Varicose and Spider Veins

Varicose veins affect nearly 40 per cent of the population. Due to hormonal factors, women are affected by this condition three times as much as men.

Vein Disease

What is vein disease?

In contrast to arteries, which take blood from the heart to the extremities, veins - through a series of small valves that pump blood upwards - bring blood back to the heart from the extremities.

There are two main systems of veins in the legs:

• a deep system, which brings about 90 per cent of the blood back to the heart; and
• a more superficial system, which brings about 10 per cent back to this area.

Between these, is a third system - of perforating veins or perforators - which transports blood from the superficial to the deep system.

Varicose and spider veins occur solely in the superficial system, when the walls of the veins lose their elasticity and the pumping valves stop functioning properly. This causes the blood to flow back down, creating a reverse process called ebb or reflux, which can be heard with a Doppler machine, and heard and seen with Duplex ultrasound.

What causes varicose and spider veins?

1. Heredity is the number one factor. They usually run in the family ("like mother, like daughter").
2. Hormones are also a factor: puberty, pregnancy, menopause, the birth control pill
3. Obesity
4. Aging
5. Prolonged periods of standing (common to nurses, pharmacists, teachers, waitresses)

What are the different types of veins?

Superficial veins of the lower limbs

Large, varicose veins

Bulging varicose veins are mainly found along the long and short saphenous veins, or their tributaries, as well as on the perforating veins.

Symptoms

• General fatigue and tiredness
• Heaviness in the legs and thighs
• Swelling of the ankles and night cramps in the lower limbs

If left untreated, these can lead to complications such as leg ulcers, phlebitis (blood clots) or hemorrhaging (bleeding).

Medium-size, reticular veins

These appear as blue veins just under the skin. They do not usually bulge out. They may cause aching and heaviness in the legs.

Spider veins (telangiectasia)

Spider veins can occur anywhere on the thighs, legs or ankles. Usually they appear in a network, fed by an underlying mid-size or reticular vein.

Spider veins can occur because of reverse pressure or a "micro-reflux" from the reticular or mid-size veins, which causes the capillary vein network to dilate or burst.

Symptoms

• Burning sensation
• Aching
• Itchiness and numbness
• Unsightly appearance

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