One of the most common areas of the legs vein specialists are asked to treat is both varicose veins and spider veins on the various areas around the knees. While they may occur in the entire leg, veins do occur more commonly in certain areas and there are good reasons for this.
The veins in the legs can be divided into two main systems: one is the superficial, or surface, and the other is a deep venous system, located deeper inside the legs. The two systems are connected to each other at numerous points and ideally blood only flows from the surface veins into the deeper veins.
The knees are an area where both larger varicose veins as well as the smaller red or darker blue spider veins can often be seen. On the inner side of the knees the largest of the superficial veins, the greater saphenous vein, passes as it travels from the ankle towards the groin helping return blood to the heart. Normally, is it not visible but may be palpable (easily felt on simple physical examination) especially in thinner people. The other larger surface vein in the legs, the small saphenous vein, starts in the inner ankle and empties into the deep system in the knee crease area. Its not nearly as common but varicose veins can be seen and even palpated on the knee cap (also called the patella) or the outer side of the knee.
The back of the knee where the skin is thinner is called the popliteal fossa. Because the skin is thinner there, the venules, which are not quite large enough to be called varicose but are certainly larger then the spider veins, can often be easily seen. They often take on a darkened green type coloration similar to what can be seen in the arms inner elbow area.
The area of the inner and lower thigh just around the knee is a very common location to see spider veins. They often appear as groups of elongated veins but can also, although less commonly, be seen as just a few scattered red or blue colored veins. The longer they have been present, the darker in color and larger in both length and diameter they become.
Vein specialists such as the doctors at the Schulman Vein and Laser Center in New York and Long Island use multiple treatment methods to eliminate these veins. Lasers are often used in the treatment of the larger veins although some are also removed using micro surgery or injection therapy. For the venules and spider veins the unquestionably most effective treatment has been vein injection treatment using FDA approved medications.