Varicose Veins

What are Varicose Veins?

Varicose Veins are normal veins that become abnormally dilated or widened due to Venous Pressure.

Affected veins typically become visible and appear swollen and twisted. Varicose Veins protrude or bulge above the skin’s surface. Varicose Veins appear as blue, purple, or red veins.

Varicose Veins may also be known as Venous Insufficiency Syndrome and is often the result of a deeper, underlying Venous Disease.

varicose veins of the leg

Where Do Varicose Veins Appear?

Varicose Veins is a fairly common condition, with studies showing as many as 10% of men and 30% of women commonly presenting with venous symptoms and signs.

Where Do Varicose Veins Occur?

Varicose Veins are most common in the superficial veins of the legs. Varicose Veins are easily found and typically appear first on the:

  • Back of the calf
  • On the inside of the leg
  • Upper thighs

However, Varicose Veins can form elsewhere in the body.

What do Varicose Veins Look Like?

Varicose Veins differ from Spider Veins, in that they are larger, however they similarly twist and turn. These visible signs may vary depending on the stage or severity of the condition.

Where do Varicose Veins Occur?

Varicose Veins most commonly occur on legs or thighs. However, they can occur on any part of the body, manifesting on the surface of the skin.

Who is at Risk of Varicose Veins?

Varicose Veins risk factors are often related to stress brought on the legs.

While anyone can be at risk of Varicose Veins, the condition is more likely in people who are:

 
  • Likely to have defective valves
  • Prone to blood clots
  • Women
  • Genetically-prone (i.e. the condition runs in the family)
  • Overweight
  • Older
  • Inactive or lack exercise
  • Pregnant.

Who do Varicose Veins Affect?

About 14% of the adult population suffer from Varicose Veins, versus 59% for Spider Veins, and they are more often found in older patients.

Varicose Veins on Women

Women are more likely to get Varicose Veins than men.

Females are more at risk due to other vein-strains including: hormonal changes, puberty and pregnancy.

Varicose Veins on the Aged or Older People

Varicose Vein onset typically occurs with age. However age isn’t an absolute factor and we also start seeing signs of Varicose Veins in patients as early as their late twenties or early thirties.

Varicose Veins on Lighter Skin Types

This condition is more likely with lighter skin types.

Causes of Varicose Veins

Leg muscles pump the veins to return blood to the heart (the skeletal-muscle pump), against the effects of gravity.

Veins have pairs of leaflet valves to prevent blood from flowing backwards (Retrograde Flow or Venous Reflux).

When veins become Varicose, the leaflets of the valves no longer meet properly, and the valves do not work (Valvular Incompetence). This allows blood to flow backwards or leak down and collect in the veins. The veins enlarge even more and become Varicose Veins.

Known Causes of Varicose Veins

While Varicose Vein causes are generally numerous, experts agree that it can be attributed to certain conditions. Common causes of Varicose Veins can include:

 
  • Pregnancy
  • Blood clots and other circulatory problems
  • Hormonal changes including Puberty, Birth Control Pills
  • Predisposition due to genetics
  • Inflammation of the veins
  • Injury or local trauma
  • Sitting or standing for a long time
  • Inactive lifestyle.
 

Unknown Causes of Varicose Veins

While Varicose Vein causes are numerous and well-understood, diagnosing causes that aren’t listed above can often be attributed to certain lifestyles.

People prone to Varicose Veins can include lifestyle causes such as: inactive lifestyles and or, people who have jobs that require them to stand for long periods of time.

Do Abnormal Veins Improve Over Time

Abnormal leg veins (Spider Veins and Varicose Veins) do NOT improve over time.

Varicose Veins left untreated will progressively worsen over time and at an accelerating rate. This means that Varicose Veins left untreated will cause more Varicose Veins to appear over time, than if the Varicose Veins were treated in the first instance.

The well understood problem of tooth decay and the risk of loss of a viable tooth if left untreated - serves as a good comparison.

How do Varicose Veins Affect You?

Varicose Veins are typically a superficial condition but can be a cosmetically disfiguring condition. Rarely are they regarded as a serious condition.

Besides unsightly veins being visible, Varicose Veins do not usually pose a threat to one’s health. Although more advanced cases of Varicose Veins may cause heavy limbs or cramping pain, especially when standing.

However, Varicose Veins may spread to different parts of the body, when the cause is associated with more serious underlying conditions. In this situation, if they are left untreated this can lead to more serious health outcomes.

Why Do Varicose Veins Form?

Your blood is carried through veins to all parts of your body. While the heart pumps the blood, the veins use valves to stop the blood flow from moving backwards especially when gravity is pulling in the opposite direction, away from your heart.

If the veins' valves become weakened, blood can leak backwards into the veins and collect there.

This problem is called Venous Insufficiency. When backed-up blood makes the veins bigger, they can become twisted, lengthened, and swollen (another adjective for this is Varicose).

What are the Signs of Varicose Veins?

Over 75% of people with Varicose Veins have symptoms that interfere with their lives. People may experience visible signs in their legs including:

 
  • Discolored skin particularly around the ankle veins
  • Twisted or bulging veins that is seen just underneath the surface of one’s skin
  • Scaly or dry skin
  • Swelling or heaviness
  • Skin ulcers.
 

Varicose Veins Symptoms

Beyond the visible signs of Varicose Veins, other symptoms of Varicose Veins can be experienced as feelings or sensations in the legs including:

 
  • Tingling or numbness  in leg
  • Burning sensations in leg
  • Restless type sensations in leg
  • Irritation or itchiness on the ankle or lower leg.
  • Throbbing or cramping of legs
  • Leg pain, muscle fatigue, tired and achy
  • Leg cramping
  • Bleeding in affected areas
 

What Related Disorders Occur with Varicose Veins?

The widening of a patient's veins that can cause Varicose Veins can also be related to an increase in Venous Pressure.

Other conditions or pathology can be associated with Varicose Veins. While rare, some complications are life-threatening.

Associated conditions with Varicose Veins include:

 
  • Spider Veins
  • Deep Vein Thrombosis
  • Lymphedema
  • Dermatitis
  • Pigmentation
  • Ovarian Vein Varices
  • Thrombophlebitis
  • Telangiectasias
  • Varicoceles
  • Hypotension
  • Fainting Episodes.
 

Severe long-standing Varicose Veins can lead to:

 
  • Skin thickening (Lipodermatosclerosis)
  • Ulceration
  • Leg swelling
  • Venous Eczema.
 

What is the Difference between Varicose Veins and Venous Insufficiency?

Both Varicose Veins and Venous Insufficiency are Chronic Venous Disorders which can include all structural and functional abnormalities of the Venous System.

Venous Insufficiency is more about the functional abnormalities of a patient’s veins and Varicose Veins can be a result of this condition.

Venous Insufficiency can produce advanced symptoms like oedema, skin changes or leg ulcers.

What is Evident with Varicose Veins?

Varicose Veins could be an early warning of more serious underlying conditions that needs to be treated, either through a doctor or through self-treatment.

Either way, the diagnosis should be made by our doctor before proceeding by any means.

Varicose Veins may also be known as Venous Insufficiency Syndrome. This is a fairly common condition, with studies showing as many as 10% of men and 30% of women commonly consulting for venous symptoms and signs.

Stages of Varicose Veins

Stage 1 - Spider Veins

Early stages of Varicose Veins are purely seen on the skin. These dilated veins and capillary vessels are called Telangiectasias.

Stage 2 - Pre Varicose Vein Stages

During the Pre Varicose Veins Stage patients can observe few signs, but patients start to become aware of early Vein Disease progresses; swelling of the legs may begin to occur but typically does not include skin changes.

The backflow in the venous system interferes with the body’s ability to reabsorb fluid leading to swelling of the leg.

Leg swelling caused by the retention of fluid in leg tissues is known as Peripheral Edema. It can be caused by a problem with the circulatory system, the lymphatic system or the kidneys. Swelling due to fluid build-up after sitting or standing for a long time may also occur.

Elevation may help with the symptoms, but will not cure venous disease. While swelling in the leg is commonly associated with vein diseases, there may be other underlying causes for swelling of the legs.

This stage can include the growth of the Varicose Veins to larger areas of the skin. It also includes pain, more swelling as well as muscle aches on the affected areas.

Stage 4 - Skin Discolouration without Ulcers

As the Vein Disease progresses, the Venous Congestion may lead to changes in the skin’s colour. The skin may also become thinner and discoloured to reddish brown or whitish in colour. At this stage, the skin is easily injured and takes more time to heal.

During this stage, skin irritation and bleeding become more common.

Stage 5 - Skin Discolouration with Ulcers

The skin colourisation can spread beyond local Varicose Veins and lead to Ulceration particularly around the ankles.

Stage 6 - Advanced Skin Ulceration

Venous Ulcers usually occur due to improper functioning of a patient's veins and valves. This stage is the most advanced form of Superficial Vein Diseases.

Venous Ulcers also known as Venous Insufficiency Ulceration, Stasis Ulcers, Stasis Dermatitis, Varicose Ulcers, or Ulcus Cruris are wounds that are thought to occur due to improper functioning of venous valves, usually of the legs (hence, leg ulcers.)

Leg and ankle ulcers are caused by Venous Congestion that has progressed and may have serious consequences.

It means a patient's blood flow is insufficient to provide nutrition to the skin. Once Vein Diseases have progressed to this stage, any type of skin injury will heal at a slower rate.

Without treatment, skin ulcers can remain unhealed for an extended period of time, and more than likely become worse.

These Venous Ulcers can become chronic wounds, if left untreated and can be extremely painful. Cellulitis or leg infection may occur, increasing the risk of sepsis or blood infection.

Why Treat Varicose Veins?

Many who opt for Varicose Vein treatment are unhappy with the unsightly appearance of the veins on the surface of their skin, so they may observe a boost of confidence when the condition is treated. This is especially true for more severe cases of the condition where it has spread to other areas of the skin.

When Should I Consider Watchful Waiting of Varicose Veins?

Watchful waiting of Varicose Veins should never be considered. Varicose Veins will never improve spontaneously. Existing Varicose Veins cause new Varicose Veins to appear at an accelerated rate.

Types of Varicose Vein Treatment

Varicose Vein emergence is unsightly and may lower one’s self-esteem. This is especially true for advanced stages of the condition.

Varicose Veins can be treated by either clinical treatment or lifestyle changes. The latter affects the the condition much slower than the former, so that may be a consideration that affects one’s course of action.

Treatment choices for varicose veins include:

 

Alternative Treatments for Varicose Veins

Alernative or non-surgical treatment of Varicose Veins include: Elastic Compression Socks or Compression Stockings.

Varicose Veins Prevention

There is no known method of prevention.

Wearing specialised Venous Support Stockings may prevent some dilated blood vessels from developing in some people.

Maintaining a normal weight and regular exercise, especially walking, may also be helpful.

Certain footwear may restrict normal ankle movement, this includes high heeled shoes. So people who are susceptible to venous disease should avoid wearing this type of footwear.

Lifestyle Recommendations for Preventing Varicose Veins

To prevent Varicose Veins, patients are advised to improve circulation in the veins. For some, this may require lifestyle changes. Circulation can be improved by following the convention methods listed below:

  • Avoid sun exposure, especially if of a lighter skin type
  • Reduce weight as obesity will increase the risk of pressure being exerted on the blood walls
  • Avoid wearing tight clothes which may interrupt the circulation
  • Avoid wearing high heeled shoes as calf muscles put in a lot of energy when you try to walk in heels, when the calf muscles are at rest the circulation will be improved.
  •  
  • Exercise and physical activity should be included in your daily routine
  • Avoid sitting for long hours without standing up for a break
  • Avoid standing for hours without significant movement
  • Avoid putting pressure on veins by resting them periodically
 

Recurrence of Varicose Veins After Treatment

Ongoing checks for any re-emergence is recommended after completion of treatment for Varicose Veins.

The likelihood of Recurrence of Varicose Veins is high in patients with a genetic predisposition. Where the cause is of a genetic nature, more active prevention may also be required.

Varicose Veins are also likely to come back with age or if other causes are not addressed such as:

 
  • Lack of physical exercise or an inactive lifestyle
  • Standing for long periods of time
  • Undertaking ineffective treatments.

It is best to consult a doctor and seek treatment, especially when recurrence causes any sort of pain or discomfort.

Preventing Varicose Vein Recurrence

Further treatment can be avoided by living a healthier lifestyle and applying preventive measures that are similarly used to treat the condition.

Lifestyle Recommendations for Preventing Varicose Veins from returning include:

 
  • Resting them periodically
  • Avoiding wearing high heels
  • Maintaining a healthy weight as to avoid putting extra stress on your circulation
  • Avoiding standing for hours without significant movement.

Periodic Vein Screening

Consult the appropriate doctor to screen for any other vein complications you may be at risk for. An appropriate assessment that gauges how likely you are to suffer from Venous Diseases is necessary especially if you have Recurring Vein Disease.