St. Augustine Woman's Journal - Educational Resource to the Women of St. Johns County Since 2009

By Ryan Pereira DPM FACFAS
Anastasia Medical Group 

Varicose Veins, Spider Veins, Venous Reflux: What's the Difference? -A Solution to Leg Pain


April 1, 2017 | View PDF

If you are one of the many who suffer from discomfort, pain, or poor self-image due to varicose veins, spider veins, or venous reflux, a wide array of minimally invasive treatment options are available at The Centre for Advanced Vein Care (CAV Care) which has been treating venous disease since 2005.

Varicose veins, and spider veins although considered a cosmetic problem is actually a sign of an underlying disorder called Venous Insufficiency. Nearly 20-25 million Americans are afflicted by this condition. By age sixty, approximately 70 percent of women and 40 percent of men will be afflicted with venous insufficiency. Left untreated, it can lead to a chronic, debilitating, and sometimes limb-threatening condition. A minimally invasive, alternative to vein stripping, office based treatment called the Closure® Procedure offers patients excellent relief from varicose vein disease in less than 45 minutes.

Spider veins present as small webs of red, purple or blue clusters or lines that disfigure the skin surface. Varicose veins appear as dark blue veins or bulging ropes beneath the skin. While these veins are not usually life threatening, they can disrupt and interfere with a person's quality of life. Venous stasis dermatitis and ulcerations are finally what occur if moderate to severe venous reflux is left untreated and may lead to threatening limb loss.

The primary contributing factor to vein disease is heredity. Venous insufficiency is 2 times more prevalent in women than in men. Hormonal factors play a significant role in aggravation of the disease process. Puberty, menopause, birth control pills, estrogen/progesterone pills, can aggravate vein disease. Pregnancy can worsen existing vein disease as the increased blood volume overwhelms the insufficient veins.

Leg pain, fatigue, tiredness, heaviness, aching, burning, itching, and restless legs are common symptoms of venous insufficiency. These symptoms often worsen with long periods of standing and can lead to leg swelling, throbbing and leg cramps. Conservative treatments include heavy support stockings, anti-inflammatory medications, and leg elevation. Venous disease is not as yet curable; however with appropriate treatment, the progressive nature of vein disease can be slowed and controlled.

At CAV Care, we evaluate many patients for treatment of their spider veins, who have had these previously treated where only the cosmetic appearance was addressed, only to see reappearance after 6-12 months. Those who opt only for superficial treatments of leg spider veins exchange the veins for dark blotches in the skin. The underlying problem is never considered or treated. A careful ultrasound vein mapping may show a deeper source of reflux in a larger source vein. We offer minimally invasive treatment options like VNUS Closure procedure to address the larger source veins. Once any nderlying large vein insufficiency has been excluded or treated. Sclerotherapy is the treatment of choice to address the most superficial skin veins.

For more information about vein treatments, please visit: or contact the office at 904-461-0821.

The Center for Advance Vein Care (CAV care) treats all of the aspects of venous disease, the most common of which are varicose veins, spider veins, venous ulcers, and refluxing veins. We utilize the VNUS® Closure® procedure and treatments usually last approximately 45 minutes. In order to provide for total comprehensive vein care, vein stripping, ambulatory phlebectomy and sclerotherapy are also performed at the Center for Advance Vein Care.

Dr. Ryan J. Pereira (pictured above) has been in practice since 2002 and has been treating venous disease since 2005. He is a Diplomat of the American Board of Podiatric Surgery and is Board Certified in both Foot Surgery and Reconstructive Rearfoot/Ankle surgery. He is also a Fellow of the American College of Foot and Ankle Surgeons. He graduated from the Ohio College of Podiatric Medicine with his Doctorate in Podiatric Medicine.

Dr. David S. Ross (pictured below) has been in practice since 1977 and has been treating venous disease since 2008. He is Board Certified in both Emergency Medicine and Family Practice and is a Fellow of the American College of Emergency Physicians. He graduated with a Doctorate in Medicine from the University of Florida.


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