ARTICLE What Causes Varicose Veins and Spider Veins? ( medicineNet.com ) Visible and bulging veins, called varicose veins, are more common in the legs and thighs, but can develop anywhere.
Varicose veins and spider veins facts
- Veins carry blood low in oxygen content from the body to the lungsand heart.
- Varicose veins can lead to aching or even ulceration of the legs.
- Varicose veins can be caused be weakened valves in the veins or weakened walls of the veins, or by inflammation in the veins (phlebitis).
- Varicose veins and spider veins are not dangerous (with rare exceptions).
- Interventions and treatments such as surgery, "ablation" by laser, radiofrequency or other technology is necessary in settings where veins cause significant symptoms that do not respond to non-interventional treatment.
- Treatments available for venous disease include surgery and sclerotherapy, among other techniques.
What are veins and what is their function?
Veins are blood vessels that return blood from all the organs in the body toward the heart. When the different organs use oxygen from the blood to perform their functions, they release the used blood containing waste products (such as carbon dioxide) into the veins. Blood in the veins is then transported to the heart and returned to the lungs, where the waste carbon dioxide is released and more oxygen is loaded by the blood and taken back to the rest of the body by the arteries.
Veins also act as a storage for unused blood. When the body is at rest, only a portion of the available blood in the body circulates. The rest of the blood remains inactive in the veins and enters the active circulation when the body becomes more active and needs the additional blood to carry oxygen to the entire body. This storing capacity is due to the elasticity (flexibility to expand) of the walls of the veins.
Veins have different sizes that depends their location and function. The largest veins are in the center of the body; these collect the blood from all the other smaller veins and channel it into the heart. The branches of these large veins get smaller and smaller as they move away from the center of the body. The veins closer to the skin surface are called superficial veins. The veins that are deeper and closer to the center of the body are called deep veins. There are also other veins that connect the superficial veins to the deep veins, and these are called perforating veins.
What are varicose veins and spider veins?
Veins can bulge with pools of blood when they fail to circulate the blood properly. These visible and bulging veins, called varicose veins, are more common in the legs and thighs, but can develop anywhere in the body.
Large varicose veins can be visible, bulging, palpable (can be felt by touching), long, and dilated (greater than 4 millimeters in diameter).
Small "spider veins" also can appear on the skin's surface. These may look like short, fine lines, "starburst" clusters, or a web-like maze. They are typically not palpable. Spider veins are most common in the thighs, ankles, and feet. They may also appear on the face. The medical term for spider veins istelangiectasias.
Varicose vein and spider vein pictures
Varicose Veins Causes RLS
What causes restless leg syndrome?
Occasionally, restless leg syndrome run in families. Recent studies have shown that restless leg syndrome appears to become more common as a person ages. Also, poor venous circulation of the legs (such as with varicose veins) can cause restless leg syndrome.
Who gets varicose and spider veins?
Varicose and spider veins can occur in men or women of any age, but most frequently affect women in the childbearing years and older people. Varicose veins are very common. Some estimates suggest that about 10% to 15% of men and most older women who have varicose or spider veins.
A family history of varicose veins and older age increase one's tendency to develop varicose and spider veins.
Other risk factors include:
- a sedentary lifestyle,
- weight gain,
- prolonged standing, and
- pregnancy.
What causes varicose and spider veins?
The causes of varicose and spider veins are not entirely understood. In some instances, the absence or weakness of valves in the veins may cause poor venous circulation (blood flow in the veins) and lead to varicose veins. Valves inside veins normally act to ensure that blood in the veins does not flow in a backward direction (retrograde) away from the large (deep) veins and the heart. They are mainly located in perforating veins and some deep veins.
In other cases, weaknesses in the vein walls may cause pooling of the blood. The walls of the blood vessels can become weaker and less competent than normal, causing the volume of blood in the veins to increase, thus leading to varicose veins.
Less commonly, varicose veins are caused by such diseases as:
- phlebitis (inflammation of the veins),
- blood clots or any obstruction to blood flow in the veins, or
- congenital abnormalities of the veins.
Venous disease (disease of the veins) is generally progressive and may not be prevented entirely. However, in some cases, wearing support hosiery, maintaining a normal weight, and regular exercise may be beneficial.
What are varicose vein symptoms?
Many people with varicose veins do not have any physical symptoms. They may, however, have concerns over the cosmetic appearance of the varicose veins.
Symptoms of varicose veins may include:
Some people may complain of a dull ache and pressure sensation from varicose veins.
Some less common, but more severe symptoms of varicose veins may include bleeding, thrombophlebitis (formation of a blood clot within the varicose vein), skin ulceration and a weeping oozing dermatitis or stasis dermatitis. In long standing venous disease, the skin may become fibrotic and scarred, forming an inverted "hourglass" appearance. These complications of varicose veins should be evaluated by a doctor promptly.
How are varicose veins evaluated (diagnosed)?
Evaluation of varicose veins includes a thorough general physical examination by a doctor. This will include asking about any family history of varicose veins, the duration and presence of any symptoms, and any worsening or expansion of the varicose veins. The individual's height, weight, and other medical conditions need to be noted as well.
In addition, general inspection and palpation (feeling the veins) and evaluation for the presence of any bleeding or ulceration also is typically performed.
Standing up for about 5 to 10 minutes can make the veins more visible, and this may further aid the doctor in assessing the extent of the varicose veins.
Can ultrasound be used to evaluate varicose veins?
Duplex ultrasound visualization is very useful in evaluating of the venous system. Ultrasound can help in delineating the presence of any defective veins and pinpoint those that require intervention. Doppler ultrasound (a device which can detect and measure blood flow) may also provide additional information such as the competency of and flow through the valves in the perforating and the deeper veins. This information is especially necessary if surgery or other procedures are being considered.
What treatments are available for varicose veins and spider veins?
There are many different treatments available for varicose veins. These treatments vary based upon the size and location of the varicose veins, the presence of symptoms, and in cases of accompanying skin changes (for example, swelling, dermatitis or ulceration, for example). Briefly, potential treatments may include:
- leg elevation while sitting or sleeping,
- compression dressings with single or multilayered systems,
- compression stockings,
- sclerotherapy (injection of a liquid or foam into the vein to form a clot and permanently destroy the vessel),
- ablation (destruction) of abnormal veins with techniques using laser, radiofrequency or other modalities
- surgery (removal of the varicose veins, including "phlebectomy" or vein stripping).
In general, sclerotherapy and laser therapy are helpful in treating spider veins (telangiectasias), while ablation and surgery may be a better option for larger varicose veins.
Is treatment always necessary?
No, not if varicose and spider veins are primarily a cosmetic problem. But severe cases that do not respond to compression therapy, especially those associated with ulcers and dermatitis, generally require further treatment.
Thousands of people every year consider getting treatment for varicose veins and spider veins. Advertisements for treating venous disease often tout "unique," "permanent," "painless," or "absolutely safe" methods, thus making it difficult for individuals make a decision on the best treatment option. If you are uncertain about the safety or effectiveness of any treatment check with a health care professional.
How can compression stockings help with varicose veins?
Compression stockings work simply by squeezing the leg, thereby reducing the amount of blood and pressure in the veins. There are various brands, styles, and colors of stockings available. The degree of pressure applied around the leg should be guided by a health care professional. Ideally, they should be fitted when the leg is not swollen, and they can be made-to-order for each patient. Older or obese individuals often have difficulty putting on the stockings, which must be worn when the patient is standing. These stockings typically lose some degree of the compression over time so they may need to be replaced regularly.
What is sclerotherapy?
"Sclerotherapy" involves using a fine needle to inject a substance directly into the vein. This solution irritates the lining of the vein, causing the vein to swell and the blood to clot. The vein then turns into scar tissue that may eventually fade from view. Sclerotherapy is typically used for spider veins and varicose veins. Veins up to 15 millimeters in diameter have been treated successfully. This is generally offered to patients who have tried compression stockings and leg elevation without much success. Today, the substances most commonly used in the United States for sclerotherapy are hypertonic saline and sodium tetradecyl sulfate (Sotradecol), and polidocanol (Aethoxysklerol, Asclera) is now also approved in the U.S. for sclerotherapy.
With sclerotherapy, after the solution is injected, the vein's surrounding tissue is generally wrapped in compression bandages for several days, causing the vein walls to stick together. Patients whose legs have been treated are put on walking regimens, which forces the blood to flow into other veins and prevents the development of blood clots. This method and variations of it have been used since the 1920's. In most cases, more than one treatment session will be required.
Pictures of sclerotherapy treatment
Below are pictures of varicose vein and spider vein treatment.
What are potential side effects and complications of sclerotherapy?
In some patients treated with sclerotherapy, dark discoloration of the injected area may occur (hyperpigmentation). This usually happens because of disintegration of the red blood cells in the treated blood vessel. In the majority of cases, this discoloration will completely go away within 6 months.
Another potential problem is the formation of new spider veins near the area that was treated with sclerotherapy. This can happen in some patients, but these new vessels also typically disappear within 6 months.
Rare complications may include the formation of an ulcer around the injection site or the formation of small blood clots in the small surface veins (superficial thrombophlebitis).
Is sclerotherapy safe for everyone with varicose and spider veins?
Sclerotherapy is generally safe for most people for the treatment of varicose and spider veins. However, in certain groups of people, such as those individuals who are unable to walk (non-ambulatory), sclerotherapy should be avoided. Other contraindications for undergoing sclerotherapy include obesity, blood clots in the deeper veins, allergy to the sclerosing agent, pregnancy, and arterial obstruction (blocked blood flow in the artery near the varicose vein).
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