Varicose Veins - Causes And Prevention
Medical researchers have estimated that about 3 in 10 adults will develop varicose veins, making varicose veins a very common condition. They are usually found in the lower leg region, but can occur in other areas of the body. For most people varicose veins are not a sign of any underlying disease and may develop without any known cause.
The word varicose means abnormally swollen or enlarged, so in order to understand more fully how a vein becomes swollen, we'll first of all look at a healthy vein and how it works.
The veins are blood vessels that take de-oxygenated blood back to the heart en route to the lungs to pick up more oxygen. Veins are generally divided into three types:
- Superficial - these are the veins that you can see just under the skin and they often easy to feel. These are the type of veins that usually become a varicose vein.
- Deep - these veins are situated deep within the muscles and you can't see or feel them.
- Perforators - these are tiny veins that act as connections between the deep underlying veins and the superficial ones.
Because as humans we stand upright, due to gravity, the blood in our legs would run back down into our feet. Therefore there are some mechanisms that prevent this from happening:
- The natural action of body muscles contracting and relaxing pushes blood through the veins.
- Veins also have a serious of valves that close the vein temporarily to prevent the blood from going back down.
This is the normal working of a healthy vein, so lets have a look at what happens when a person develops a varicose vein.
Varicose vein development
As we can see from the diagram above, normal veins are a regular shape with smooth walls and strong valves. When you see a varicose vein it not only looks swollen but frequently has a knotted or twisted appearance. They are also generally blue-purple in colour. This is due to the pooling of blood that stretches the vein wall. The reason we can see them is because varicose veins tend to occur just under the surface of the skin.
Often you will also see tiny veins that seem to form a spider or star-like pattern, but these are not proper varicose veins.These spider veins can be caused by a back-up of blood but also injury, too much exposure to the sun and hormones.
When the wall of the vein becomes weak in a section it stretches and becomes larger. If this weakness occurs near to a valve, this can become damaged, causing leakage of the blood backwards. This can start off a chain reaction as the leaking blood puts more pressure on the vein and other valves so they too become weaker and damaged. When blood continues to become stagnant in the vein it begins to bulge and its shape can become distorted as with the knotted effect we see in some varicose veins.
Factors that may cause varicose veins:
- It's probable that more women than men will suffer from varicose veins at some time. In addition, family history of the condition may make it more likely for a person to develop varicose veins.
- Overweight - the more you pile on the pounds the more stress is put onto the veins so increasing the risk of damage and varicose veins developing.
- Age - when we get older the risk of varicose veins increases.
- Jobs - it has long been believed that jobs that involve standing for long periods of time will cause varicose veins. However, some scientific research suggests that there is no proof of this. Nevertheless, when people do have varicose veins, standing for long periods of time generally makes the pain worse.
- Pregnancy - varicose veins may develop due to the extra weight being carried by the mother and the pressure of the baby. In addition, hormones related to pregnancy are also believed to be a risk factor in developing varicose veins. For most mothers, the varicose veins that develop usually return to normal after the birth. However, for women who have a few pregnancies, varicose veins may become permanent.
- Other medical conditions - these may lead to the development of varicose veins. For example there are rare conditions where the blood vessels have not developed properly and these lead to the formation of varicose veins. In addition, swelling or tumours in the lower pelvic region can cause congestion of the veins at the top of the legs. Also, if a person has suffered from a previous injury to a vein or has had a blood clot then varicose veins may develop in this area.
Some people don't have any symptoms when they have varicose veins but others may experience:
- Very heavy feeling in the legs that is uncomfortable.
- Aching of the legs and there may also be a burning sensation and throbbing.
- Itchy skin that is also dry and delicate over the area.
- Swollen feet and ankles.
- Muscle cramps - these frequently occur at night time.
In addition, there can sometimes be complications when you have varicose veins so we'll take a look at these now.
Tips on varicose vein prevention
1. Keep your weight within normal range.
2. Regular exercise keeps the circulation in the legs healthy - walking and running are two of the best.
3. Elevate your legs for a while when resting.
4. Avoid sitting with your legs crossed for long periods of time as this may lead to damage.
5. Wearing low heeled shoes helps to exercise the leg rather than high heels.
6. Eating less salt in the diet helps to reduce swelling and fluid retention.
Complications and prevention of varicose veins
The majority of people who have varicose veins, won't develop complications. Most of the problems arise from increased pressure on the smaller veins that causes damage to surrounding tissues and skin. Normally these issues will only appear a few years after varicose veins have developed. In addition, the size of the varicose vein is not an indication that complications will develop and there are no clear pointers as to who will have medical issues with them.
The Most Common Complications:
The following is a list of the most commonly reported complications that may arise due to varicose veins:
- Changes in the skin noticed over the varicose vein site. These changes can include discolorations, red and thickened skin (lipodermatosclerosis), eczema, venous ulcers.
- Chronic venous insufficiency can develop over a period of time where the blood flow is diminished and causes interference with the delivery of oxygen and nutrients, as well as taking waste matter and carbon dioxide away. This can lead to conditions such as those described above - venous ulcers, eczema and lipodermatosclerosis.
- Thrombophlebitis - this is basically an inflammation that develops in the varicose vein.
- Swelling of the lower foot and leg, (oedema) due to vein congestion.
- In rare cases the varicose veins may start to bleed and this can be potentially life threatening.
Emergency procedure for a bleeding varicose vein:
- Lie down flat and raise the leg as high as you can - it must be higher than the rest of the body, so use a chair or other object to rest the leg against in order to keep it elevated.
- Using a clean cloth or dressing put this around the area that is bleeding and keep pressure on it for at least 10 minutes.
- If the bleeding does not stop or if it's very heavy call the emergency services immediately.
- If the bleeding does stop, you must next make an appointment with your doctor so that they can check the area for likely further bleeds.
There are various treatments for varicose veins that should be discussed with your doctor. However, if you are in the UK and you want varicose veins removed for cosmetic reasons, this is rarely carried out on the NHS and you would need to go to private health care. Treatment will usually be started if there are complications arising from varicose veins and/or to ease the symptoms.
Your doctor may advise on some of the following:
- Compression stockings. These are very tight fitting stockings that basically squeeze the legs so helping to increase circulation as well as giving support. Many people do find them beneficial especially in relieving pain but other people don't. According to the NHS UK, medical research carried out on the benefits of using compression stockings had mixed results, but this could have been due to people being reluctant to wear them or being unable to use them properly.
- Surgery - stripping and litigation is the main method used for removal of the varicose vein. Once removed the veins that are left in the area take over the role of the vein that has been removed. This procedure is often very painful for a period of time following the operation.
- Sclerotherapy - this involves injecting a chemical into the affected veins causing scarring that seals them closed. The varicose veins begin to fade after a few weeks and other veins in the area take over the role of the sealed vein. However, this procedure is usually only suitable on small to medium sized varicose veins.
You can carry out some treatment at home for your varicose veins and these include:
- Leg elevation
- Avoid standing for long periods.
However, don't use home therapy as an alternative to seeing a doctor. Speak to your doctor first about your concerns and then discuss how effective the home therapy is likely to be for your circumstances.
I hope that you've found something useful in the hub on varicose veins. As always, this hub is for information only and not a substitute for medical advice.