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veins in johnson city, tn

Healthy Veins

The Caudle Center understands how important maintaining healthy veins is to overall health and well-being. Our expert team of medical professionals works together to provide the best care for both varicose veins and spider veins.

The latest technologies we use results in shorter recovery time, minimal disruption to daily activities, and satisfied patients. Each patient receives personalized care from our team. The most advanced laser therapies, sclerotherapy, and microphlebectomy options all prove the commitment The Caudle Center has to providing the highest level of treatment possible for our patients' veins.

  • Varicose Veins
  • Spider Veins
Varicose Veins
legs of a woman

Varicose Veins

Veins are the vessels that return blood to the heart once it has circulated through the body. They have one-way valves that help keep blood flowing in the proper direction toward the heart. If these valves stop functioning the way they are supposed to, blood can flow backward and pool in the vein, causing it to stretch.

Varicose veins are swollen, dark blue or purple blood vessels that you can see and feel beneath the skin. They often look like twisted cords, and usually appear on the calves, inside of the legs, and ankles.

Varicose veins form when the valves within a vein weaken and allow some blood to flow backward. The vein weakens under the additional strain and balloons outward, raising the skin surface.

Patients with varicose veins do not usually experience severe pain from this condition, although most will develop some swelling, aching, throbbing, cramping and other symptoms that may indicate a need for medical attention.

Causes and Risks Factors of Varicose Veins

While varicose veins can affect nearly anyone, they tend to occur more often in patients possessing certain risk factors, including:

  • Older age.
  • Family history of varicose veins.
  • Pregnancy.
  • Obesity.
  • Lack of physical activity.
  • Excessive sun exposure.

Varicose veins occur more commonly in men than in women, and the risk tends to increase with age. While not usually of debilitating medical concern, most patients with varicose veins are bothered by their appearance and physical symptoms as discussed earlier and seek treatment.

FAQ's about Varicose Veins

Diagnosing varicose veins

Your doctor can usually diagnose varicose veins after a physical examination of the affected area. Additional testing may also be performed, such as an ultrasound to evaluate the anatomy, structure, and blood flow within the veins. The physician will ‘map out’ and identify the bad refluxing veins from the good functioning veins.

Treatment of varicose veins

Many people with venous disease seek cosmetic treatment to reduce the appearance of varicose or spider veins on the legs. Treatment usually relieves the discomfort associated with the condition such as swelling, fatigue, aching, itching, and cramps. Sometimes, however, more significant problems can develop if veins are left untreated. Clogging of the blood in the veins can result in the formation of a clot that blocks blood flow or breaks free and travels to the heart or lungs, causing severe damage and even death.

There are several treatment options available to eliminate or reduce the appearance of veins and relieve any symptoms and may include self-care methods such as losing weight, keeping the legs elevated and wearing compression stockings.

For veins that do not respond to these remedies, more advanced treatments may be required:

  • Sclerotherapy treats varicose veins by injecting a chemical solution into the targeted veins that causes them to gradually disappear. The sclerosing solution used during this procedure irritates the vein lining and turns it into scar tissue that eventually fades away. In most cases, desired results are achieved after two to four treatment sessions.
  • Catheter-based Endovenous laser therapy (EVLT) is a minimally invasive procedure that treats truncal varicose veins faster, safer, and effectively. Other effective modalities include endovenous foam sclerotherapy and mechanical endovenous technique. These procedures precisely target the affected veins with each modality under ultrasound guidance. The laser energy delivered to the vein damages the vein walls and shrinks the vessel so that blood can no longer flow through and is diverted to healthy veins. The endovenous foam sclerotherapy does the same using chemicals.
  • An ambulatory phlebectomy is an outpatient procedure designed and performed to remove non-truncal (tributary or branching) varicose veins through small, slit-like incisions in the skin.
  • High ligation and vein stripping: This procedure involves tying off a varicose vein before it joins a deep vein and removing the vein through small cuts or stripping. This requires general anesthesia and is infrequently done in the present time due to newer techniques. This is an outpatient procedure for most people. Removing the vein won't keep blood from flowing in the leg because veins deeper in the leg take care of the larger volumes of blood.
  • Ambulatory phlebectomy: Your vein surgeon removes smaller varicose veins through a series of tiny skin punctures. Only the parts of the leg that are being pricked are numbed in this outpatient procedure. Scarring is generally minimal.
Preventing varicose veins

While there is no surefire way to prevent varicose veins from developing, there are certain life changes that can be made in order to reduce your risk of developing this condition. This may include:

  • Exercising regularly.
  • Maintaining a healthy weight.
  • Eating a diet high in fiber and low in salt.
  • Elevating the legs.
  • Avoiding sitting or standing in one position for too long.

Your doctor will provide you with more information as to how you can reduce your risk of varicose veins and maintain strong vascular health.

Why do I have varicose veins?

All varicose veins occur because the venous valve does not function as it should. In the standing position, blood flows the wrong way. Gradually, these areas around the valve dilate and the veins become visible. Why valves do not work right is really unknown. Hereditary plays a big factor, as well as pregnancy.

Will I be able to exercise normally after I have my varicose veins removed?

You will be able to walk but, will be sore for a few days. It is recommended that patients rest the day of surgery and take it easy on day 2. It is also advised that patients wait at least one week for vigorous exercise such as leg presses, running 2 miles, etc…

How long does it take for my leg to heal after treatment?

You may have some discomfort and bruising. Taking NSAIDs, using a post-treatment cream and wearing compression stockings will help minimize redness, discomfort & bruising.

Do I need to elevate my leg after treatment?

It is often recommended to elevate your leg on the day of the procedure. Lying in a recliner chair or elevating your legs on a couch is fine.

Should I wear compression stockings after treatment?

Often patients will wear compression stockings for a few days after the procedure. You wear the stockings during the day only. You do not have to sleep in your stockings. Some patients wear stockings for a few days and others wear their stockings for a week.

How long will my results last?

It all varies but, the results should be good. You may develop new veins but, usually, they are less severe than what you originally had.

Spider Veins
woman's legs with spider veins

Spider Veins

Spider veins are small-dilated veins near the surface of the skin and measure about 0.3 to 1.0 millimeters in size. They may be red, blue, purplish, or greenish in color. The medical term for spider veins is telangiectasia.

Spider veins can develop anywhere on the body but are commonly found on the face and legs. There are larger superficial veins called reticular veins that may be the source of spider veins.

Reticular Veins

Reticular veins are 1 to 2 millimeters in size and are the greenish color veins and are often visible on the skin surface. In actuality, these veins are in the subdermal area of the skin and many times associated with spider veins. The Reticular veins transmit high pressure usually from a deeper source to the visible spider vein complex.

The most common pattern of spider veins is located on the lateral aspect of the thigh. Spider veins in this location are related to high pressure in the lateral reticular vein. Treatment must not only be directed at the spider veins but at the underlying reticular veins as well.

FAQ's About Spider Veins

Why do I have spider veins?

Spider veins occur in up to 80% of the population. Spider veins are the result of high venous pressure in the skin circulation. This is not high blood pressure but, elevated vein pressure secondary to nonfunctioning valves at some location. They may be the result of genetics, pregnancy, deeper venous reflux, or trauma.

Why do spider veins keep coming back?

Spider veins can reoccur for many reasons. Usually, there is an underlying cause that is responsible for spider veins. Spider veins are the end result of dilatation of the cutaneous veins. This may occur from hormonal or higher transmitted pressure from the venous circulation.

If the cause of the spider vein is not properly treated, they can easily reoccur. Perforating veins can also cause spider veins to appear. Even if everything has been done properly to address spider veins and treat them, reoccurrence is always a possibility. Just as with larger veins, your body has the tendency to reform spider veins once they have already occurred. Pregnancy with its increased venous pressure and genetic susceptibility, are major factors in the formation of spider veins.

What is the best treatment for spider veins?

The treatment varies according to the size and the cause of the spider veins. In most cases, sclerotherapy will be necessary. If the spider veins are very small then laser treatment is usually required. Reticular veins and “feeder veins” that supply the spider veins usually require sclerotherapy. Other therapies can be added to improve the treatment. Examples of other modalities are ohmic thermolysis, laser, and micro-surgical techniques.

Can I exercise after treatment?

If you exercise, you should not wear tight shorts or do exercise that increases venous pressure such as leg presses, etc. Mild exercise can be started within a few days of treatment.

What is sclerotherapy?

Sclerotherapy refers to the injection of a solution into the vein to cause eventual internal scarring of the vein. Sclerotherapy has been used for years and both large and small veins can be treated. After injection, it may take a few weeks to a few months for the vein to go away. Repeated injections may be necessary to treat all of the diseased veins.

Will my spider veins that are treated come back?

If the source of the spider veins is identified and treated, then there is a good chance that the veins will not come back. However, you can always form new veins in a different location.

Do I have to wear compression stockings after my treatment?

Some studies have shown that wearing stockings provides comfort and may speed the resolution of the treated veins. However, all doctors do not agree with this.

Is spider vein treatment painful?

There is minor discomfort with all forms of treatment. Sometimes doctors cool the skin with ice, cooling air or a cooling spray to minimize discomfort. Most patients tolerate the procedure very well without skin cooling.

Can I go back to work after treatment?


What can I use after treatment to help with healing?

Look for an all-natural product that can help soothe the skin and promote healing. Dermaka is an all-natural plant-based product that decreases bruising and has anti-inflammatory properties.


Sclerotherapy is a procedure where your provider injects a solution directly into spider veins or small varicose veins causing the vein walls to collapse together and reabsorb into the local tissue.

Smaller veins absorbed in 3-4 weeks and large within 3-4 months. Patients receiving the treatment have 87% satisfaction in the results. Based on the size and complexity of the veins, some patients require several treatments for satisfaction.

Sclerotherapy is sought by patients for cosmetic improvements of the affected site. However, some find relief from the treatment of pain, swelling, cramping, and burning in the region of the veins.

The treatment is generally 45 to 90 minutes long. The provider uses vision, touch, and usually a vein light to identify treatable veins and confirm adequate injection occurred. The site will be bandaged, and compression garments will be applied to ensure the medication remains in the treatment area, reduce complications, and help compress the treated vein walls together increasing success.

Compression garments will be worn for 3-7 days depending on the size and amount of treatment required. They will then be worn periodically to prevent further spider or varicose veins.

You are encouraged to walk immediately and can participate in light exercise within 24 hours. You should avoid heavy exercise, sunbathing, hot tubs, saunas, pools, baths, and lakes for 3 days after the procedure.

Possible but rare side effects are anaphylaxis or allergic reaction to the medication, “burns” or ulcers at the injection sites, localized pain, localized bleeding or bruising. Localized clotting is expected, however, very rare events of clots entering the deep vein system have occurred. Seek immediate medical care if you experience difficulty breathing, chest pain, or dizziness, or you cough up blood.

Contraindicated in pregnancy, known allergy to medication being used, acute blood clots, or known bleeding disorder.