What are Varicose Veins?
bring blood from the heart to the extremities.
Veins contain one way valves and carry blood back
to the heart. When prolonged pressure is placed
on the veins, the valves stretch and no longer
close properly. This allows blood to travel back
down the veins towards the feet. The veins in
the legs that are near to the surface of the skin
enlarge. These are called varicose veins. These
can range from minor dilatated vein to big lumpy
veins in the calf. Very small purple or blue veins
in the skin of the legs are called "thread
veins" or dermal flares and often occur alongside
large varicose veins. Some people are only affected
by dermal flares. Both types of varicose veins
are probably caused by the same factors. Varicose
veins is a slowly progressive disease which if
left untreated can lead to marked skin change
damage or ulceration near the ankle.
Why do varicose veins arise?
is important in the development of varicose and
spider veins. Up to 20% of the adult population
have varicose veins and experience discomfort
as a result. Many people know of other family
members with the same problem. A recent study
showed that where both parents had varicose veins
there was an 80% chance of their children developing
factors also play a large part in the development
of varicosities, for example, prolonged standing
- especially for workers such as nurses, sales
assistants, flight attendants, waitresses and
teachers, for example. Diet may also be a factor,
and our Western diet with high content of fat
and refined sugar with low fiber content may contribute
to the development of varicose veins. Varicose
veins may also become more frequent with advancing
age, but may appear at any time of life and small
varices are sometimes seen in school children.
all factors such as puberty, pregnancy and the
menopause also influence the course of the disease.
As many as 70 - 80% of pregnant women develop
varicose veins during the first trimester. Pregnancy
causes an increase in hormone levels and blood
volume which in turn causes veins to enlarge.
Later in pregnancy, the enlarge uterus causes
increased pressure on the veins in the pelvis.
Approximately 60 - 70% of varicose veins due to
pregnancy will disappear within a few months of
research has been done to investigate the role
of the pill and hormone replacement therapy (HRT)
in the development of varicose veins. These probably
have no influence on them.
Symptoms of Varicose Veins
veins may cause feelings of fatigue, heaviness,
aching, burning, throbbing, itching and cramps
in the legs. These symptoms are often accompanied
by swelling of the ankle, which frequently appears
after long hours of standing. Some people are
very troubled by the aching that varicose veins
produce. Even small dermal flares can result in
severe aching which prevents standing for any
length of time.
Preventing Varicose Veins
of the things that seem to cause varicose veins
are difficult to avoid such as a family history
of Western way of life. Where possible standing
still for long periods should be avoided. Walking
is much better for the veins and helps the blood
return to the heart from the legs. In occupations
that require extended periods of standing then
a few steps should be taken at regular short intervals
to help circulation. Wearing support stockings
may also reduce the likelihood of varicose veins.
No creams or drugs are available to prevent varicose
veins. The earlier varicose veins and dermal flares
are treated the better the long term and cosmetic
All these treatments! Which is the one for
Philip Coleridge Smith DM FRCS
Reader in Surgery, UCL Medical School, London .
Consultant Vascular Surgeon – BVI Medical
The West London Vein Clinic: Tel 0870 609 2389