VARICOSE VEINS
Varicose veins are dilated (widened) tortuous (twisting) veins usually involving a superficial vein in the leg. It is usually the result of malfunction (incompetency) of the valves in the vein. These visible and bulging veins are often associated with symptoms such as tired, heavy, or aching limbs. In severe cases varicose veins can rupture or open sores (stasis ulcers) can form on the skin particularly in the shin area.
Varicose veins most frequently affect women. Advancing age and a family history of varicose veins are usually factors. Other factors include pregnancy, birth control pills, hormone replacement therapies, lack of exercise, prolonged sitting or standing, obesity and constipation. The absence or weakness of valves in veins, which prevent the backward flow of blood away from the heart, may cause the varicosities. Sometimes weaknesses in the vein walls can cause the blood to pool. Varicose veins may also be caused by are diseases such as phlebitis (inflammation of the veins).
Varicose veins are usually progressive and cannot be prevented entirely. Left untreated they can eventually lead to ankle swelling,pigmentation,ulceration, bleeding, and advanced Chronic Venous Insufficiency (CVI). Wearing support stockings and maintaining normal weight and regular exercise are helpful to both slow down the progress of the condition and reduce its effects.
Treatment is not always necessary for varicose veins. Those severe cases, especially those involving ulcers, require treatment by physician familiar with this condition. The condition can be improved by eliminating the incompetent (leaking) veins thus allowing blood to flow through the remaining healthy veins. Once the leaking vein is eliminated the other veins in he leg can work more efficiently.
Spider veins also may occur in conjunction with varicose veins due to the increased venous pressure. They develop shunts, or microscopic short cuts, connecting the venous and arterial systems that give their characteristic thin spider like appearance.
Treatments for varicose veins include:
Phlebectomy. Surgically removing varicose veins near the skin surface by inserting a surgical instrument with a hook into small incisions in the skin and pulling veins out in segments. This procedure is often repeated 10 to 20 times per leg until all visible varicose veins have been removed.
Sclerotherapy. A chemical solution is injected into small or medium-sized veins near the skin surface causing them to become inflamed and eventually close. Sclerotherapy treatment often requires multiple injections and multiple visits to the doctor.
Endovenous Laser Treatment. A laser fiber is inserted into the larger veins of the leg through a small puncture. Laser energy is then applied and the fiber is pulled back slowly to destroy the vein. There can be some bruising and pain after the procedure. Pain can be managed by taking analgesics. There is also a technique that uses radiofrequency to accomplish the same affect.
Extracorporal Laser Treatment. Laser energy is applied with a hand-piece on the skin over the varicosity that is to be treated. This is the gold standard for treatment of these types of lesions on the face but their effectiveness is much reduced in the lower extremity. Larger varicose veins of the foot and leg are best treated with another form of therapy but the smaller spider veins and telangiectasias can still be effective be improved by this method.
Compression Stockings. Compression stockings squeeze the leg from the ankle to the upper calf or thigh, applying greater pressure to the lower leg than the upper leg, thereby reducing blood pooling, swelling and pain. This involves inconvenient lifestyle modifications and, as a result, independent studies have shown that patient compliance is poor.
How can I prevent varicose veins and spider veins?
Not all varicose and spider veins can be prevented. But some things can reduce your chances of getting new varicose and spider veins. These same things can help ease discomfort from the ones you already have:
- Wear Sunscreen to limit spider veins on the face by protecting your skin from the sun.
- Exercise regularly. Focuses on exercises that work your legs, such as walking or running.
- Controlling your weight avoids placing too much pressure on your feet and legs.
- Avoid crossing your legs when sitting.
- Elevate your legs when resting as much as possible.
- Do not stand in one place or sit for long periods of time. If you must stand, shift your weight from one leg to the other every few minutes. If you must sit for long periods of time, stand up and move around or take a short walk every 30 minutes.
- Wear elastic support stockings and avoid tight clothing that constricts your waist, groin, or legs.
- Eat a low-salt diet rich in high-fiber foods. Eating too much salt can cause you to retain water or swell. Eating fiber reduces the chances of constipation, which can contribute, to varicose veins.