Varicose Veins

Varicose veins or Spider veins affect nearly 50% of the adult population. While they tend to affect women more than men, sufferers of both genders will testify to the discomfort and downright agony they feel. In this article, we’ll look at what causes this problems and how it can be treated.

What are Varicose Veins?

Varicose veins are abnormally enlarged blood vessels – typically appearing as blue, purple, or skin-colored – which look dilated or twisted and may be raised above the surface of the skin.

Our veins are one of the most important parts of our circulatory system. The main function of the veins is to return blood from the various organs to the heart.They are often referred to as “capacitance vessels” because most of the blood volume (60%) is contained within veins. Veins also have pairs of leaflet valves that prevents reflux blood from flowing backwards (Retrograde flow or venous reflux).

Veins carry deoxygenated blood from the tissues back to the heart with the exception of the pulmonary and umbilical veins, both of which carry oxygenated blood to the heart. On the other hand, the arteries carry blood away from the heart.

When veins become varicose, the leaflets of the valves no longer meet properly and the valves cease functioning leading to ‘Valvular Incompetence’.Such structural abnormalities of blood vessels cause Spider veins and varicose veins to develop.

Now the muscles in the legs pump the venous blood to the heart against gravity. Any structural abnormality in such veins that carry blood back to the heart from other parts of the body can cause pooling of blood, leading toincreased pressure within the veins and weakeningof the walls of the blood vessels. Spider veins and varicose veins then develop from the engorgement and dilation of the affected blood vessels.

Spider Veins vs Varicose Veins

Spider veins (Telangiectasias) are a milder variation of varicose veins and more of a cosmetic concern than a life-altering condition. Spider veins are found closer to the skin’s surface and are often red or blue in colouration. They look like short, fine lines or “starburst” clusters. Spider veins are most common in the thighs, calves, ankles, and feet, but sometimes on the face as well.  They vary in size and often look like a spider’s web hence the name “Spider Veins”.

Varicose veins, on the other hand, can be quite painful and lead to discomfort in the legs and feet. They can also lead to moreserious health problems, for instance, a higher risk of other circulatory problems.

Some Indicators of Varicose Veins:

  • Veins that arediscoloured, mostly dark purple or blue in colour.
  • Veins that appear twisted orbulging, giving a heavy itchy feeling in the legs.
  • Swelling and discoloration at the ankles because of waste products building up in the leg.
  • A burning sensation, throbbing pain or muscle cramping in the legs.
  • Pain in the legs, ankles or heels after sitting or standing for a long time.
  • Bleeding from varicose veins (ulcer).
  • Hardening of the veins with colour changes and inflammation of the skin,or presence of skin ulcers near your ankle.

 

Varicose Veins vs Deep Vein Thrombosis

Although life-threatening complications are highly unlikely, varicose veins may be confused with Deep Vein Thrombosis, which is more of a life-threatening condition. Deep vein thrombosis (DVT) is the formation of a blood clot in a deep vein, most commonly found in the legs, and has similar symptoms like varicose veins.

Risk Factors and Prognosis

There are a lot of different factors that increase the chances of a person getting spider veins and/or varicose veins. Risk factors include advanced age, prolonged sitting/standing, obesity, pregnancy, hormone therapy (HT), birth control pills, injury, prior vein surgery, a history of blood clots, and a family history of varicose veins.

As one gets older, the veins can lose elasticity which causes them to stretch. Menopause also tends to aggravate the situation at times. The valves in your veins may become weak, allowing blood that should be moving toward your heart to flow backward.

Pregnancy increases the volume of blood in your body, but decreases the flow of blood from your legs to your pelvis. This circulatory change is designed to support the growing foetus, but it can produce an unfortunate side effect i.e. enlarged veins in your legs.Varicose veins may surface for the first time or may worsen during late pregnancy, when your uterus exerts greater pressure on the veins in your legs.Hormonal changes during pregnancy or menopause also may play a role. Varicose veins that develop during pregnancy generally improve without medical treatment three to twelve months after delivery.

Treatment

If you suffer from varicose veins, then it is best to seek help from doctors who specialize in vein care/peripheral vascular diseases, i.e. vascular surgeons, phlebotomists or interventional radiologists. One thing to know is that the treatment for spider veins is similar to that of varicose veins but the chances of them resurfacing are high even after the treatment is completed.

Lower limb venous ultrasonography is the test commonly performed to confirm varicose veins or DVT. Non-surgical treatments include elastic/compression stockings, leg elevation, yoga/exercise and sclerotherapy. Traditionally,vein stripping was a common surgical treatment but now, new and less invasive treatments which can seal the main leaking vein are available. Alternative techniques like ultrasound-guided foam sclerotherapy, radio frequency ablation and endovenous laser treatment are also available and pain-free life.

 

Author credits – Reshma Shekatkar Batra