20-25 million Americans, mostly
women, suffer from varicose and spider veins causing pain, discomfort,
and cosmetic concerns.
While arteries transport blood
from the heart to the extremities, it is the function of veins to
return blood to the heart. When a vein loses its capacity to return
blood to the heart, it is labeled incompetent, becoming enlarged
due to congestion and pooling of the blood, collecting in the veins
below. Spider veins are congested smaller veins within the skin.
Symptoms include pain, heaviness, burning, throbbing,
itching, tingling, cramping, swelling, and restlessness of legs.
These may worsen during the menstrual cycle.
Types of Veins
Deep Veins They account for 90% of the total venous return
power of the legs. These veins usually become incompetent or diseased
after a blood clot has affected them.
Main Superficial Veins They consist of the long and short saphenous
veins. They run approximately one half inch under the skin, but
are visible when varicose. These are usually the main culprits when
one develops varicose veins.
Reticular or Feeder Veins These are small blueish-greenish veins seen through
the skin. They "feed" spider veins, so their elimination is important
in the treatment of these.
Spider Veins or Telangiectasia Fed by the reticular veins, they are a major
cosmetic concern in women. Due to hormonal factors, these are rarely
seen in men.
Perforator Veins These veins connect the superficial veins with
the deep veins. When incompetent, they play an important role in
the development of varicose veins. Most cases of recurrence are
due to failure by the clinician to accurately diagnose and treat
them.
1. Heredity It is the most frequent contributing factor.
If one has a strong family history of venous disease, it is very
likely varicose veins will develop. Early detection and treatment
of incompetent veins under the skin can prevent or retard the progression
of the disease.
2. Hormonal Factors
Pregnancy Sometimes the
first sign of pregnancy is not a missed period, but rather pain
in legs due to a rapid rise in female hormone levels. For unknown
reasons, they usually develop with the second pregnancy, but some
or most of them may disappear after delivery when hormone levels
drop. There is also a mechanical factor when the enlarged uterus
compresses or obstructs veins in the pelvic area.
Birth control pillsIncreased levels of female
hormones will create a pre-disposition for the development of
varicose and spider veins.
Hormone replacement therapy
Same principle as with birth control pills when progesterone is
part of the regimen.
3. Occupational If one's job entails prolonged standing or sitting,
there is an increased risk of developing varicose veins due to the
weight of gravity increasing the pressure in the veins causing them
to dilate and fill with blood.
4. Aging The incidence of varicose and spider veins peaks
between the age of 50 and 60. It can start at any age, but mainly
between 30 and 45 years of age.
5. Leg Injuries Trauma to veins can damage their internal valves
causing the veins to become incompetent. This usually happens when
a deep vein is affected.
Avoid prolonged standing and sitting (more
than 30 minutes). On long airplane automobile trips, walk for
5 minutes every hour. Periodically flex your ankles to pump the
blood out of your legs while sitting.
Avoid constricting bands on the leg that
would leave an indentation.
Wear support compression stockings when standing
for prolonged periods of time, when flying, and during pregnancy.
Walk or bicycle frequently to boost circulation
in the legs.
Avoid heavy weight-lifting in legs. More
repetition with less weight is better.
Maintain your ideal body weight.
Elevate your legs whenever possible.
Protect yourself from the sun to reduce the
number of unwanted vessels on the face.
Bi-directional continuous wave hand-held Doppler (the
stethoscope of the phlebologist), is provided at your initial consultation.
It determines the existence of blood flow and its direction in your
main superficial and deep veins. Be weary of any vein specialist
who doesn't examine you with this device. It is the equivalent of
a Cardiologist not listening to your heart.
Venous Duplex Ultrasound is the gold standard for
the accurate diagnosis of vein disease. Non-invasive, without injection
of contrast material, it allows us to map your incompetent or diseased
veins corroborating and complimenting the hand-held Doppler exam.
This is provided at all of our facilities, if warranted, based on
your physical and hand-held Doppler examinations.
