Humanity’s struggle with varicose veins goes back a long way. The first recorded mention of the ailment is in a document known as the “Ebers Papyrus,” an ancient Egyptian text about medical knowledge and remedies; the papyrus, dated around 1500 B.C.E., identifies hundreds of medical conditions, including “serpentine windings” on the legs that scholars believe refers to varicose veins.
Over the centuries, as medical science has evolved and developed, this unsightly malady has inspired a variety of (sometimes deadly) treatments. The Ebers Papyrus alludes to ancient Egyptian surgical attempts that resulted in massive hemorrhaging and death in patients. Hippocrates recommended compression wraps. And it was another ancient Greek physician, Galen, who developed the first successful type of phlebectomy, a version of a procedure that is still sometimes used today.
History and medicine may have moved on, but the same varicose vein problems that irritated pharaohs and centurions still exist today. In fact, varicose veins (also known as varicosities) are currently quite common around the world; some indications are that a full 25% of the world’s population is struggling with them.
What are Varicose Veins?
So what precisely are varicose veins? In the simplest terms, they are superficial veins that become twisted and swollen under the skin. This condition is typically seen in leg veins, but it is also possible anywhere in the body where superficial veins are present. Hemorrhoids, for example, is the term for varicosities when they develop around the rectum.
While not considered a serious or life-threatening condition, varicose veins can nevertheless be a burden for people. Beyond physical discomfort, varicose veins can also be emotionally distressing since they are visible beneath the surface of the skin; some people can become embarrassed about the rope-like texture of the skin that can occur in some severe cases.
A condition that is related to varicose veins is known colloquially as “spider veins.” Essentially a more mild version of varicose veins, spider veins (technically known as telangiectasias) are similarly twisted and swollen. In this case, though, it is smaller blood vessels that are affected, often on the face as well as the legs.
Causes of Varicose Veins
The cardiovascular system functions by the heart continually pumping blood in a closed system that circulates all over the body. Blood enters the lungs and is oxygenated, and that oxygenated blood is then pumped all over the body through the arteries. Oxygen and other nutrients are distributed to our cells, and then the blood returns to the lungs through the veins.
Our veins are the site where varicosities can occur. Their primary role in the circulatory system is to act as one-way valves that transport blood that has been sapped of oxygen from around the body back to the lungs to be re-oxygenated. Sometimes the vein walls can become weakened or damaged, essentially disrupting their ability to function as valves for blood flow.
When that happens, blood can collect (or even flow backward) and cause the vein to swell and become distorted and stretched. The resulting varicose veins can become so swollen and twisted that they bunch up under the surface of the skin and are clearly visible to the eye.
This condition is most commonly found in subdermal leg veins because those veins are furthest from the heart and also lack the thick walls of their artery counterparts. Pushing blood further and against gravity puts additional pressure on the vein walls that can be further exacerbated by lifestyle factors such as sitting or standing for long periods of time.
Risk Factors
The immediate cause of varicose veins is essentially the same for everyone in that it involves the damage of vein walls and the subsequent pooling of blood that leads to swelling. But the underlying cause that leads to that damage can come from a variety of sources. Here are some of the most common risk factors that can lead to varicose veins:
- Age: The older you get, the more likely you are to develop varicose veins. This is in large part due to the ongoing wear and tear your veins (and your body in general) endure over the years. Over time, the valves in our veins begin to weaken, allowing blood to flow backward and collect.
- Inactivity: Standing or sitting for long periods of time (especially on a regular basis, such as those who have jobs that require it) can put considerable pressure on your upper or lower leg veins. Over time, additional pressure can lead to damaged vein walls.
- Sex: Women are about twice as likely as men to develop varicose veins. Doctors don’t know the reason for this, but the current thinking is that it is related to the amount of progesterone women produce. In addition to serving a variety of other functions, progesterone is a hormone that relaxes the walls of blood vessels; it is suspected that this effect may add to the propensity for women to develop varicosities.
- Pregnancy: Besides the hormonal changes that are also a factor during pregnancy, the volume of blood in a woman’s body increases in order to support the fetus. The additional blood can cause veins to become swollen and thus more likely to develop the distortions and pooling associated with varicose veins.
- Heredity: Research has shown that you are more likely to develop varicose veins if a member of your family already has it.
- Obesity: In general, being obese or overweight puts additional pressure on your veins.
Symptoms of Varicose Veins
The most obvious symptom of varicose veins is the bulging and swollen veins on your legs. The bulges can sometimes be bluish or brownish-yellow in color and can also be accompanied by red and blue spider veins. The skin in the area may also be dry or itchy due to a related condition called venous stasis dermatitis; this forms when the building vein pressure causes blood to leak and pool under the skin.
Apart from the visual effect, common symptoms include aches or a feeling of heaviness in the legs. Cramps are often common, particularly when you stand up quickly or change positions after being stationary for a long time. Indeed, the symptoms may be noticeably more intense after long periods of sitting or standing. A somewhat less common symptom is additional bleeding or prolonged healing time for minor cuts or abrasions.
Complications
People with varicose veins sometimes experience complications and new, separate conditions. One example of this is thrombophlebitis, an inflammation of a vein that leads to a blood clot. Superficial thrombophlebitis is especially concerning if it further leads to deep vein thrombosis (DVT), a swelling and subsequent clotting of a vein deep inside a muscle. Deep vein thrombosis can be very serious if the blood clot breaks free and travels to the lungs.
Varicose Vein Treatment and Prevention
For mild cases of superficial varicose veins, medical attention usually isn’t necessary. However, there are ways to find relief from the symptoms. One easy home remedy is to wear compression stockings. These are designed to promote upward blood flow by gradually decreasing the amount of pressure as the stocking goes up the leg. They are useful for those with sedentary jobs or anyone who has to stand for long periods of time.
If at all possible, you should find ways to make changes to your circumstances so you don’t need to sit or stand a lot. Other lifestyle changes that can function as treatment or prevention include maintaining a healthy weight (or reducing weight if necessary), increasing regular exercise, or elevating your legs if you absolutely must sit for long periods.
For more severe cases, your doctor may recommend one of a number of treatments based on your situation and the location of your varicose veins:
- Sclerotherapy: This commonly-used therapy involves injecting the veins in question with a special foam that causes the vein walls to return to their normal shape and size.
- Laser Treatment: This is a type of endovenous thermal ablation that uses lasers and optical fiber to shrink the vein. This procedure has also been performed using radiofrequency ablation.
- Ligation and vein stripping: This surgery involves tying off and removing the veins that have become varicose.
Varicose Veins Appointment
If you have been experiencing symptoms of varicose veins and you want to talk to a doctor, contact The Woman’s Clinic to make an appointment. As a longtime provider of quality health care for women, you’ll be able to talk to a doctor about varicose veins or any other health topics that are on your mind.
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