It is not uncommon for spider and varicose veins to first appear following pregnancy. Multiparous women appear to be even at greater risk. Fortunately, the new unsightly veins generally follow a benign course. Most women have little or no discomfort and treatment is not always sought. However, some women demonstrate heavy, achy legs that progressively worsen with the pregnancy. Palpable, tender varicose veins are often observed with this presentation. Skin eczema, itching or burning are also described. The symptoms tend to be worse at the end of the day.
What changes during pregnancy cause varicose veins?
Normal physiologic changes during pregnancy include an increase in the volume of blood in the body. This may lead to common findings such as edema, especially during the third trimester. Additionally, blood flow from the legs to the pelvis slows due to increase in progesterone and size of the fetus. The circulatory and hormonal changes support the development of the fetus and prepare the body for labor and delivery. It is unclear how these normal physiologic changes can trigger the development of varicose veins in susceptible women.
Are varicose veins in pregnancy serious?
Spider and varicose veins can be disconcerting to look at. They may cause discomfort even, however most remain harmless. For this reason, we recommend against any aggressive treatment measures during pregnancy including sclerotherapy.
Importantly, pregnant patients should still discuss their symptoms and consider an early evaluation with a vein specialist. The diagnosis is confirmed by duplex ultrasound and can be safely performed during the pregnancy, if needed. Any vein treatments are ideally postponed until after delivery. Early diagnosis during pregnancy can help to prevent progression of spider and varicose veins through the use of compression stockings, elevation, and diet modification.
Importantly, a great number of spider and varicose veins tend to improve even without treatment following delivery. However for patients with persistent symptoms or pre-existing vein disease, effective vein treatments are minimally-invasive and safely performed in our offices.
What can I do to prevent varicose veins?
Some preventative measures to help manage and prevent symptomatic varicose veins include:
- Exercise daily—promoting health circulation helps prevent blood from pooling in the legs.
- Stay within the recommended weight range guided by an OB.
- Elevate the legs to the level of your heart or higher whenever possible.
- Avoid crossing your legs or ankles when sitting. This tends to further slow down the circulation of blood.
Compression stockings are an essential consideration for women suffering from symptomatic varicose veins during pregnancy. Graded pressure promotes blood flow and reduces edema to lessen symptoms of varicose veins.
There is insufficient data on the safety of vasculera during pregnancy. Vasculera is a prescription medical food containing diosmin. The anti-inflammatory action controls symptoms of chronic venous insufficiency in randomized control trials
What are my options after pregnancy?
If varicose veins persist after pregnancy, a vein specialist can help you navigate different cosmetic and medical treatments. Early diagnosis and treatment can also prevent progression of small spider or varicose veins into larger ones.
The Vein Specialist Centers specialize in the latest advancements with radiofrequency ablation, sclerotherapy (including advanced techniques with cryotherapy, foam, and ultrasound guidance), and Venaseal. Modern vein treatments provided at our centers are performed directly in the office without sedation and are significantly safer than outdated surgical stripping procedures.
This article was contributed by Dr. Alissa Brotman-O’Neill. She was recently featured on the Dr.Who Show discussing pregnancy and varicose veins. Dr. Brotman is recognized as one of the top varicose vein doctors in New Jersey. She specializes in varicose vein and spider vein removal. Dr. Brotman uses the latest innovations in vein management including radiofrequency ablation (VNUS), endovenous laser therapy (EVLT), and also VenaSeal for management of vein disease. If you are looking for a vein treatment center in New Jersey, contact us for details on how you can see Dr. Alissa Brotman-O’Neill in NJ.