Varicose Veins

General Information

Varicose veins are dilated (enlarged) superficial veins. They can occur in any area of the body surface, but they are primarily a problem in the legs. There are several causes for the dilatation that occurs in superficial veins. Primary varicose veins are a result of gradual degeneration in the valves within the veins. These valves occur at regular intervals along the course of the veins. The valves permit blood to flow toward the heart and restrict the ability of blood to flow away from the heart and into the veins. These valves prevent the development of high pressure within leg veins even when one is standing.

The tendency toward valvular degeneration is familial. Primary varicose veins cause little if any interference in the health of the individual, but they do gradually increase in frequency with age. Three fourths of the population in the United States age 65 or older have varicose veins.

The development of varicose veins occurs earlier in those individuals destined to develop valvular degeneration if they wear garments that permit blockage of the flow of blood in the veins. Constricting bands from elastic garments, garters, and hose (particularly hose with elastic leg bands) cause slowing of the blood flow in veins below the point of constriction. Careful attention to unimpeded venous blood flow can delay the onset of varicose veins and slow their progression, even in patients who by familial history are unusually susceptible.

Important Points in Treatment
Most of the concern related to primary varicose veins is related to appearance. Occasionally a varicose vein may be traumatized and bleed or develop clots and become inflamed, but these are infrequent complications. Complications of this sort tend not to be life threatening.

Treatment involves the use of support hose. Such hose must be well fitting and provide firm, even support over the entire leg. If you wear ill-fitting support stockings, they will permit periodic constriction that leads to worsening of the varicose veins rather than their prevention. Support garments often need to be tailormade to provide satisfactory relief.

Surgical procedures strip out the distended veins or obliterate them by injection. Obtaining the guidance of your physician is wise in determining the desirability of undergoing such procedures solely for cosmetic reasons.

Your physician may use one of several diagnostic methods to distinguish primary varicose veins from secondary varicose veins. This is important because treatment opportunities are different for each variety. Secondary varicose veins are a result of damage to deep veins. The deep venous insufficiency may be related to dire complications and requires careful treatment.

Notify Our Office If ...

• You have a varicose vein that becomes red, hard, or tender.
• You have a varicose vein that begins to bleed.

General Information
Varicose veins are dilated (enlarged) superficial veins. They can occur in any area of the body surface, but they are primarily a problem of the legs. There are several causes for the dilatation that occurs in superfi- cial veins. Secondary varicose veins are distended superficial veins that form because of insufficiency in the deeper leg veins. Deep vein insufficiency is a result of thrombophlebitis, inflammation, and deterioration involving the deep veins. The obstruction of the veins and the associated inflammation cause impairment of the valves in the veins. This results in unusual pressure on the superficial veins that are just beneath the skin. These superficial veins become distended with blood and are visible as tortuous veins beneath the skin.

The superficial veins are an unfortunate cosmetic consequence of serious disease of the deeper veins. The visible varicose veins themselves pose little health risk.

Important Points in Treatment
First in importance is to treat the deep vein thrombophlebitis and to prevent the chronic deep venous insuf- ficiency that is a result. Reduction of inflammation and of chronic edema not only prevents further complications of deep venous insufficiency but also can slow and arrest or even prevent the development of superficial varicose veins. During acute attacks of thrombophlebitis, anticoagulants (blood-thinning agents) are often needed. As chronic insufficiency develops, attention moves to preventing edema. Elevation of the legs several times daily can help keep swelling down, as can the use of properly fitting support hose. Poorly fitting hose may result in the development of worsening deep vein thrombosis. Other garments that may be tight or restrictive around the leg or thigh should be avoided as well.

Notify Our Office If ...

• You notice swelling and tenderness or redness in your calf.