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Spider and Varicose Veins Info
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Av. Moema , 87 cj 51-52
Moema – São Paulo
Parking : Al. dos Jurupis 452
phone: 55 11 50511075
Naturale Clinic II -Limeira
Avenida Antonio Ometto, 525
Limeira – São Paulo
Phone 55 19 34538490
clinical director
Informations about varicose and spider veins for patients and health professionals
Informações sobre varizes para pacientes e profissionais de saúde
Information à propos des varices et des télangiectasies pour patients et profissionnelles de la santé
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The Types of Varicose Veins 

There are two types of varicose veins: the primary, that are caused by the hereditary factors, and the secondary, that appear because of diseases during the life.

The primary varicose veins are the responsible for the unaesthetic red and blue lines of several sizes in the woman's legs and also for the varicose veins of larger sizes. The primary varicose veins are the most frequent ones.

The secondary ones are the most difficult ones to be treated. They are erroneously called "internal varicose veins". "Internal varicose veins" do not exist. But, what do exist are serious problems of diseases in the internal veins, that are the secondary varicose veins. 

We can also consider the varicose veins, in a simplistic way, as "less severe" or "more severe". The "less severe" are the ones that, although they are a disease, do not cause an immediate health problem but aesthetic concerns. The "more severe" are the ones that result in serious problems, as bleeding, ulcers (wounds), eczema, infections, redness, stains, thickness of the skin, pain, phlebitis and even the lung clot, that although rare in primary varicose veins, may put in risk the patient's life. 

The Types of Varicose veins according to the Naturale Clinic 

A scientific classification of the varicose veins, called CEAP, is used all over the world for the scientific researches. But this classification is very complex, and it is not used in practice to treat the patient. In scientific researches, led by doctors of the Naturale Clinic, a new Clinical Classification was developed, known as Functional - Aesthetic Classification or " Francischelli' s Classification". It divides the patients with varicose veins in 4 Types or Groups. Each one of the groups has common characteristics that allow us to choose the best treatments. 

TYPE 1 - PAVD: The varicose veins that are more an aesthetic problem. 

We call Type 1 or PAVD -Predominantly Aesthetic Venous Disease - the presence of small varicose veins that are the telangiectasies (spider veins) and reticular veins (microvarices). The telangiectasies (spider veins) are the small red or blue veins of the skin, with the thickness of a hair. They may be very small or a little larger and they are inside the skin. They present several formats, from small lines to large webs. They can be present in all the lower extremities: the thigh, the leg, the buttocks and, in some cases, in the back. The reticular veins (microvarices) are larger, longer, bluish, and located under the skin, but linked to it. These veins are frequently linked to the telangiectasies. The association of telangiectasies of the thigh's lateral area with these reticular veins that extend on the lateral area of the knee and reach the leg is very common. In spite of being a health problem, these small veins they do not cause immediate risks, but they affect the patient's self-esteem. Therefore, the patient usually seeks the doctor for the aesthetic subject. That is the reason why we called this type PAVD - Predominantly Aesthetic Venous Disease. They are the small varicose veins of the skin, such as the telangiectasies (spider veins), and under the skin, such as the reticular veins (microvarices). Although it is not a health problem in a short term, it is still a long term disease because some problems may appear, as bleeding, for example. 

Type 2 - FAVD: The varicose veins that are a health problem (functional) as well as an aesthetic problem. 

We call Type 2 or FAVD - Functional and Aesthetic Venous Disease - the presence of veins of medium and larger caliber. It is a disease already and it involves some risks and problems for the patient. For that, it should be treated. Besides, it can cause some cosmetic concerns for the patient. In this case the two problems should be considered: the disease (functional) and the aesthetics. FAVD - Functional and Aesthetic Venous Disease - happens when the patient presents both, the varicose veins that needs treatment to avoid complications, and concerns about the appearance. 

It is important to recognize these two conditions: the disease (functional) and the appearance (the aesthetics), because during the treatment the doctor should not only correct the disease, but also use aesthetic techniques to fulfill the desire of a better appearance of the patient's lower extremities.

A perfect balance between the two factors is desirable in the treatment. This type of varicose veins is very frequent, and aesthetic and functional techniques are used for this treatment, so that the disease is corrected and, at the same time, an aesthetic result is also obtained. For this double characteristic, this condition type needs specific attention from the doctor, and it is classified in one separated group. 

Type 3 - FVD : The Varicose veins that are a health problem (functional) without an aesthetic concern by the patient and that still haven't presented complications. 

We call Type 3 or FVD - Functional Venous Disease, all of the situations of varicose veins where the aesthetic subject is not involved. In this case, the disease (functional) is present, without the patient's concerns with the appearance (aesthetics). In some cases the varicose veins can reach great dimensions before presenting complications. The treatment, in this case is directed more to the functional subjects of the venous disease, although the concern with the appearance is present for the most careful doctors. 

Type 4 - CVD: The varicose veins that are a health problem (functional) and that already present complications. 

We call Type 4 or CVD - Complicated Venous Disease, all of the situations when varicose veins have shown complications . The most frequent complications are Trombophlebites , Leg Ulcers, Hyper-pigmentation , the Venous Eczema, Bleeding , Fibrosis, the Dermatitis Ocre, Infections , Pain, and Pulmonary Embolism. In this case, the disease (functional) is present, without the patient's concern with the appearance (aesthetics). They are usually patients who have had this problem for a very long time without treatment, and that already present complications. In this case, the doctor concentrates more on the disease, that is very serious, and that could cause serious restrictions for the patient. 

All these types follow an evolution, but it does not mean that one type will necessarily evolute to the other. The varicose veins always get worse, but each patient will have a different history. The disease is chronic and it should always be accompanied by a competent vascular surgeon that will know how to choose the best treatment alternatives, 

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