I have a problem with tiny spider veins close to the surface of the skin on my legs and behind my knees. I have heard of a treatment which uses a substance which, when injected into the vein, dries it up. Could you let me know more?

Varicosity tends to develop in the superficial veins and mostly the lower legs. The tendency may be inherited, but female hormones, pregnancy, obesity, standing for prolonged periods, wearing constricting stockings or girdles, crossing the legs, inactivity, etc. can increase their formation.

Blood is transported through the body by arteries and veins. Arteries conduct oxygenated blood from the heart while the veins carry the de- oxygenated back toward the heart to be re-oxygenated. Thus the veins, being further away from the pumping action of the heart, have less pressure than the arteries and depend upon the muscular contraction of the muscles of the leg to move the blood along. The veins have valves along their length that act like locks on a canal to prevent a backflow. In the event that the valves are not functioning properly or have weakened or collapsed, the blood does not flow freely, and therefore collects in pockets, causing swelling and distention of the vein. The vein wall loses its elasticity and appears on the surfce of the skin as a swollen, bluish line. It can be somewhat painful and be accompanied by swollen ankles and dermatitis of the feet. Depending upon the severity of the condition, the veins may be surgically stripped or treated with a method called “sclerotherapy injection.”

Sclerosing injection involves an agent injected in the veins which can destroy the incompetent vein in about a couple of months. The veins are destroyed and their work or blood circulation is taken over by healthy veins. The veins are treated from the thighs downward and the larger spider veins are treated first. Some of the side effects of the injections are bruising (which should disappear in about three weeks); tiny red spots which are slightly raised (they will also disappear in a short time); pigment staining of the skin, and sensitivity reaction to the sclerosing agent.

After the treatment, physical activity, such as walking and swimming, is recommended. Watch your diet and weight, avoid sunburn and use sun screen. Don’t wear any girdles, knee highs or any clothing which would impair circulation. Whenever possible, put up your feet at a higher level than the heart.

Lately I have noticed that my large toenails are becoming thick and kind of yellow looking. How can I get rid of this?

Some of the main causes of toenail problems are tight stockings and short shoes (too small), improper cutting of the nails, perspiration, fungus infection, external damage to the nail, systemic problems such as arthritis or diabetes or tissue stress (such as when a person is overweight). Circulatory conditions, psoriasis, eczema, lung or coronary disease may leave the nails ridged, shiny, flecked, yellow and crumpled.

More frequently, an injury – an article dropped on the toe, a hard bump, pressure from tight shoes or stockings – can cause the toenails to look discolored and thickened. If the nail has been lifted from the nail bed due to an injury, a fungus infection is one of the most frequent toenail problems. About one in every five persons over the age of 25 has this problem. It has increased in the last couple of years due to the increased spozs such as tennis, raquetball and squash, where tremendous pressure is exerted on the toes due to the short stop-start movement.

Once the fungus is on the nails and then gets into the shoes, it tends to remain there as shoes are not normally cleaned regularly everyday. As a result they become a source of infection and re-infection. A fungus on the nail appears dry, scaly, lustreless and has a grey-yellowish, worm-eaten look. Part or all of the nail may be infected and it gradually works its way back to the nail root. To ignore the condition may increase the danger of developing other problems such as athlete’s foot or the infection of the fingernails from touching the toes. Treatment of the fungus can involve reducing the thickness of the nail, removal of the nail if it so badly infected, daily application of various liquid or ointment fungicides or internal medicine.

I suggest that you see your doctor or a podiatrist to properly diagnose the condition and suggest treatments.