Veins are the blood vessels that return deoxygenated blood to the heart. Valves in the vein open to allow the blood to pass through and close to prevent reflux, or the backward flow of blood.
Legs are made up of a network of veins. There are three types of leg veins.
- Deep veins, located deep in the leg, are responsible for returning 90-95% of the deoxygenated blood back to the heart.
- Superficial veins, the small veins at the skin’s surface, are responsible for taking blood from the skin and returning it to the heart.
- Perforating veins link the deep and superficial veins together.
Varicose veins are twisted, enlarged veins, often dark blue in color, near or raised above the surface of the skin. They are found most often on the backs of the calves or on the inside of the leg, anywhere from the groin to the ankle. Any of the vein types may become varicose.
In healthy veins, blood travels in one direction only, towards the heart. In contrast, varicose veins are abnormal or damaged veins that have lost their ability to efficiently return the deoxygenated blood back to the heart. Blood leaks back through weakened valves and pools in the vein, distending and twisting the vein. This condition is called venous reflux and is often the underlying cause of varicose veins. There are multiple causes of varicose veins, and treatments differ by cause and severity of symptoms.
Contributing Risk Factors
An estimated 10-20% of adult Americans have varicose veins. While the cause of varicose veins is not known, a number of contributing risk factors have been identified.
- Heredity – Varicose veins tend to run in families. A defect in vein walls or valves is the greatest contributing factor in 70% of cases.
- Gender – Women are much more likely to get varicose veins than men.
- Age – Varicose veins usually appear between ages 30 and 70 and get progressively worse.
- Obesity – Excess weight increases the pressure on leg veins and valves
- Hormones – Hormonal changes during pregnancy, premenstruation and menopause may be a factor. Female hormones tend to relax vein walls
- Pregnancy – An increased progesterone level, increased volume of blood in the body and increased pressure on the pelvic veins are all contributors.
- Occupation – Professions involving sitting or standing for prolonged periods of time have an increased risk of developing varicose veins, i.e. store clerks, waitresses, hair dressers, flight attendants, teachers, nurses. Your blood doesn’t flow as well if you’re in the same position for long periods.
There is no way to prevent varicose veins from occurring. However, by adhering to the following suggestions, you may be able to alleviate symptoms of varicose veins and slow down the progression of the condition.
- Maintain a healthy weight to avoid placing excess pressure on your legs.
- Avoid crossing your legs while sitting.
- Do not sit or stand for extended periods of time. Be sure to shift your weight from side to side or get up and stretch every 30 minutes.
- Avoid tight clothing that might constrict your waist, groin or legs, such as garter belts.
- Wear elastic support stockings
- Control your salt-intake to prevent inadvertent water retention and swelling.
Varicose Veins Symptoms:
People with varicose veins may notice visibly twisted, swollen leg veins just below the skin’s surface. Some will experience discomfort from swelling, throbbing or cramping at night. Additionally, because the skin tissue around the varicose vein may not be receiving enough nourishment, itching or burning of the skin over the vein is not uncommon. In cases where the symptoms are mild and limited to the above, home treatment can be very successful and medical treatment is usually not necessary.
Varicose veins are common and are not always associated with more severe health problems. However, they can become painful, unattractive and worsen over time.
In cases where the varicose veins are a symptom of more serious underlying vein problems, the patient may experience more severe signs and symptoms. See a doctor if your symptoms include:
- Varicose veins that become red, swollen or tender and warm to the touch
- Heaviness, fatigue, or pain in your legs
- Fluid buildup or swelling in the leg
- Swelling and pain in the calf after sitting or standing for an extended period of time.
- Changes in the color and pigmentation in the skin around the ankles and lower legs.
- Dry, itchy skin or rashes in the area of the varicose vein
- Open sores or ulcers
Exams and Tests
More severe symptoms may be reduced through one of a number of medical procedures. Only a doctor can determine whether a particular medical procedure is appropriate for your condition. Your doctor will perform a physical exam and take a medical history. In addition, your doctor may use duplex ultrasound to take pictures of the blood flow through the vein and assess the cause and severity of the problem.