Q: I am a 57-year-old female. I have always had trouble with broken veins in my legs. They have a bluish red, spider’s web appearance. Recently the slightest knock will cause a bruise or a broken vein. The doctor does not think it is anything to worry about. What is your opinion?
A: I think what you are describing are thread veins, sometimes known as spider veins. The small blood vessels just underthe surface of the skin play an important role in regulating bodytemperature.
The blood supply comes from small arteries known as arterioles and as the blood vessels narrow and become even smaller, they are called capillaries. The capillaries form networks of tiny vessels with thin walls, and they meet up with other capillaries that lead back to small veins called venules, which eventually lead the deoxygenated blood back to the lungs for reoxygenation.
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The body controls blood flow to the skin by the use of hormones and the autonomic nervous system. When you get too hot, more blood flows into the capillary network so that more heat is lost through the surface of the skin.
This process leads to flushing and a pink or red colour to the skin. Blushing is also caused this way due to heightened emotions, or flushing from menopausal hot flashes.
Alcoholic drinks can also do this to some people, even in small quantities. Chronic alcoholics may have permanently dilated capillaries due to constant alcohol intake, leading to permanently flushed or purple cheeks and nose.
The reverse happens in the cold. Blood does not enter the capillary network, so the body retains heat. This gives the skin a whitish appearance.
The most common cause of visible venules in the legs that cause the spider vein appearance is from varicose veins. There is an increased back pressure in the veins, which leads to dilation of the smaller vessels.
Thread veins are easily treated with sclerotherapy or, in some cases, laser surgery. There are doctors who specialize in the treatment of varicose veins and most dermatologists will tackle spider veins in the face. If you do not want the minor surgical procedures, the unsightly veins can be masked with camouflaging skin makeup.
You say you bruise easily, so it is important that your doctor checks your blood for clotting defects, such as a low platelet count. I expect he has already done this and found it within normal limits, and this is why he tells you that there is nothing to worry about.
Mental imagery and medication
Researchers at the University of Michigan decided to see whether it was better for elderly diabetic patients to remember when to test their blood sugars at regular intervals by repeatedly reciting the instructions out loud or visualizing what they would be doing at the time of the next day’s test. One group simply listed the pros and cons of testing their blood glucose levels.
They taught 31 elderly volunteers to do the home blood glucose tests and split them into three groups, one to try each type of memorization.
Over a period of three weeks, the visual imagery group remembered to do the blood test at the correct time 76 percent of the time compared to only 46 percent for the other two groups.
Clare Rowson is a medical doctor with a practice near Belleville, Ont. Her columns are intended for general information only. Individuals are encouraged to also seek the advice of their own doctor regarding medical questions and treatments.
