15 myths and facts about spider veins, varicose veins, and vein disease

Hardly anyone escapes spider veins or varicose veins during their lifetime. There are many myths and old wives’ tales about the causes, consequences, and methods of treatment of varicose veins. Most of these can be refuted by scientific findings and well-substantiated facts. We will now deal with 15 of the most popular misconceptions.

Misconception 1: Varicose veins are purely a cosmetic problem

Fact: Varicose veins represent a health risk

Spider veins are bluish or reddish-purple dilated veins in the skin, found on the thigh and lower leg. Women in particular find their appearance unsightly. These dilated veins of 1 mm diameter are usually harmless, but may be the precursors of vein weakness and larger varicose veins. “If there is a predisposition and a certain lifestyle, blood can pool in the legs with the result that individual veins stretch over time and visibly protrude as nodular varicose veins”, explains Professor Eberhard Rabe, Head of Phlebology in the Department of Dermatology at the Bonn University Hospitals. “If varicose veins are left untreated for a long time, the restricted circulation threatens to cause skin changes and poorly healing wounds in the region of the diseased veins. At the same time, there is also an increased risk of blood clots in the legs. This so-called thrombosis can block important vessels and, in the worst case scenario, cause a pulmonary embolism – the most dangerous complication of chronic vein disease”, he warns.

Misconception 2: Only old people have varicose veins

Fact: Spider veins often appear at a relatively young age

Even though time plays a large part in the development of varicose veins and the risk of varicose veins increases with age, a tendency to spider veins reveals itself at a relatively young age. Many 20- to 29-year-olds already have spider veins. With advancing age, more and more people are battling with very pronounced varicose veins and their complications, such as oedema of the legs and skin changes.

Misconception 3: Spider veins and varicose veins do not cause any symptoms

Fact: All changes in the veins can impair wellbeing

The prestigious Bonn Vein Study found that more than half of the participants had complained of leg symptoms in the preceding weeks. In particular, pain in the legs after standing for long periods, a feeling of heaviness and tension, swelling, and night cramps in the calves substantially impaired the quality of life of those concerned.

Misconception 4: Men do not get varicose veins

Fact: The “stronger sex” does not take the warning signals seriously

Because of their weaker connective tissue, women have to battle with varicose veins somewhat more often than men, although the difference is not that great. Even so, less than half the number of men come for treatment, as only a small minority of them regard varicose veins as a disease to be taken seriously. The result: severe complications such as skin changes, venous leg ulcers, thrombosis, and pulmonary embolism affect men more often.

Misconception 5: Varicose veins are a typical “saleswoman’s disease”

Fact: Standing or sitting for long periods promotes vein problems in anyone with a tendency to vein weakness – not only saleswomen are vulnerable

Very few people today have “active” working days. On the contrary, more and more people have sedentary occupations, spending hours sitting down, whether at an office workstation or a checkout desk. This puts a similar strain on the veins like standing for long periods of time when serving in shops or in the catering business. Symptoms of varicose veins such as swelling and feeling of heaviness in the legs are often worse at the end of the day.

Misconception 6: Anyone with varicose veins should rest as much as possible

Fact: When vein weakness is present, the legs need exercise

Viewed long-term, exercising as much as possible promotes healthy veins. Activities such as walking, cycling, and swimming are particularly good for this purpose, as they activate the calf muscles and stimulate the circulation in a natural way without putting too much strain on the legs. Anyone who walks a lot, uses the stairs, and makes the most of breaks to take a walk is helping to keep the veins in good condition, even in ordinary everyday routine. A tip for people who have to sit or stand for a long time at work: keep moving the feet in a circular motion or alternate between standing on the heels and the balls of the feet.

Misconception 7: Spider veins and varicose veins in pregnant women disappear spontaneously once the baby is born

Fact: Varicose veins do sometimes disappear spontaneously, but unfortunately this is not always the case

A woman’s hormone levels reach their peak during pregnancy. Muscles and connective tissues become looser, the vein walls are less resilient, and more blood flows through the vessels. All these factors can weaken the veins. Varicose veins are therefore common in pregnant women and young mothers. “Varicose veins that first appear during pregnancy may disappear partially or completely once the baby is born, but there is no guarantee”, says Professor Eberhard Rabe, a phlebologist from Bonn. “If possible, varicose veins should not be treated during or shortly after pregnancy, in order to find out whether and to what extent they resolve spontaneously. Any symptoms during this time can usually be relieved by compression stockings. As a general rule, every pregnancy increases the chances of developing permanent varicose veins”, explains the expert.

Misconception 8: Women should always wear flat shoes to prevent varicose veins

Fact: Even when a woman has vein weakness, she can wear high heels now and again

There is no doubt about it: high heels are chic, but they also have their downside. They place additional strain on the joints, encourage a poor posture, and increase the risk of falling. The veins likewise suffer with every additional centimetre. High heels alone do not, however, cause varicose veins, so women do not have to give up wearing them altogether. Nevertheless, they should not constantly wear high heels, but, whether at home or on holiday, go barefoot as much as possible or wear comfortable, flat shoes that are more foot friendly.

Misconception 9: Crossing the legs leads to varicose veins

Fact: Just crossing the legs does not cause varicose veins

Women in particular find it more comfortable to cross their legs when sitting down, rather than place them side by side. This action alone does not give rise to varicose veins when the veins are healthy. In other words, the sitting position is less to blame for varicose veins than the genetic predisposition and age. Sitting for long periods, with or without one leg crossed over the other, increases the risk of leg swelling and complaints. Move around as much as possible and use your free time for sporting activities.

Misconception 10: People with varicose veins should not go south for their holidays

Fact: The holiday destination is not crucial for vein problems

People in southern climes are not affected by vein problems any more often than those in cooler regions. The temperature alone does not cause varicose veins or prevent them. As the veins dilate in warm weather, varicose veins become more obvious to the naked eye. If you want attractive legs in the evening, it is not a good idea to sunbathe on a sun lounger all day. Swimming or treading water in the sea, walking along the beach, or taking a cycling tour through the vineyards stimulates the veins.

Misconception 11: Anyone with varicose veins has to give up a lot of enjoyable things in everyday life

Fact: Most people with varicose veins can lead a perfectly normal life

“People with varicose veins can take a sauna, as the veins are constricted by the cold shower or plunge at the end”, assures us Professor Eberhard Rabe, vein expert from the Bonn University Hospitals. “Removing hair with razors, depilatory creams, or wax is also allowed as long as the skin is intact and there are no open wounds”, continues the experienced vein expert. People with varicose veins can lead normal lives. Nevertheless, large varicose veins should always be examined by a doctor. Actively training the veins is the most important prevention strategy. Those who would prefer to jog or play squash rather than walk through the countryside should wear well-cushioned shoes and compression stockings to protect from vibration.

Misconception 12: Doctors cannot do anything about spider veins or varicose veins

Fact: Many doctors have specialised in vein disease

The right person to talk to about vein problems is a vein specialist or phlebologist. Using ultrasound and other painless methods of examination, the doctor can establish how healthy your veins are and offer you the appropriate treatment. While certain medicines, vein exercises, and compression therapy only relieve the symptoms, other treatment procedures get to the root of the problem and eliminate spider veins and varicose veins.

Misconception 13: It is not worth treating varicose veins in elderly people

Fact: Professional treatment is recommended for people of all ages

Besides the aesthetic aspects, there are good medical reasons for having varicose veins treated promptly. After all, vein problems may be associated with considerable symptoms and cause serious complications. Proper treatment to eliminate the affected veins can do away with any worries on this score. There are gentle methods of treatment, such as sclerotherapy, that have no need of a general anaesthetic and are also appropriate for elderly people.

Misconception 14: Varicose veins require surgery

Fact: Modern procedures such as sclerotherapy do not need incisions or general anaesthesia

Stripping operations are carried out under general anaesthesia. They require incisions into the skin to separate and take out the diseased veins. Other techniques, such as sclerotherapy, which do not require a general anaesthetic and can be carried out on an outpatient basis, are much less invasive. A fine needle is used to inject a medicine with the active pharmaceutical ingredient polidocanol into the varicose veins. This closes off the veins and they are resorbed into the body over the next few weeks. After the treatment session, patients do not have to follow any strict rules about what they can do – they are able to resume their normal daily activities and go back to work immediately.

Misconception 15: The treatment of varicose veins is expensive and hardly researched

Fact: Sclerotherapy gives good results and is cost-effective

“Sclerotherapy has been the gold standard for the treatment of spider veins for several years now. It also offers a good, cost-effective alternative to surgery for people with pronounced varicose veins”, assures vein specialist Professor Eberhard Rabe from Bonn. Many scientific studies have confirmed that the procedure is effective and well tolerated. The current European guideline on sclerotherapy has been developed by several medical professional associations working together and summarises the results of these studies. The guideline considers sclerotherapy to be both safe and effective and recommends this procedure for varicose veins of all types.