein become damaged, blood begins to flow backward instead of upward.
This condition is called Venous Reflux Disease. Over time, the increased venous pressure causes superficial veins to enlarge, resulting in spider veins and varicose veins.
What Causes Varicose Veins?
Healthy vein valves ensure that blood flows in only one direction toward the heart (left image). When these valves fail, blood pools within the vein and creates excessive pressure (right image).
This pressure can lead to:
• Varicose veins
• Spider veins
• Leg heaviness
• Leg swelling
• Aching legs
• Skin discoloration
• Venous ulcers
Why Treating Surface Veins Alone May Not Be Enough
If the underlying problem originates from the saphenous vein, treating only the visible veins may provide temporary cosmetic improvement.
However, the abnormal pressure remains.
As a result, new veins may develop over time and symptoms may recur. This is why identifying the root cause is critical before deciding on treatment.
The Importance of Venous Duplex Ultrasound
Venous Duplex Ultrasound is considered the gold standard for evaluating venous reflux disease.
This examination helps physicians determine:
• Whether valve failure is present
• Whether blood reflux exists
• Which veins are involved
• Whether treatment of the saphenous vein is necessary
Accurate diagnosis allows for a more personalized and effective treatment plan.
Endovenous Laser Treatment For Saphenous Vein Reflux
When significant reflux is detected, Endovenous Laser Ablation (EVLA) may be recommended. This minimally invasive procedure targets the diseased saphenous vein and eliminates the source of abnormal venous pressure. Once the underlying reflux has been treated, cosmetic treatment of residual surface veins can be performed if necessary.
When Should You Seek Evaluation?
If you have:
• Spider veins
• Varicose veins
• Leg swelling
• Leg heaviness
• Aching legs
• Skin changes around the ankles
You may benefit from a comprehensive vein evaluation. Send us a direct message through WhatsApp +66818846638 or email [email protected] today to discuss your symptoms with our vein specialists. Early diagnosis often leads to better long-term treatment outcomes.
Key words #varicose vein #spider vein #sclerotherapy #EVLA #duplex scan