An Overview of Varicose Veins

About Varicose Veins

Veins are an important part of your vascular system. After the arteries deliver blood to all the extremities, your veins channel blood back to the heart using one-way valves. When these valves don’t close properly, gravity pulls blood down the leg instead of allowing it to flow back to the heart. The blood can pool in the veins and they become varicose, which is a medical term meaning enlarged. There are also reticular and spider veins, which are smaller, enlarged veins on the surface of the skin that can be red, blue or purple.

According to the American College of Phlebology, it is estimated that more than 80 million Americans suffer from some form of venous disease, which includes (in order of descending size): varicose veins, reticular veins and spider veins.

Causes of Varicose Veins

Varicose veins are more common in women than in men, and are linked with heredity. Other related factors are pregnancy, obesity, menopause, aging, prolonged standing, leg injury and abdominal straining. Less common, but not exceptional, are varicose veins caused by other conditions such as post phlebitic obstruction and/or incontinence, or venous and arteriovenous malformation.

Varicose veins are common

Heredity is the No.1 contributing factor casing vein disorders. Women are more likely to suffer from abnormal leg veins. According to the April 2005 issue of the Cleveland Clinic Journal of Medicine, some 25 to 33 percent of women and 10 to 20 percent of men have varicose veins.

Varicose veins are problematic

Varicose veins are the more complex problem veins. They are the large, ropey veins that protrude above the skin, and they can be more than unsightly. They are often a source of leg pain as well. Symptoms can include feelings of fatigue, heaviness, cramping and restlessness of the legs. Severe varicose veins can compromise the nutrition of the skin and lead to eczema (i.e., inflammation of the skin characterized chiefly by redness, itching, and the outbreak of lesions that may discharge serous matter and become encrusted and scaly), inflammation, or even ulceration of the lower leg.

Symptoms of Varicose Veins

• Aching, heavy legs (often worse at night and after exercise).
• Appearance of spider veins (“telengspacticion”) in the affected leg.
• Ankle swelling.
• A brownish-blue shiny skin discoloration near the affected veins.
• Redness, dryness, and itchiness of areas of skin (“stasis dermatitis” or “venous eczema”) from the build up of waste products in the leg.
• Minor injuries to the area may bleed more than normal and/or take a long time to heal.
• In some people the skin above the ankle may shrink (“lipodermatosclerosis”) because the fat underneath the skin becomes hard.
• Restless legs syndrome appears to be a common overlapping clinical syndrome in patients with varicose veins and other chronic venous insufficiency.
• Whitened, irregular scar-like patches (“atrophie blanche”) can appear at the ankles.

Complications

Most varicose veins are relatively benign, but the severe varicosities can lead to major complications, which is due to the poor circulation through the affected limb. These complications can include:

• Pain, heaviness, inability to walk or stand for long hours thus hindering work
• Skin conditions / Dermatitis which could predispose skin loss
• Skin ulcers especially near the ankle, usually referred to as venous ulcers.
• Development of carcinoma or sarcoma in longstanding venous ulcers. There have been over 100 reported cases of malignant transformation and the rate is reported as 0.4% to 1%.
• Severe bleeding from minor trauma, which is of particular concern in the elderly.
• Blood clotting within affected veins. Termed superficial thrombophlebitis. These are frequently isolated to the superficial veins, but can extend into deep veins becoming a more serious problem.
• Acute fat necrosis can occur, especially at the ankle of overweight patients with varicose veins. Females are more frequently affected than males.