Veins

What Are Varicose Veins

Varicose veins are twisted, enlarged veins near the surface of the skin. They are caused by weakened valves and veins in your legs. Normally, one-way valves in your veins keep blood flowing from your legs up toward your heart. When these valves do not work properly, blood collects in your legs, and pressure builds. The veins become large, weak, and twisted.

If you have varicose veins, typically prolonged sitting or standing tends to make your legs feel worse. That is because 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 a build-up of pressure occurs in the veins.  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.

Varicose veins can trigger medical problems, not just the embarrassment of unsightly leg veins. Luckily treatment, unlike the past, is relatively easy and painless.

What are Spider Veins?

Spider veins (telangiectasia) are small, dilated veins, usually 2 mm or less, near the surface of the skin. Spider veins are also affected by venous pressure. They are typically red, blue, or purplish in color. Spider veins can develop anywhere on the body, but are commonly found on the face and legs. Spider and varicose veins coincide surprisingly 60-80% of the time.

Why Do Spider Veins Keep Coming Back?

Think of leg veins as you would a tree.  There is the trunk, the large branches, medium width branches, and even more smaller branches all connected to one another. If one of the large or medium branches was diseased, pruning the very small branches to make the tree look better wouldn’t work.  This is similar to why spider veins reoccur. Typically, spider veins may be a sign of deeper venous insufficiency. For this reason, any underlying problem contributing to spider veins must be addressed before treatment may begin. We evaluate many patients who present for treatment of spider veins, who have had these treated, only to see reappearance after 6-12 months. A careful ultrasound evaluation will usually show a deeper source of reflux in one or more of the superficial veins in the legs.

The Vein System

There are 3 basic types of veins in your legs; the superficial, perforating, and deep veins. The Great Saphenous Vein (GSV) and the Small Saphenous Vein (SSV) are the two major veins of the superficial vein system in the legs.

If you have a varicose vein, there is a strong probability that it is the result of one of the many valves failing in the GSV/SSV.  Many more superficial veins branch off of both the GSV and the SSV. The (GSV) is the longest superficial vein which extends from the groin to the foot. The SSV runs from the back of the calf to the lateral ankle.

These superficial veins are connected to the deep veins by the perforator veins.  Perforator veins perforate the deep fascia of muscles to connect the superficial veins to the deep veins where they drain. Their role is maintaining correct blood draining, from deep to superficial veins to prevent blood flowing backwards (reflux). When the valves of perforator veins become incompetent, they can cause insufficiency of the blood flow or reflux.

Common Questions

How common are varicose veins?

Varicose veins are a very common medical condition. In the United States, approximately 40% percent of women and approximately 25 percent of men are affected.

Where do varicose veins develop?

Any vein in your body may become varicose.  However, varicose veins most commonly occur in the legs, because standing and walking increases the pressure in the veins in the lower extremities.  Unfortunately when varicose veins form, they can inhibit a person's ability to walk or run as they used to.

Can varicose veins improve on their own over time?

Unfortunately, vein disease doesn't go away on its own and will only get worse over time – making future treatment more extensive. The good news is that with today's technology, the decision to undergo treatment for most venous disease has become an easy, almost inconsequential choice! No more complicated, unsafe vein surgery, with unpredictable results.  Modern day treatment modalities, as refined by Dr. Gregory Bazell have made treating vein disease remarkably safe, easy, and effective, with minimal discomfort and downtime.

Are varicose veins only a cosmetic concern? For many men and women, varicose and spider veins makes them feel self-conscious about the appearance of their legs. 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 developing other disorders of the circulatory system including blood clots.

Signs and Symptoms of Varicose Veins

The most common locations varicose veins appear are on the inside of the leg or on the calves. However, varicose veins can form anywhere on your legs, from your groin to your ankle.

Varicose veins typically can look dark blue, swollen, and twisted just below the surface of the skin. Sometimes these diseased veins may not seem very conspicuous, but patients may present with symptoms of varicose veins. Not all patients with visible varicose or diseased veins will have symptoms, whereas some patients will present with only 1, or even all symptoms.

Common symptoms may include:

• Heaviness, tiredness in your legs (Symptoms may be worse after you stand or sit for long periods of time)

• Pain, burning, aching, cramping in your legs (Symptoms may be worse after you stand or sit for long periods of time)

• Restless legs, especially at night

• Swelling in your feet and ankles

• Itching over the vein.

  More serious symptoms include:

• Leg swelling

• Swelling and calf pain after you sit or stand for long periods of time

• Skin changes, such as: color changes, dry, thinned skin, Inflammation, scaling

• Open sores, or you may bleed after a minor injury.

  Factors that Increase your Chance of Developing Varicose Veins

• Standing, sitting, walking for long periods of time. Standing and walking puts greater pressure on the circulatory system of the lower body, and the veins in the leg must work against gravity to return blood to the heart.

• Obesity. Extra weight puts more pressure on your veins.

• Age. The natural aging process causes wear and tear on the valves in your veins which regulate blood flow. These leg veins can lose their elasticity or become weak, allowing deoxygenated (blue) blood to pool and enlarge the veins to a visible level.

• Sex. Women have a higher chance than men to develop varicose veins and spider veins. This is attributed to hormonal changes during pregnancy, and also pre-menstruation or menopause may be a factor.  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.