| Understanding Varicose Veins
Varicose veins and spider veins are visible surface manifestations of abnormal, dilated blood vessels. Varicose veins occur when healthy vein walls become weak and swell, causing blood to back up and  pool inside the vein. Varicose veins are also related to increased pressure in the leg veins or defective valves in the veins. They may appear as swollen, twisted clusters of blue or purple veins and are sometimes surrounded by thin red capillaries known as spider veins .
Mild forms of venous insufficiency are merely uncomfortable, annoying, or cosmetically disfiguring, but severe venous disease can produce serious systemic consequences and can lead to loss of life or limb. Most patients with venous insufficiency have subjective symptoms that may include pain, soreness, burning, aching, throbbing, cramping, muscle fatigue, and restless legs. Over time, chronic venous insufficiency leads to cutaneous and soft tissue breakdown that can be debilitating.
What are the symptoms?
Most people will not have symptoms but may be concerned about the appearance of the veins. If symptoms occur, they may include:
- Swollen legs
- Muscle cramps, soreness or aching in the legs
- Tiredness, burning, throbbing, tingling or heaviness in the legs
- Soreness behind the knee
- Itching around the vein
- Brown discoloration of the skin, especially around the ankles
Symptoms often worsen after prolonged standing or sitting. In women, symptoms may be worse during menstruation or pregnancy. Occasionally varicose veins can form a painful blood clot, referred to as superficial phlebitis (inflammation of a vein).
Chronic non-healing leg ulcers, bleeding from varicose veins, and recurrent phlebitis are serious problems that are caused by venous insufficiency and can be relieved by the correction of venous insufficiency.
In some cases, varicose veins can be harmful to your health because they may be associated with the development of:
• Venous stasis ulcers - ulcers (open sores) that result when the enlarged vein does not provide enough drainage of fluid from the skin. As a result, an ulcer may form.
• Fungal and bacterial infections - may occur as the result of skin problems caused by fluid retention (oedema) in the leg. These infections also increase the risk of tissue infection (cellulitis).
• Phlebitis - an inflammation of the vein
• Thrombosis - blood clots that form in the dilated vein
• Bleeding - Superficial varicose veins can sometimes cause problems like bleeding if you scratch or cut the skin over a larger vein
• Skin changes -
The first sign of venous insufficiency is the formation of oedema and bothersom skin alteration.
Complications are more common when varicose veins are the result of a problem or disease in the deep veins or in the perforating veins which connect the deep and superficial veins. These underlying conditions may include deep vein thrombosis or chronic venous insufficiency.
Contributing Factors
Multiple factors can cause the development of varicose veins:
Age - the development of varicose and/or "spider" veins can occur at any age, however, they most commonly begin between the ages of 18 and 35 years, and peaks between 50 and 60 years.
Heredity - there is a significant relationship between heredity and the development of varicose and "spider" veins. If your mother or father has varicose or "spider" veins, there is a greater chance that you will develop these abnormal veins.
Gender - approximately four females are affected to every one male.
Pregnancy - Approximately 8 to 20% of pregnant women will develop varicose veins, however, some may disappear shortly after delivery. Both hormonal changes during pregnancy and compression of veins by the enlarged uterus can contribute to varicose or "spider" veins.
Lifestyle or Occupation - People who are involved in prolonged periods of sitting or standing are at increased risk for developing varicose veins. Blood tends to collect in the veins putting pressure on the valves, thus causing the vein to distend.
What can I do to prevent them?
Many of the things that seem to cause varicose veins are difficult to avoid such as a family history of Western sedentary way of life. Where possible standing still for long periods should be avoided. Walking is much better for the veins and helps the blood return to the heart from the legs. In occupations that require extended periods of standing then a few steps should be taken at regular short intervals to help circulation. Wearing support stockings may also reduce the likelihood of varicose veins. No creams or drugs are available to prevent varicose veins. The earlier varicose veins and dermal flares are treated the better the long term and cosmetic outcome will be.
 Elevate your legs. Shower your legs with cold water as often as possible
 Use compression support hose as described above.
 Maintain your ideal body weight to reduce excess pressure on your legs.
 Avoid prolonged sitting and standing. If this is not an option, move your feet up and down as  described above to activate your calf muscle. On long car trips, you should stop every few  hours for short walks.
How are varicose veins diagnosed?
During a physical exam, the doctor will check your legs while you are standing. Your doctor also may request that you have a Doppler scan, an ultrasound exam to check the blood flow in the veins near the skin's surface (called superficial) and deep veins.
Call your doctor if:
- Varicose veins make walking or standing painful
- A sore or tender lump develops on or near a varicose vein
- You have swelling in the feet or ankles
- Your leg suddenly becomes swollen and painful
- Skin over a varicose vein bleeds on its own or when injured
- You have any other symptoms that cause concern
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