What are Varicose Veins?
Varicose veins, sometimes called venous reflux, are swollen, gnarled, tangled, twisted, enlarged and discolored veins. They are easily visible through the skin.
A healthy vein allows blood to flow in one direction through one-way valves. A varicose vein is caused when one or more of these valves weaken and allow blood to flow backwards, or pool. The walls of the veins become stretched, losing elasticity as the blood accumulates. The appearance of the veins becomes enlarged and bulged due to trapped blood.
The furthest veins from the heart are often the most susceptible. Because gravity and weight make it more difficult for blood to flow back to the heart, varicose veins are most common in the legs. However, venous reflux can also occur in the hands, pelvis, face and other areas in the body.
What is Vein Disease?
While varicose veins can be uncomfortable and unsightly, the biggest concern is they are a sign of a larger underlying problem. Varicose veins are a symptom of Vein Disease, a problem over 30 million Americans suffer from.
When the one-way valves in the veins do not close all the way, it is called vein disease.
Varicose Veins are considered stage 2 of the 5 stages of Vein Disease. Although initial symptoms are mild, untreated advanced stages can have deadly side-effects like blood clots because Vein Disease does not get better over time.
Signs and Symptoms of Varicose Veins
Varicose Veins are usually easy to see and feel through the skin. However, it is important to note that sometimes they can be hidden deep within the body. They are often purple in color and swollen, twisted or bumpy. Some patients may feel itchy, heavy or swollen legs and notice discoloration or bruising. Others complain of burning or throbbing and cramping that can be more noticeable at night.
The furthest veins from the heart are often the most susceptible. Because gravity and weight make it more difficult for blood to flow back to the heart, varicose veins are most common in the legs. Nonetheless, venous reflux can also occur in the hands, pelvis, face and other areas in the body.
Patients may have one or more of these symptoms:
- Swollen Veins
- Purple or Blue Veins
- Skin Discoloration
- Heavy Legs
- Trophic Ulcer
- Thinner Skin Over Vein
- Restless Leg Syndrome
- Atrophie Blanche
- Venous Eczema
Causes of Varicose Veins
Blood flows through the veins in one direction. As a person ages, the walls of the veins become stretched and less elastic. This weakens the valves allowing blood to leak backward trapping it against the forward flowing blood. This creates a pool of blood in the vein which makes the characteristic “bulging” associated with varicose veins.
The legs are most often affected because they are furthest away from the heart. Gravity is a big proponent of this. Gravitational pull makes it more difficult for blood to flow back to the heart causing the weakening of the vein and valves mentioned above.
While experts cannot determine exactly why some people have varicose veins and others do not, there are some potential risk factors that increase a person’s chances.
- Gender or Hormones
- Genetics or Heredity
- Age (50+)
Conditions like pregnancy and constipation put pressure on the abdomen which is a known cause of varicose veins. Women are at higher risk. It is hypothesized that hormones, contraceptives, menopause and pregnancy may produce a chemical that relaxes the veins causing them to weaken. Obesity is a factor because the extra weight can inhibit or slow proper blood flow and make the heart work harder to pump it around the body. Genetics are considered because weakness of veins may run in the family. Age and jobs that require standing are risk factors due to the wear and tear it puts on the veins, weakening them, causing varicose veins.
Types of Varicose Veins
Spider veins are not technically Varicose veins, but are listed here because they often precede varicose veins as the first stage of Vein Disease. Spider veins are characterized by twisted red, purple or blue blood vessels that appear as webs or thin lines. They are visible through the skin but are usually painless. Spider veins are often caused by the same valve weakness that causes varicose veins.
Moderate Varicose Veins
Moderate Varicose Veins are characterized noticeable blue or purple bulges underneath the skin. Still considered a cosmetic concern at this stage, moderate Varicose Veins are generally not painful. It is still important to have a vein exam if you notice moderate varicose veins as they are often a symptom of Chronic Venous Disease. These veins no longer allow blood to flow properly to the heart.
Severe Varicose Veins
If left untreated, Varicose Veins can become deformed and unhealthy. These badly swollen, mangled veins are a sign of Chronic Venous Disease and should be treated immediately. Complications like skin ulcers, severe swelling, discoloration and thickening of the skin and tissue often accompany severe Varicose Veins. Life threatening issues like deep vein thrombosis (DVT), also known as blood clots are at higher risk.
Pregnancy Varicose Veins
When a woman is pregnant she produces about 50% more blood. This extra blood puts added pressure on the veins leading to weakening valves and subsequently varicose veins. Multiple pregnancies can lead to Pelvic Congestion Syndrome (PCS) which causes painful varicose veins in the legs and pelvis. Pregnancy related varicose veins may go away on their own, but more severe cases should be checked by a vein specialist to rule out risk of future complications.
Pelvic Varicose Veins
Pelvic Varicose Veins are often a sign of Pelvic Congestion Syndrome (PCS). The veins in the pelvis become enlarged, twisted or purple and blue in color, however they are not externally visible. PCS is often characterized by a constant, dull pain in the pelvic area and is difficult to diagnose. Pregnant women are at higher risk of Pelvic Varicose Veins, but they can be found in both non-pregnant females and males.
Diagnosis of Varicose Veins
Varicose Veins are often diagnosed through a physical exam. A varicose vein physical exam includes a specialist looking at your legs while sitting and standing to identity visible varicose veins. These are usually purple, swollen, enlarged or appear tangled. The doctor or nurse will also look for swelling or skin discoloration. You will be asked about any pain, cramping, aching or itching in your legs, medical history and family history.
The vein specialists at Vein Institute of Pinellas also recommend an ultrasound to test the valves in your veins for vein disease. Vein Disease is characterized by malfunctioning vein valves that let blood travel backward causing it to get trapped and pool in the vein behind the valve. An ultrasound can also check for blood clots, a potentially deadly side-effect of Vein Disease.
Less common, but still used to diagnose Varicose Veins are X-Ray or Computed Tomography (CT) Scan.
Treatment of Varicose Veins
Varicose Veins can be treated through a multitude of relatively pain-free procedures. Most treatment is covered by insurance and Vein Institute of Pinellas uses all the top options on the market to ensure the best individualized treatment for every patient.