Causes of varicose veins
There are two main types of blood vessels: arteries and veins. Arteries are blood vessels that take oxygenated blood away from the heart to supply all parts of the body. After oxygenation process in the lung, oxygen-rich blood is pumped through arteries by the heart. In contrast to arteries, veins are blood vessels that carry deoxygenated blood from all parts of the body toward the heart for recirculation.
Varicose veins are described as twisted or enlarged veins. In our body, systemic veins are classified into superficial veins (located in the fatty layer under the skin) and deep veins which are found in muscles or along bones. Within the veins, especially those of the legs are valves, flap like structures made of elastic tissue. The valve’s function is to keep blood moving in one direction against gravity. Muscle contractions in lower legs act as pumps and vein walls help blood returning to the heart. As a regular pattern, tiny valves in veins open as blood flows toward the heart and close to stop blood from flowing backward. If these valves are weakening or damaged, blood can flow backward and pool in the veins, causing the veins to stretch, enlarge or twist, leading to varicose veins which are characterized by spider veins, particular in the legs. Actual causes of varicose veins remain unknown. Most relevant factors involve weakness of valves and lining of veins as well as against gravity positions such as prolonged periods of sitting or standing.
Risk factors of varicose veins
Family history doubles chances of developing varicose veins, especially if first degree relatives such as mother and father had varicose veins. Additionally, anatomical abnormalities of the valve might lead to varicose veins. Normally, each valve has a mean distance of approximately 2 inches. These valves in veins open to allow blood to flow toward the heart and close to stop blood from flowing backward. These tiny valves maintain the unidirectional flow of blood. In case of varicose veins, the distance of valves are greater than 2 inches, thus allowing blood to flow backward and pool in the veins, causing the stretched or twisted veins.
Occupations and working posture
Certain occupations that require standing or sitting for long periods of time do not allow blood to flow regularly. These include dentists, hair dressers, waiters and waitresses. Owning to the veins of the legs work against gravity, prolonged period of standing leads to increase pressure in the leg compared to other parts of the body while standing up. In a combination with weakened veins and abnormal valves, the result shows up as varicose veins.
During pregnancy, there are several factors that largely contribute to varicose vein. Hormonal changes during pregnancy also plays a role to weaken the vein walls and increase the pressure in the veins. Due to pregnancy, blood circulation to support the growth of fetus in the uterus increases. This blood recirculates by flowing toward the heart via the same vein that carries blood back to the heart from the feet and legs. As a result, the uterus applies additional pressure to the veins, allowing blood to flow backward and pool in the veins. In addition, increased weight and total body fluid can largely affect the pressure of the veins, leading to altered blood flow. These contributing factors enhance greater risks of developing varicose veins. In patient diagnosed with varicose veins, the pressure of veins is considerably high. Pregnancy greatly increases this pressure, resulting in exacerbation of varicose vein.
Warning signs and symptoms
Varicose veins are more commonly found in female, rather than male. They may cause wide range of signs and symptoms, including:
These manifestations usually last permanently. If left untreated, complications might involve:
Treatment of varicose veins
There are several types of treatment for varicose veins. The selected option entirely depends on symptoms and its severity.
In mild cases of varicose veins, avoiding prolonged standing and wearing compression stockings, elastic garments worn around the leg (from the ankle to the thigh) with pressure gradient largely help to alleviate varicose veins. It steadily squeezes the legs and helps veins and leg muscles circulate blood more efficiently. In more severe cases, traditional vein stripping surgery is surgical technique to repair affected veins which is considerably complicated and time consuming procedure with increased risks of postoperative complications.
Due to the advancements in technology, varicose veins could be recently treated by using less invasive technique with high degree of safety, known as endovenous laser treatment or EVLT. This procedure treats varicose veins by using laser heat to cauterize (burn) and close the abnormal veins. During this procedure, a thin tube (catheter) sized smaller than 3 mm. is inserted into an enlarged vein. The tip of the catheter heats with laser energy used together with ultrasound image-guided system without the need of general anesthesia and surgery. As the catheter is pulled out, the heat destroys the vein by causing it to collapse and seal shut. Since it is minimally invasive approach, this technique does not cause scar and hospitalization is not required. Patient can return home within 1-2 hours after procedure completely finishes. In general, varicose veins starts disappearing 8 weeks after procedure or longer, depending on size and severity of affected veins. If it heals completely, compared to traditional vein stripping surgery, no scar remains, leading to satisfactory cosmetic outcomes.
Prevention of varicose veins
Although there is no definite way to completely prevent varicose veins, improving blood circulation and muscle tone may reduce risk of developing varicose veins or getting additional ones. These include: