May 16, 2021
Almost everyone has seen someone with varicose veins in their legs. Or maybe you even have them yourself. They have the appearance of swollen, twisted, bluish “ropes” which are actually veins that lie just underneath the skin. Most of the time varicose veins affect the legs, although they can appear in other places in the body as well. Hemorrhoids are varicose veins that form in the rectum, but people usually don’t think of them as such. Varicose veins can develop in the esophagus, the liver, and the stomach. So-called “spider” veins are also a form of varicose veins. So you can see how common they are.
Normal Vein Functioning
Before we get into what causes varicose veins, let’s first look at the function of normal veins, which are blood vessels that bring deoxygenated blood back from other parts of your body to your heart. Valves within the veins open and close to prevent the blood from flowing backward and pooling in the legs.
This is in contrast to arteries, which function to carry oxygenated blood from your heart to the tissues of your body. Unlike arteries, which take advantage of the pressure of the pumping from the heart, veins rely on the contraction and relaxation of your muscles, plus the help of the valves, which help the blood flow toward the heart. Arteries don’t require these valves.
When the valves in the veins become weak or damaged, the blood can backflow and pool in the veins, stretching them and causing damage to the veins themselves. This backflow is also known as venous insufficiency or venous reflux. So what causes this? Why do the valves become damaged?
Most of the time, varicose veins are caused by an increase in blood pressure inside the veins. This increase in pressure can come from pregnancy, being overweight or obese, or can run in the family as some people seem to have a genetic predisposition for varicose.
The risk of developing varicose veins increases as you age, if you either sit or stand for long periods of time, you are overweight or obese, or have a family history of varicose veins. Pregnancy, especially multiple pregnancies, greatly increases a woman’s risk. Symptoms include bulging, bluish veins underneath the skin of your legs, swelling in the legs, aching or heaviness, leg cramps at night, discoloration of the skin, and itching. Your symptoms may get worse if you are on your feet for a long time or sit for a long time and get better when you lie down or put your feet up.
Diagnosis is based on your health professional asking you about your symptoms and physical exam. Sometimes, the doctor will order an ultrasound or other tests to get a better look at the condition of the veins. Complications from untreated varicose veins can range from skin color changes, skin ulcers or sores, and even deep vein thrombosis, which is a clot in the deeper veins of the legs and is a serious condition requiring medical treatment.
Occasionally, varicose veins can spontaneously rupture and bleed or will bleed if you sustain some type of trauma to the skin overlying the vein. Many times, this bleeding will not stop without medical attention and can result in the loss of a serious amount of blood.
Prevention and Treatment of Varicose Veins
Avoid standing or sitting for prolonged periods of time and aim for a healthy body weight. This is good advice for anyone, whether you have varicose veins or not. Keep active and exercise regularly, as this helps the pumping of blood through your veins. If you already have varicose veins, consult with your health care provider before beginning a new exercise program, as strenuous exercise can sometimes make varicose veins worse. When sitting, try to sit with your legs elevated above the level of your heart, as this eases blood flow and decreases the pressure on your veins.
Treatments vary, depending on the severity of your condition. These procedures include closing off the varicose veins with laser or radiofrequency energy. Sometimes liquids are injected into the veins to close them off, especially with spider veins. This procedure is called sclerotherapy.
Veins can also be surgically removed. For treatment options, seek out an experienced specialist and speak about the choices you might have.