Varicose veins are blood vessels which have become enlarged. They classically appear in the extremities, and over time, they will become twisted and raised, making them clearly visible on the calves and feet. A variation on varicose veins, spider veins, is caused through the same process which creates varicose veins.
This condition appears most commonly in the lower legs because the lower legs are ideally suited to the formation of varicose veins. As blood circulates through the body, the veins in the lower legs must work especially hard to push blood up to the heart, since the blood must contend with gravity. Over time, the valves in the veins become loose, allowing blood to pool in the veins and causing them to stretch. As the veins stretch, they lose their elasticity, becoming swollen and lumpy.
There are no immediate medical problems associated with varicose veins. People usually choose to treat them because the excessively dilated veins may look and feel unsightly. In some cases, people may experience pain, itchiness, or throbbing in their lower extremities, and occasionally ulcerous sores may form. Sores require medical attention, as they indicate an underlying medical problem.
People can reduce the risk of developing varicose veins by staying active, wearing loose clothing, and ensuring that they do not stand or sit for extended periods. People with heavier weights also appear to be at increased risk of developing varicose veins, as are pregnant women. Periodically elevating the legs in a seated position can also help the blood circulate more easily, keeping the valves in the veins in good shape.
Once varicose veins start to appear, there are a number of treatment options. Some people choose to do nothing at all, accepting varicose veins as part of the aging process. Others may choose to wear compression garments, which can help, and to engage in exercise. Varicose veins can also be treated with procedures like a sclerotherapy injection, in which a substance is injected into the veins to tighten and close them. Offending veins can also be removed in vein stripping, or closed off with lasers and other surgical treatments.
Many theories exist for why varicosities occur in veins, but the consensus is that defective/damaged valves within the veins are the cause. Valves prevent backward flow of blood within the vein. They keep blood in the vein moving toward the heart. It is unclear what causes the valves to work less efficiently.
Some experts think inherited problems cause some people to have too few valves or valves that do not function properly.
Some people may be born with abnormalities of the vein wall. The resulting weakness may predispose the valves to separate and become leaky.
The result is that when a person with poorly functioning valves stands up, the blood flow actually reverses and flows down the superficial veins, when it should be flowing up, toward the heart.
When the muscles surrounding the deep veins contract, emptying the deeper veins, a build-up of pressure occurs.
This causes even more blood to flow the wrong way from the deep to the superficial veins through faulty valves in the perforator veins.
This increases pressure in the superficial veins and causes varicosities.
Many factors can aggravate the varicose veins.
Pregnancy is associated with an increase in blood volume. Also, added pressure on the veins in the legs by the weight of the growing uterus and the relaxation effects of the hormones estrogen and progesterone on the vein walls contribute to the development of varicose veins during pregnancy.
Prolonged standing
Obesity or distended belly
Straining: Chronic constipation, urinary retention from an enlarged prostate, chronic cough, or any other conditions that cause a person to strain for prolonged periods of time causes an increase in the forces transmitted to the leg veins and may result in varicose veins. These mechanisms also contribute to the formation of hemorrhoids, which are varicosities located in the rectal and anal area.
Prior surgery or trauma to the leg: These conditions interrupt the normal blood flow channels.
Age: Generally, most elderly individuals show some degree of varicose vein occurrence.
Varicose veins are relatively easy to identify and can be a nuisance for many people.
They protrude or bulge from under the skin and feel ropey
The legs often ache and feel heavy and itchy
Symptoms can intensify after a long day of standing the feet
A person may have severe pain upon standing or even have cramps in the legs at night.
Varicose veins can be more prominent or first appear during menstruation or pregnancy, and they may be more bothersome during these times.
Varicose veins are prone to developing superficial thrombophlebitis, which is a blood clot along with inflammation of a segment of vein.
Blood clots in the superficial veins are easy to detect and troublesome but are usually harmless.
A person may feel an area of tenderness and pain in the varicose vein, along with redness and swelling.
The area may also feel hard or firm.
Sometimes such areas can represent infection within the vein, so it is a good idea to visit a health care professional if a person develops any of these symptoms.
This condition is not to be confused with a deep vein thrombophlebitis, which is a blood clot in a deep vein. Deep vein thrombophlebitis (DVT) is more serious because of the clot's potential to travel toward the heart and lodge in the lung (pulmonary embolism). This condition requires emergent admission to the hospital for treatment with blood thinning medications.
Treatments are available for varicose veins. Many of them are simple things a person begin immediately.
Elevate the legs as much as possible. If the person can take half-hour breaks during the day to rest, do it. It is important to raise the legs up above the level of the heart to get the maximum effect, and to do this for about a half-hour each time.
Wear compression stockings. The key is to put them on in the morning before walking around and before the veins become more swollen. If a person tries them and experiences worsening pain, especially after walking, remove them and see a health care professional. A person may have problems with the blood supply to the legs (the arterial supply, which provides oxygen).
If the person are overweight, try to lose weight. A healthy diet high in fiber and low in fat and salt can help.
Avoid alcohol, which can cause the veins in the legs to dilate.
See a health care professional if the person has problems such as chronic constipation, urinary retention, or chronic cough. Relieving conditions that are causes straining may help with the varicose veins.
Avoid wearing tight clothing such as girdles or belts.
Do not cross the legs when sitting.
Walking is good exercise. It can help the muscles force the blood out of the deeper vein system.
If the person is driving on a trip, traveling by air for a long period of time, or working at a desk all day, try to get up and walk around every hour or so to allow the muscles to pump the blood out of the veins.
Sclerotherapy involves injecting a chemical inside the vein that obliterates it and causes it to scar. Sclerotherapy is not completely successful in alleviating symptoms, and preventing formation of more varicose veins. Complications associated with sclerotherapy include allergic reactions to the chemical used, stinging or burning at the various injection sites, inflammation, skin ulcerations, and permanent discoloration of the skin. Bandages often remain in place for as long as three weeks. Wearing compression stockings is usually recommended after sclerotherapy. Doctors who perform this procedure must have specialized training and experience in order to avoid complications.
Lasers are also used as a treatment for varicose veins, but are frequently used in the treatment of smaller veins, medically referred to as telangiectasias. These veins are small, measuring only up to 1 millimeter in diameter, and represent dilated capillaries. Using lasers to treat these smaller vessels can cause changes in the color or texture of the skin. Multiple treatments are often required. The technique is less helpful in the treatment of larger varicosities. If a person have superficial thrombophlebitis, a health care professional will usually recommend warm compresses and pain medication. Additional treatment depends on whether the physician thinks the patient may have an infection.