About Varicose Veins

Varicose veins are a very common problem, generally appearing as twisting, bulging rope-like cords on the legs, anywhere from groin to ankle. Spider veins are smaller, flatter, red or purple veins closer to the skin surface. While many people have heard about varicose veins, very few truly understand their underlying cause, and the potential they have for developing into a serious medical issue. Fortunately, there are new and exciting treatments for varicose veins.

Facts about varicose veins

Varicose veins affect an estimated 25% of women and 15% of men. There are a number of factors which lead to varicose veins, including:

Heredity	One of the most important factors. If your parents and grandparents had the problem, you are at increased risk.
Gender	Women have a higher incidence of varicose vein disease due in part to female hormones and their effect on the vein walls.
Pregnancy	Blood volume increases during pregnancy and hormonal effects contribute to vein enlargement.
Age	The tissues of our vein walls lose elasticity as we age causing the valve system to fail. The following additional factors, while not directly causing varicose veins, may speed up the development of this disease and make the veins worse.
Prolonged Standing	Occupations that involve standing for a long period of time cause increased volume and pressure of blood in the lower limbs due to the effects of gravity.
Obesity	Increases in weight often increase abdominal pressure which may worsen vein problems.
Hormone Levels	Treatments like birth control pills and post-menopausal hormone replacement may cause the same hormonal effect as pregnancy.
Physical Trauma	Injury to the lower limbs can damage underlying blood vessels and add to the problem.

How Varicose Veins Occur

Arteries carry blood from your heart out to your extremities (hands, feet, head, skin), delivering oxygen deep into the tissue. Veins then return the ‘de-oxygenated’ blood (now bluish in color) back to your heart to be re-circulated. Nearly 75% of the body’s blood is found in your lower limbs (legs).

To return this blood to the heart, your leg veins must work against gravity. Muscles in the leg squeeze the deep veins to help push blood forward. Small, one-way valves in the veins open to allow blood to flow upward, towards the heart, and then close to prevent it from flowing backwards. While deep veins are assisted in their efforts by muscles, a second type of leg vein, lying outside the muscle layer and closer to the skin (superficial veins), are not. The largest superficial vein is called the Great Saphenous Vein (GSV), which begins at the ankle and ends at the groin.

Varicose veins occur when the valves in these superficial veins malfunction. The vein walls can lose elasticity (due to age or hormones) causing them to stretch. When this occurs, the valve may be unable to close, allowing blood that should be moving towards the heart to flow backward (called venous reflux). Blood collects in your lower veins causing them to enlarge and become varicose. In this manner, faulty valves high on the leg may cause varicose veins lower down (e.g., mid or lower leg).

What are the symptoms and will they get worse?

In addition to the visual appearance of purplish, knotted veins, many patients may experience one or more of the following leg symptoms:

• Pain (an aching or cramping feeling)
• Heaviness/Tiredness
• Burning or tingling sensations
• Swelling/Throbbing
• Tender areas around the veins

If you experience symptoms and delay treatment, your symptoms may progress onward to more serious complications including:

• Inflammation (phlebitis)
• Blood clots (e.g., DVT)
• Ankle sores or skin ulcers
• Bleeding