Varicose veins—which afflict 10 to 20 percent of all adults—are swollen, twisted, blue veins that are close to the surface of the skin. Because valves in them are damaged, they hold more blood at higher pressure than normal. That forces fluid into the surrounding tissue, making the affected leg swell and feel heavy.
Unsightly and uncomfortable, varicose leg veins can promote swelling in the ankles and feet and itching of the skin. They may occur in almost any part of the body but are most often seen in the back of the calf or on the inside of the leg between the groin and the ankle. Left untreated, symptoms are likely to worsen with some possibly leading to venous ulceration.
What causes varicose veins?
The normal function of leg veins—both the deep veins in the leg and the superficial veins that feed them—is to carry blood back to the heart. During walking, for instance, the calf muscle acts as a pump, contracting veins and forcing blood back to the heart. To prevent blood from flowing in the wrong direction, veins have numerous valves. If the valves fail (a cause of venous reflux), blood flows back into superficial veins and back down the leg. This results in veins enlarging and becoming varicose. The process is like blowing air into a balloon without letting the air flow out again—the balloon swells.
To succeed, treatment must stop this reverse flow at the highest site or sites of valve failure. In the legs, veins close to the surface of the skin drain into larger veins, such as the saphenous vein, which run up to the groin. Damaged valves in the saphenous vein are often the cause of reversed blood flow back down into the surface veins.
Why do varicose veins occur more in the legs?
Gravity is the culprit. The distance from the feet to the heart is the furthest blood has to travel in the body. Consequently, those vessels experience a great deal of pressure. If vein valves can't handle it, the backflow of blood can cause the surface veins to become swollen and distorted.
Who is at risk for varicose veins?
Conditions contributing to varicose veins include genetics, obesity, pregnancy, hormonal changes at menopause, work or hobbies requiring extended standing, and past vein diseases, such as thrombophlebitis (inflammation of a vein as a blood clot forms.) Women suffer from varicose veins more than men, and the incidence increases to 50 percent of people over age 50.
What are the symptoms?
Varicose veins may ache, and feet and ankles may swell towards day's end, especially in hot weather. Varicose veins can get sore and inflamed, causing redness of the skin around them. In some cases, patients may develop venous ulcerations.
What are venous ulcerations?
Venous ulcerations are areas of the lower leg where the skin has died and exposed the flesh beneath. Ulcers can range from the size of a penny to completely encircling the leg. They are painful, odorous, open wounds that weep fluid and can last for months or even years. Most leg ulcers occur when vein disease is left untreated. They are most common among older people but can also affect individuals as young as 18.
What is the short-term treatment for varicose veins?
ESES (pronounced "ess-ess") stands for Exercise, Stockings, Elevation and Still and is an easy way to remember the conservative approach to relieving varicose vein symptoms. Exercising, wearing compression hose, elevating and resting the legs may provide some symptomatic relief; however, these measures will not make the veins go away or necessarily prevent them from worsening, because the underlying disease (venous reflux) has not been addressed. Weight reduction is also helpful. For inflamed areas or an infection, topical antibiotics may be prescribed. If ulcers develop, medication and dressings should be changed regularly.
What is sclerotherapy?
Sclerotherapy as a procedure in which a chemical injection, such as a saline or detergent solution, is injected into a vein causing it to "spasm" and close up. Other veins then take over its work. This may bring only temporary success, and varicose veins frequently rec