Veins are blood vessels that return deoxygenated blood from the outer parts of the body back to the heart and lungs. When veins become abnormally thick, full of twists and turns, or enlarged, they are called varicose veins.
Generally, the veins in the legs and thighs have a tendency to become varicosed.
- The thickened, twisting or dilated parts of the vein are called varicosities.
- Varicose veins can form anywhere in the body, but they are most often located in the legs.
- In the United States alone, about 19%of men and 36%of women have varicose veins.
- Varicose veins tend to be inherited and become more prominent asthe personages.
Veins in the leg are either superficial or deep.
- The superficial veins and their branches are close to the skin. These veins typically become varicosed. Also included in this category are the communicator or perforator veins, which connect the superficial veins with the deep veins.
- The deep veins are encased by muscle and connective tissue, which help to pump the blood in the veins and back to the heart. The veins have one-way valves to prevent them from developing varicosities.
- Generally, blood travels from the superficial veins to the deep veins. From there,the bloodtravels through a network of larger veins back to the heart.
Varicose veins are relatively easy to identify and can be a cosmetic 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 on one's feet.
- One 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.
Some peoplemay have no symptoms at all. For most people, varicose veins are mainly a cosmetic problem.
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.
- You 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 your health care provider if you should develop 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 is more serious because of the clot's potential to travel toward the heart and lodge in the lung. This condition requires emergent admission to the hospital for treatment with blood thinning medications.
Many theories exist for why varicosities occur in veins, but the consensus is that defective/damaged valves within the veins are to blame.
Valves prevent backward flow of blood within the vein. They keep blood in the vein moving toward the heart.
Why the valves stop working is up for debate.
- 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 go 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 situation.
- 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 you 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.
Self-Care at Home
Treatments are available for varicose veins. Many of them are simple things you can start right now.
- Elevate your legs as much as possible. If you can take half-hour breaks during the day to rest, do it. It is important to raise your legs up above the level of your heart to get the maximum effect, and to do this for about a half-hour each time.
- Wear compression stockings (such as Ted Hose or Jobst stockings). The key is to put them on in the morning before you start walking around and before your veins become more swollen. If you try them and experience worsening pain, especially after you have been walking, remove them and see your health care provider. You may have problems with the blood supply to your legs (the arterial supply, which provides oxygen).
- If you 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 your legs to dilate.
- See your health care provider if you have problems such as chronic constipation, urinary retention, or chronic cough. Relieving conditions that are causing you to strain may help with the varicose veins.
- Avoid wearing tight clothing such as girdles or belts.
- Do not cross your legs when sitting.
- Walking is good exercise. It can help the muscles force the blood out of the deeper vein system.
- If you are driving on a trip 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. The treatment is only helpful for the spider veins and very small veins. It has no use in the treatment of large varicose veins.
- Even for the smaller veins, many treatments are usually necessary.
- The therapy is not totally successful in helping symptoms and preventing formation of more varicose veins.
- Complications associated with this technique 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 3 weeks.
- Wearing compression stockings is usually recommended after treatment.
Lasers have received attention recently as a treatment for varicose veins but are frequently used in the treatment of smaller spider 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.
- Since this mode of therapy is relatively new, only time and experience will tell if it is as effective as older techniques.
If you have superficial thrombophlebitis, your health care provider will usuallyrecommend warm compresses and pain medication. Additional treatmentdepends on whether your physician thinks you may have an infection.