What are Varicose Veins?
Varicose veins are twisted, enlarged veins, often dark blue in color, near or raised above the surface of the skin. Varicose veins are often a symptom of an underlying condition called venous insufficiency. Varicose veins do not occur suddenly; it usually takes years for symptoms to develop.
In healthy veins, one way valves direct the flow of venous blood upward and inward. Blood is collected in superficial small veins and flows into larger veins. The blood eventually passes through valves into the deep veins and then centrally to the heart and lungs.
When one or more of these valves fail to function correctly or leaks, some blood flows down the leg, in the reverse direction. The blood tends to overfill and stretch the branches of superficial veins under the skin. Deep veins can withstand this pressure because of their construction and because the surrounding conforming muscle prevents the veins from becoming excessively stretched.
Over time, this additional venous blood pressure causes the veins to stretch, bulge, and become visible. Continued exposure to high pressure can cause superficial veins of any size to become dilated and twisted.
photgraphs showing examples of varicose veins.
When valves fail, blood will accumulate under pressure causing swollen, engorged or rope-like veins. These veins have become weakened and fill up with blood. The valves inside these veins no longer close allowing blood to leak back down the leg producing a stretching of the vein.
Early symptoms of varicose veins include:
- Pain in the legs with a feeling of tiredness and heaviness in the lower legs.
- Swelling of the ankle and lower leg.
- Discoloured, brownish skin near the ankle.
- A rash or skin ulceration on the ankle or lower leg can also be an indication of varicose veins.
There may be other reasons for any one of the above symptoms; however, a combination of these symptoms may be an indicative of varicose veins or other venous disorders.
Who Is Affected By Varicose Veins?
There is growing medical evidence that varicose veins are an inherited (genetic) condition, although it is important to note that anyone can get them. Varicose veins are more common in people that have had certain types of leg injuries, deep vein blood clots or whose occupations lead to them spending long periods of time standing still or sitting down. These activities reduce the flow of blood in the veins of the leg muscles.
Whilst the cause of varicose veins has not been established, a number of contributing factors have been identified:
- Heredity - varicose veins tend to run in families. If your parents, grandparents, aunts, uncles, etc. had varicose veins there is a high likelihood you will develop them as well.
- Gender - primarily due to the production of progesterone (one of the major female hormones), females are more likely to get varicose veins than men are, by a ratio of 4:1.
- Age - presence of varicose veins is a progressive condition that worsens in frequency and severity with age. As we age, elastic fibres in all tissues deteriorate, leading to the production of wrinkles in the skin and dilated and tortuous blood vessels.
- Obesity - excess weight increases the pressure on vein valves and can lead to their weakening.
- Hormones - changes in hormone levels brought on by puberty, pregnancy, menopause, hormone replacement therapy and the birth control pill can cause varicose veins to develop.
- Pregnancy - an increased progesterone level, increased volume of blood in the body and increased pressures on the pelvic veins are all contributing factors. 70% of women develop venous problems during pregnancy. These include fluid retention, pain, heaviness or fatigue in the feet and legs, mild oedema (swelling in feet and legs) and spider veins - 20% of whom will develop a more serious varicose vein condition.
- Occupation - people whose jobs require them to stand or sit for prolonged periods of time have an increased risk of developing varicose veins. While standing still or sitting, there is an increased pressure of blood on the closed vein valves that contributes to their weakening.
Possible Long-term Complications
- Varicose veins are common and are not generally associated with more severe health problems. However, they can be painful, unattractive and worsen over time. Varicose veins can cause legs and feet to swell, create a sense of fatigue in leg muscles, and throbbing and cramping at night. The skin surrounding the veins may also itch and burn.
- Very rarely the return of blood to the heart can be impaired which can lead to problems like deep vein thrombosis (blood clot).
- Left untreated, varicose veins can lead to swelling, increased pain, skin discolouration, and ulcerations of the lower legs. These ulcerations are difficult to treat and can become easily infected and painful.
Many of these symptoms and complications can be prevented by early treatment of varicose veins. Please feel free to contact the Surrey Vein Clinic if you need advice or wish to arrange an initial consultation.
