What are Varicose Veins?

Varicose veins are abnormal, dilated blood vessels caused by a weakening in the vessel wall. They usually develop in the legs and can be seen through the skin.


They may appear as swollen, twisted clusters of blue or purple veins and usually develop in the legs. (img)


What are Spider veins?

Sometimes varicose veins are surrounded by thin red capillaries known as spider veins (group of small blood vessels located close to the surface of the skin).  Spider veins may also be called venous telengiectasias.

Spider and varicose veins can appear anywhere, but most often appear on the legs and in the pelvic area.

Most varicose veins develop near the surface of the skin. Deeper varicose veins may cause the skin above them to swell, become darker or hard.


Who gets spider and thread varicose veins?

Varicose veins are common and are seen more often in women than in men. Varicose Veins become more prevalent with age and have been reported to affect from 30-60% of the adult population.


Causes of varicose and spider veins?

Varicose veins occur when healthy vein walls become weak and swell, causing blood to back up and pool inside the vein. Varicose veins are also related to increased pressure in the leg veins or defective valves in the veins.

The exact cause of varicose veins is unknown, but there are a number of factors that contribute to the development of varicose and spider veins, including:

  • Heredity
  • Advancing age
  • Prolonged standing (especially for people who work in occupations such as nurses, beauticians, teachers factory workers and others) Being overweight
  • Hormonal influences during pregnancy
  • The use of birth control pills
  • Post-menopausal hormonal replacement therapy
  • Prolonged sitting with legs crossed
  • Wearing tight undergarments or clothes
  • A history of blood clots
  • Injury to the veins
  • Conditions that cause increased pressure in the abdomen including liver disease, fluid in the abdomen, previous groin surgery, or heart failure. Other reported factors include topical steroids, trauma or injury to the skin, previous venous surgery and exposure to ultra-violet rays.

Varicose veins can be harmful to your health because they may be associated with the development of:

    • Venous stasis ulcers & ulcers (open sores) that result when the enlarged vein does not provide enough drainage of fluid from the skin. As a result, an ulcer may form.
    • Fungal and bacterial infections may occur as the result of skin problems caused by fluid buildup (oedema) in the leg. These infections also increase the risk of tissue infection (cellulitis).
    • Phlebitis – an inflammation of the vein.
    • Thrombosis – blood clots that form in the dilated vein.


Symptoms of Varicose Veins

Some people do not have symptoms of varicose veins but may be concerned about the appearance of the veins. If varicose vein symptoms occur, they may include :

  • Swollen legs
  • Muscle cramps, soreness or aching in the legs
  • Tiredness, burning, throbbing, tingling or heaviness in the legs
  • Soreness behind the knee
  • Itching around the vein
  • Brown discolouration of the skin, especially around the ankles

Varicose veins symptoms often worsen after prolonged standing or sitting. In women, symptoms may be worse during menstruation or pregnancy. Occasionally varicose veins can form a painful blood clot, referred to as superficial phlebitis (inflammation of a vein).


When treatment is necessary for varicose veins?

Varicose and spider veins may not require medical treatment. If varicose veins make walking or standing painful, you should call your doctor for advice. You also should call your doctor if a sore develops on or near a varicose vein or if your feet or ankles swell. Venous disease usually progresses and should be managed.


How are varicose veins diagnosed?

During a physical exam, the doctor will check your legs while you are standing. Your doctor also may request that you have a Doppler scan, an ultrasound exam to check the blood flow in the veins near the skin’s surface (called superficial) and deep veins.


What are the treatment options for varicose and spider veins?

The goals of treatment are to reduce symptoms and prevent complications. Since not all varicose and spider veins require medical treatment, the goal of treatment may be simply to improve the appearance of the affected areas.

Conservative options (non surgical)

The most conservative approach for treating varicose veins is to wear properly fitting support hose (also called compression stockings), especially when the veins are symptomatic.

These stockings can generally be purchased at any surgical supply store and come in various styles including below-the-knee, above-the-knee and pantyhose styles. They also come in different compressions varying from 18 to 20 mmHg and up to 40 to 50 mmHg.

Other conservative treatment approaches include:

  • Practising good skin hygiene
  • Losing weight if you are overweight
  • Exercising regularly (especially walking)
  • Avoiding prolonged periods of sitting or standing
  • Elevating your legs while sitting and sleeping.

When you need to stand for long periods of time, take frequent breaks to sit down and elevate your feet. If conservative treatment does not achieve satisfactory relief of symptoms, or if the appearance of the veins is bothersome, other treatments may be offered, depending on your overall medical condition.