After many years in my profession I've noticed that when women are asked about their biggest cosmetic issue, leg veins tend to top the list every time.
Leg veins include small, but unsightly spider veins as well as distended and painful varicose veins. Vein issues can be purely cosmetic or they can be a sign of an underlying circulatory problem.
What causes leg veins?
The biggest cause of leg veins - and unfortunately the one thing you can't control - is genetics. Check out your parents. Do they have spider or varicose veins? If so, then it's likely you will too. In saying that, there are some environmental factors as well, such as high impact exercise, oral contraceptive and other hormone therapy.
What is the best way to prevent them?
Since we can't choose our parents, make sure you avoid harmful factors such as long term hormone therapy with estrogen high impact aerobics and running. To really slow down the progression of leg veins, wear compression pantyhose, especially if you're on your feet a good part of the day. Don't worry - they're not your grandmother's stockings anymore - they are now fashionable and available in an array of colors.
Can they be a sign of poor health?
We are all living longer and the older we get, the greater chance varicose veins will appear if you are genetically predisposed. For some women, after pregnancy is a common time for spider veins and varicose veins to surface. In this case, support pantyhose are particularly important to slow down their development. Excessive weight can also be a factor associated with the development of varicose veins because it puts increased pressure on your circulatory system.
While spider veins - the superficial veins that lie flat under the skin - are never a sign of an underlying health problem, this is not true when it comes to varicose veins. These veins which are elevated above the skin may be a sign of poorly functioning deeper circulatory veins. If they occur, consult a doctor that specializes in the treatment of varicose vein disease. Signs of true medical varicose vein disease include rashes on the legs, thickening of the skin and ulcers.
So what can you do?
To eliminate spider veins, I recommend sclerotherapy, in which a liquid solution is injected. Larger varicose veins can also be treated with no downtime, using non-invasive, advanced laser and radiofrequency technologies. In terms of prevention, if you're not lucky enough to have good genes, minimize estrogen exposure, maintain a healthy weight and avoid high-impact exercises. This will slow the development of both spider and varicose veins. If you have already developed unsightly veins, don't worry - there are always solutions to ensure your legs look young and healthy.
Dr. Neil Sadick is one of the most renowned dermatologists and researchers whose multiple discoveries have strongly influenced and transformed the future of dermatology. He is a Professor of Dermatology at Weill Cornell Medical College and President of the Cosmetic Surgery Foundation. Dr. Sadick is author, or co-author, of more than 500 articles in peer-reviewed scientific journals and has contributed more than 75 chapters of medical books. Read more at