Venous Disease FAQ’s
Veins in the lower extremities must work against gravity to carry blood back to the heart. To make this possible, there are one-way valves within the veins that open to allow blood to flow upward toward the heart when your muscles contract. These valves then snap shut when your muscles relax to prevent blood from flowing in the wrong direction. Many factors can cause veins to become weak and the valves to malfunction. Blood is then able to flow in the wrong direction, toward your feet. This results in more pressure being put on the walls of your veins, which causes the valves to malfunction even more. This causes a variety of symptoms, including varicose and spider veins. Venous insufficiency, synonymous with venous reflux, is the medical condition in which these valves do not function properly.
Varicose (var-i-kohs) veins are enlarged veins that often look like ropes cords and appear twisted and bulging. They can be blue, red, purplish, or flesh-colored. Often swollen and raised above the surface of the skin, varicose veins are often found on the thighs, backs of the calves, or the inside of the leg. During pregnancy, varicose veins can also form around the vagina and buttocks.
Spider veins are like varicose veins but smaller, and like the name suggests, they often have a spider web-like appearance, or resemble tree branches. They are closer to the surface of the skin than varicose veins. They often appear red or blue. Often found on the legs and face, they can cover either a very small or very large area of skin.
Varicose veins can be caused by weak or damaged valves in the veins. The heart pumps blood filled with oxygen and nutrients to the whole body through the arteries. Veins then carry the blood from the body back to the heart. As your leg muscles squeeze, they push blood back to the heart from your lower body against the flow of gravity. Veins have valves that act as one-way flaps to prevent blood from flowing backwards as it moves up your legs. If the valves become weak, blood can leak back into the veins and collect there. (This problem is called venous insufficiency.) When backed-up blood makes the veins bigger, they can become varicose. Research is ongoing as to the true underlying causes of venous insufficiency. Some potential causes are heredity, pregnancy, trauma, age, obesity, and standing or sitting for long periods of time.
Spider veins can be caused by the backup of blood in the capillaries closest to the surface of the skin. They are often related to varicose veins and share many of the same underlying causes, but can also be caused by hormone changes, exposure to the sun, and injuries.
About 50 to 55 percent of women and 40 to 45 percent of men in the United States suffer from some type of vein problem. Varicose veins are very common, affecting up to 25 percent of men and up to 40 percent of women, as well as up to half of people 50 years and older. In the United States there are at least 20 million people with varicose veins. It is estimated that over half of all adult females will develop spider veins in their lifetime.
Due to unique risk factors for women, including pregnancy and estrogen levels, women typically experience more vein problems than men. However, men also most certainly suffer from vein problems and can get varicose veins.
Many factors increase a persons chances of developing varicose or spider veins. These include:
- Increasing age. As you get older, the valves in your veins may weaken and not work as well.
- Medical history. Being born with weak vein valves increases your risk. Having family members with vein problems also increases your risk. About half of all people who have varicose veins have a family member who has them too.
- Hormonal changes. These occur during puberty, pregnancy, and menopause. Taking birth control pills and other medicines containing estrogen and progesterone also may contribute to the forming of varicose or spider veins.
- Pregnancy. During pregnancy, there is a huge increase in the amount of blood in the body. This can cause veins to enlarge. The growing uterus also puts pressure on the veins. Varicose veins usually improve within 3 months after delivery. More varicose veins and spider veins usually appear with each additional pregnancy.
- Obesity. Being overweight or obese can put extra pressure on your veins. This can lead to varicose veins.
- Lack of movement. Sitting or standing for a long time may force your veins to work harder to pump blood to your heart. This may be a bigger problem if you sit with your legs bent or crossed.
- Sun exposure. This can cause spider veins on the cheeks or nose of a fair-skinned person.
- Other potential factors include heredity and trauma.
Most varicose and spider veins appear in the legs due to the pressure of body weight, force of gravity, and task of carrying blood from the bottom of the body up to the heart. Compared with other veins in the body, leg veins have the toughest job of carrying blood back to the heart. They endure the most pressure. This pressure can be stronger than the one-way valves in the veins.
Varicose veins can often be seen on the skin. Some other common symptoms of varicose veins in the legs include:
- Aching pain that may get worse after sitting or standing for a long time
- Throbbing or cramping
- Rash that’s itchy or irritated
- Darkening of the skin (in severe cases)
- Restless legs
- Pruritus (Itchy legs)
- Numbness or tingling
- Night cramping
These symptoms typically get worse as the day progresses, and are often relieved somewhat by leg elevation and aerobic activity. Even without visible varicose veins on the surface of the skin, symptoms may still be present due to dilated non-visible veins exerting pressure on nerves.
Spider veins rarely are a serious health problem, but they can cause uncomfortable feelings in the legs. If there are symptoms from spider veins, most often they will be itching or burning. Less often, spider veins can be a sign of blood backup deeper inside that you can’t see on the skin. If so, you could have the same symptoms you would have with varicose veins.
Left untreated, varicose veins may sometimes cause significant health problems. These include:
- Bleeding: The skin over varicose veins can become thin and easily injured. With only minor trauma, varicose veins may bleed, sometimes profusely due to elevated pressure.
- Stasis pigmentation: Leaking of blood products into the skin may occur, resulting in damaged and discolored skin, which usually occurs around the ankles and lower legs.
- Venous Eczema (also known as stasis dermatitis): The skin becomes dry and itchy. This may progress to blistering and a scaly appearance to the leg.
- Venous Stasis Ulcers: Due to chronic backing up of blood, the skin becomes damaged and is predisposed to open sores known as venous stasis ulcers. These are painful, difficult to treat, and are prone to bleeding. This is relatively rare.
- Superficial Thrombophlebitis(throm-bo-fli-BYT-uhs): A blood clot that forms in a vein just below the skin. Symptoms include skin redness; a firm, tender, warm vein; and sometimes pain and swelling.
- Deep vein thrombosis: A blood clot that forms in a deeper vein. It can cause a “pulling” feeling in the calf, pain, warmth, redness, and swelling. However, sometimes it causes no significant symptoms. If the blood clot travels to the lungs, it can be fatal.
With the many safe and effective treatments available today, there is no need for you to suffer with varicose or spider veins. Even without visible varicose or spider veins, you may be suffering from venous insufficiency if you are experiencing fatigue or heaviness of the legs, itchy legs (pruritus), aching leg pain, restless legs, skin color changes in the legs, night cramps, or bleeding skin ulcers on the legs. These symptoms typically get worse as the day progresses, and are relieved somewhat by elevating your legs and aerobic activity.
You should see a doctor immediately about varicose veins if:
- The vein has become swollen, red, or very tender or warm to the touch
- There are sores or a rash on the leg or near the ankle
- The skin on the ankle and calf becomes thick and changes color
- One of the varicose veins begins to bleed
- Your leg symptoms are interfering with daily activities
If you are having pain, even if it’s just a dull ache, don’t hesitate to get help. Also, even if you decide not to see a doctor about your varicose veins, you should take steps to keep them from getting worse.
Diagnosis typically begins with a physical exam. Your legs are examined while you’re standing or sitting with your legs dangling. You will also be asked about your symptoms, including any pain you’re having. You may also have an ultrasound, which is used to see the veins’ structure, check the blood flow in your veins, and look for blood clots. This test uses sound waves to create pictures of structures in your body.
Please refer to our “vein treatment options” found under “Treatment Services” tab on our website.
Current treatments for varicose veins and spider veins have very high success rates compared to traditional surgical treatments. Over a period of years, however, more abnormal veins can develop because there is no cure for weak vein valves. Ultrasound can be used to keep track of how badly the valves are leaking (venous insufficiency). Ongoing treatment can help keep this problem under control.
Varicose veins lead to leg symptoms such as pain, swelling, and heaviness, and other health issues like leg ulcers and blood clots. For these reasons, leg veins are considered a medical problem & are covered by most health insurances.
You will be able to resume most normal daily activities immediately after treatment with the exceptions of heavy lifting, strenuous exercise, and application of heat to the treated extremity. Complete recovery times vary from person to person. You can typically resume strenuous exercise in about one week.
For spider vein treatment there is no significant recovery time and patients experience minimal if any bruising.