What are Varicose Veins?
Varicose veins differ from spider veins in a number of ways. Varicose veins are larger - usually more than a quarter-inch in diameter, darker in color and tend to bulge. Varicose veins are also more likely to cause pain and be related to more serious vein disorders. Varicose veins are abnormally swollen or enlarged blood vessels in the leg caused by the failure of the valves in the veins. Varicose veins and spider veins can be found in 35% of women and 20% of men above the age of 20.
Varicose veins are the blue or purplish enlarged veins you typically see bulging out of one's leg. The word "varicose" is derived from the Latin root word "varix," which is translated in English as "twisted." Any vein in your body may become varicose, however, its important to note that this condition or varicose veins exists most often in the legs and feet. Varicose veins occur in the legs and lower extremities because standing and walking increases the pressure in the veins in the lower half of your body.
Is it only a cosmetic concern? For many men and women, varicose veins and spider veins (these are the smaller and more common variation of varicose veins) makes them feel less attractive. However, it's important to note that for others, varicose veins cause aching pain and discomfort. This condition may lead to serious problems if not treated. Moreover, varicose veins may also serve as an indication that the individual is at a higher risk of other disorders of the circulatory sys.
As with many other health related issues, self-help measures work well for prevention; compression stockings and changing certain aspects in one's lifestyle.
Pregnancy and Varicose Veins
Pregnant women sometimes complain of developing varicose veins. This is true. Pregnancy increases the volume of blood in a woman’s body, however, it decreases the flow of blood from the legs to the pelvis. This change in circulation is designed to support the growing baby, but it can produce an unfortunate side effects such as enlarged veins in the legs. Varicose veins may appear for the first time during pregnancy. It has been observed that the varicose veins may worsen during late pregnancy because the uterus exerts greater pressure on the veins in your legs.
Hemorrhoids and Varicose Veins?
Some are very surprised to learn that hemorrhoids are actually varicose veins located in and around the anus. Moreover, this condition is very common in the United States. By age 50, about half of adults have had to deal with the itching, bleeding and pain that often signal the presence of hemorrhoids.
Hemorrhoids, also known as “piles”, are swollen veins in your anus and rectum. The causes include straining during a bowel movement or the increased pressure during pregnancy.
Effective medications and procedures are readily available to treat hemorrhoids. Fortunately, in many cases hemorrhoids may require only lifestyle changes.
What causes Varicose Veins?
The reason varicose veins developed is not fully understood. The basic problem appeared to be that of damaged valves. Normally, the veins transport blood from the leg to the heart. In order for this to be possible, it has one-way valves to allow blood to travel in only one direction. In varicose vein, these valves have failed. Without the proper valve function, the blood tends to flow down (leaky), giving rise to blood pooling in the leg, thus causing the vein to bulge.
People who have varicose veins often have an inherited weakness of this valve. They may also give history of prolonged standing at work or multiple pregnancies, situations that will cause significant stress on the veins in the leg. These ultimately cause the veins to stretch and the valves to fail.
The factors below may play a part in the development of varicose and spider veins:
- Heredity - There is a significant relationship between heredity and the development of varicose veins and spider veins.
- Age - The development of varicose veins and spider veins may occur at any age but usually occurs between the ages of 18 and 35 years, and peaks between 50 and 60 years.
- Gender – Females are affected approximately four to one to males.
- Pregnancy – Pregnancy is a common factor contributing to the formation of varicose and spider veins. The most important factor is circulating hormones that weaken vein walls. There is also a significant increase in the blood volume during pregnancy. This tends to distend veins, causing valve dysfunction which leads to blood pooling in the veins. Additionally, later in pregnancy, the enlarged uterus can compress veins, causing higher vein pressure leading to dilated veins. Varicose veins that form during pregnancy may spontaneously improve or even disappear a few months after delivery.
- Lifestyle/Occupation - People who are involved with prolonged sitting or standing in their daily activities have an increased risk of developing varicose veins. Thus, the weight of the blood continuously pressing against the closed valves causes them to fail, leading to distention in the veins.
Lifestyle factors that may contribute to the development of varicose and spider veins are:
• Prolonged standing or sitting
• Binding clothing
• Chronic constipation
• Birth control pills/estrogen replacement therapy
• High-heeled shoes
• Menstrual cycle
• Obesity
• Sedentary lifestyle
• Number of pregnancies
• Westernized population
• Heat
Different Types of Veins
Deep Veins are are located deep in the leg between muscle and fascia (tough fibrous tissue). They are responsible for returning 90-95% of the venous blood back to the heart. Perforating Veins link the deep and superficial veins together.
Superficial Veins are usually affected by varicosities because they have little external support like the deep veins. These veins are visible from the skin when varicose. They drain the blood from the skin and are also responsible for blood storage. When these veins become varicose they can appear engorged and distended. This group also includes reticular veins and 'spider' veins. Reticular veins are small blue veins often seen through the skin. These are often the cause of 'spider veins, which are the tiniest blue purple veins seen in the skin.
Symptoms of Varicose Veins
A number of people do not experience any discomfort with varicose veins, however, certain people do. For those that do experience discomfort, below are some of the symptoms
- Achiness or heavy feeling in one's legs; burning, throbbing, muscle cramping and swelling in the lower legs.
- Itching around one or more of your veins in the legs.
- Skin ulcers near your ankle, which represent a severe form of vascular disease and require immediate attention.
If you have varicose veins, typically prolonged sitting or standing tends to make your legs feel worse. The varicose veins are easy to spot because they are dark purple or blue in color and sometimes appear twisted and bulging. The most common spot they appear is on the inside of the leg or on the backs of calves. But don’t let that fool you, they can form anywhere on your legs, from your groin to your ankle.
The symptoms of Varicose Veins can be grouped into:
- Asymptomatic-some patients has no symptoms at all apart from the veins being unsightly. They are usually very active physically and their active leg muscles compensate for the weakness of the vein function.
- Mild symptoms-aching and cramps in the leg, itchiness near the area of the veins and swollen ankle. All these are worse with prolonged standing.
- Severe symptoms and complications –leg ulcers, bleeding and thrombophlebitis
Risk Factors that Increase your Chances of Developing Varicose Veins
- Standing for long periods of time. Blood doesn't flow as well if you're in the same position for long periods of time because your muscles are not contracting to push the blood back to the heart.
- Obesity. Extra weight puts more pressure on your veins.
- Age. The normal processing of aging causes wear and tear on the valves in your veins which regulate blood flow. The wear and tear may causes the valves to malfunction.
- Sex. Women have a higher chance than men are to develop varicose veins and spider veins. This is attributed to hormonal changes during pregnancy, and also premenstruation or menopause may be a factor. Some researchers have found that female hormones may relax vein walls. Moreover, the use of hormone replacement therapy or birth control pills may increase the risk of varicose veins.
- Genetics. Check to see whether your family members have varicose veins, heredity plays a big role.
Ulcers
Painful ulcers may form on the skin near varicose veins, particularly near the ankles. Increased pressure of blood within the affected veins can cause "water logging" which is a cause of the ulcers. Sometimes there is a brownish pigmentation prior to developing the ulcer. It is important to see a physician immediately if you suspect you've developed an ulcer
Sudden Swelling of the Leg
If you have considerable swelling in the leg (caused by the enlarging of veins deep within the legs) you must see a doctor immediately. Any sudden leg swelling requires urgent medical attention because it may indicate a blood clot — a condition known medically as thrombophlebitis.
Prevention of Varicose Veins
There's no way to completely prevent varicose veins. But improving your circulation and muscle tone can reduce your risk of developing varicose veins or getting additional ones.
This may not always be possible; however some simple measures and changes in our lifestyle can potentially delay the onset of varicose veins.
- Regular exercise will improve circulation and strengthen the veins. Focus on exercises that work your legs, like walking or running.
- Watch your weight. Obesity can put a lot of pressure on the legs and is known to cause spider veins.
- Do not cross your legs when sitting.
- Elevate your legs when resting or sleeping. To achieve this, the ankle should be place above the level of the heart. Try sleeping with 2 pillows under the feet, or lean on a couch and elevate the leg while watching TV.
- Try not to sit or stand for long periods of time. When you have to sit for a long time, get up and take a walk every now and then. If you must stand for a long time, shift your weight from one leg to the other or do tip toeing exercises to improve circulation in the leg.
- Wear elastic support stockings as much as you can.
- Avoid wearing tight clothing and high heel shoes. They can constrict your waist and legs and impede circulation.
- Eat a well balanced diet with sufficient fibers and cut down on salt intake.
Treatment of Varicose Veins
Beverly Hills Medical Group is a one-stop medical centre that caters to the management of all stages of vein disorder; from diagnosis to laser elimination of spider veins and non surgical treatment of the more serious varicose veins. As each patient case vary, we have a wide selection of treatment options that can be tailored to each case. These services include:
- Duplex Ultrasound
Duplex ultrasound scanning is first used to evaluate the condition of the varicose veins. As varicose veins result from the incompetence of leg valves, leading to abnormal blood flow, the use of Duplex ultrasound is therefore one of the most accurate methods for determining the location of the leaking valves. Once the incompetent valve is localized, a suitable treatment method can then be selected. This procedure is conducted by a trained surgeon.
- Endovenous Laser (EVLT) Technique
Endovenous Laser Treatment, or EVLT, is an alternative to surgical procedures for enlarged veins. EVLT is done under local anaesthesia and it works by heating the inside of the vein, which causes it to seal shut and disappear.
EVLT requires a very thin laser fiber be inserted into the damaged underlying vein. The surgeon first uses an ultrasound machine to map the vein and then numbs the area with local anaesthesia. A needle is then placed into the lower end of the diseased underlying vein, through which a small shealth is put into the vein. Laser energy is then delivered to the fiber, which causes the vein to close as the fiber is gradually removed.
- After the endovenous laser treatment, any remaining residual surface varicose veins with either sclerotherapy or ambulatory phlebectomy.
The advantages of using EVLT include:
1. Office procedure
2. Minimal Discomfort/Pain
3. No Downtime (Patient can return to normal activity immediately)
4. No anaesthesia/Hospitalization required
5. No Incision /Scar Mark
- Ultrasound Guided Sclerotherapy
Sclerotherapy is a technique that involves the use of a very fine needle to inject a solution, called a sclerosant, directly into the veins. The solution causes the lining of the vein wall to a swell, which eventually seals off the blood vessel. Ultrasound Guided Sclerotherapy uses high tech ultrasound machines to provide a visual window, so that medication can be administered onto precise locations in the vein.
With this technique, sclerotherapy is done while the doctor visually monitors the vein on an ultrasound screen. This enables treatment of veins that can’t be seen because they are below the surface of the skin. The procedure takes about 15 to 30 minutes and is done with no anaesthesia or local anaesthesia. This method is only effective for smaller veins and branching veins.
- Micro-Sclerotherapy with Vein-Lite
Vein-lite is a special imaging device that uses Advanced Transillumination Technology to visualize veins. The Vein Clinic utilizes Vein-Lite to find those hard to locate spider veins during Micro-Sclerotherapy, in order to achieve accurate elimination of these veins.
- Veinwave
Veinwave is one of the most effective treatments available for red veins. Thermo-coagulation is based on a high frequency wave producing a thermal lesion with protection of the skin. This exclusive method is effective and relatively painless. Equipped with a magnifying loop, the surgeon introduces a fine needle over the vein and in most cases it disappears instantaneously. There is no bandaging required. Veinwave can be applied to any kind of skin complexion because it does not cause loss of pigmentation. It treats red spots and all spider veins on the legs and the feet as well as troublesome facial red veins. The sterile needle, for single use, is covered with an insulating shealth which protects the skin, enabling a targeted action without any side effects.
- Mini-Ambulatory Phlebectomy
Ambulatory phlebectomy is a method of removing varicose veins on the surface of the legs. It is done in the office under local anaesthesia. This procedure involves making tiny punctures or incisions through which the varicose veins are removed. The incisions are so small no stitches are required. Veins are very collapsible such that even larger veins may be removed through the tiny incisions used in this technique. The patient is able to walk following the procedure.
After treatment, a compression bandage and/or compression stocking are worn to reduce pressure in the veins to increase flow in the veins and reduce the chances of forming a blood clot.
- Intense Pulsed Light (IPL)
Intense pulsed light sources provide safe and effective, non-surgical treatment options for the removal of spider veins. The advanced IPL treatments allow your doctor to deliver a precise dosage of energy to each vein, with minimal risk to the skin. During your treatment, light energy is delivered to the targeted vein, in a series of short and/or long pulses. The light energy is absorbed by the blood vessels. This heat absorption causes a clogging of the blood vessel, and a gradual absorption by the body. As a result, the veins will slowly fade and disappear over time. This method of treatment has the advantage in treating finer spider veins which are too small to inject.
There are many other varicose vein treatments out there which include laser surgeries, catheter-assisted procedures and endoscopic vein surgeries. Please consult your physician or other medical care provider regarding what type of treatment is best for you.
Please also remember that current treatments for varicose veins and spider veins are highly successful. However, it's possible that varicose veins can recur.
Always Be a Cautious Consumer. Before, undergoing any procedure, ask your doctor about any health risks and possible side effects.
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