VARICOSE AND SPIDER VEINS: THE FACTS

What happens in normal leg veins?

Healthy arteries and veins in the leg allow blood to travel through them in one direction only - just like the direction of a car in a one-way street. Muscles in the calves act like pumps to help move the blood in the veins against gravity and back up the leg. The valves in leg veins prevent the blood from back-flowing back down into the foot. In normal veins, the valves and muscles maintain vein integrity with little retention of blood within the vein itself.

What happens when these veins become abnormal?

Due to various reasons, the vein walls become weaker and tend to collect and retain more blood than normal, causing enlargement along the vein segment. Consequently the valves in the vein do not function properly as they no longer meet resulting in backflow of blood called reflux or vein incompetence. The vein bulges from the pool blood and appears as visible lumpy lines.

What types of abnormal veins are there?

• Spider veins: these are the fine, red web-like veins visible on the surface of the leg - also known as telangiectasias. These veins serve no known biological purpose.
• Reticular Veins: These larger veins lie a little deeper below the skin and are blue in colour.
• Varicose Veins: These are the largest of the abnormal veins and can be seen bulging above the surface of the skin looking like knots. Early treatment of these veins is usually easier as the varicose veins worsen with time.

What causes abnormal Veins?

There is no known reason why veins become incompetent although there does appear to be links with a family predisposition. A strong family history of varicose veins makes some people more likely to inherit veins that deteriorate. Approximately 30% of people are affected by varicose veins, with a 75:25 ratio of female to male with an average age of 50.

Abnormal underlying veins are detectable with ultrasound years before the visible knots and lumps appear. Abnormal veins in women can also get worse from the use of birth control pills and fluctuations in hormone levels experienced in puberty, menopause and pregnancy. Some other factors that influence abnormal vein development include obesity, occupations that involve long periods of standing or sitting, immobility, ageing, previous venous thrombosis and some leg injuries.

What are the symptoms of Abnormal Veins?

Symptoms can include:

• Heaviness
• Aching
• Chronic pain
• Burning of legs
• Itchiness
• Night cramps
• Restless legs
• Leg swelling
• Skin discolouration
• Ulcers

How are Abnormal Veins Treated?

A duplex ultrasound of your affected leg is vital in determining which treatment options are appropriate. Microsclerotherapy, Ultrasound Guided Sclerotherapy and Endovenous Laser Ablation are the treatment options utilized.

Microsclerotherapy
Ultrasound Guided Sclerotherapy
Endovenous Laser Ablation

Don't I need all of my Veins as part of my Circulation?

There are definitely certain veins that are required for healthy blood flow in the legs. Abnormal veins though, are unhealthy veins that do not function properly and usually haven't been relied upon by the body as part of normal blood circulation (sometimes for years). These abnormal veins contain poorly oxygenated blood and by-products of metabolism including free radicals that cause tissue damage. To compensate for this lack of function, more stress is placed on the deeper veins, which can, in certain cases, also become abnormal. Once treated, circulation improves in the affected limb.

Varicose veins in the legs are diseased veins and are not used for heart by-pass grafts.

My Mum had her Varicose Veins Stripped - Why has the treatment changed?

Because of the ability to treat large veins with ultrasound guided sclerotherapy and endovenous laser ablation as a walk in walk out procedure, vein stripping is no longer the only treatment option. Traditionally vein stripping requires surgery in a hospital under general anesthetic. Despite good surgical techniques, vein stripping often leads to a high incidence of recurrence of abnormal veins due to localised tissue damage during surgery as well as leaving bits of varicose vein behind. Generally ultrasound is not used during surgery to monitor the removal of veins.

When do My Veins need Treatment?

If you are experiencing any of the symptoms above then assessment and treatment is appropriate. In general, it is easier and more effective to treat varicose veins early in the disease process. Early treatment minimizes the risk of varicose vein-related complications and can reverse the symptoms of vein congestion. Obviously urgent treatment is required if there are co-existing factors such as bleeding, phlebitis (inflammation), thrombosis (clots), ulcers or dermatitis.

Can I help prevent the progression of Abnormal Vein Development?

Yes, you can. There are some effective measures that can assist in reducing the further deterioration of abnormal veins.

• Include daily exercises that work your calf muscle.
  This stimulates the movement of blood back to the heart and encourages good circulation. Exercises such as running, walking, jogging, cycling and step machines are all beneficial. Cross trainers and some other elliptical trainers do not activate the calf muscle or create that "pumping" effect in the lower leg.

• Elevate your legs whenever able.
  Although this is often difficult for busy people, take the opportunity whenever you can - for example when watching TV and reading or try resting your legs on a stool under your work desk.

• Wear medical grade compression stockings.
  While providing excellent support from the ankle upward, these stockings assist with blood flow back to the heart. At  VenusCentre, we offer several different styles.

• Avoid prolonged sitting and standing.
  Exercise assists with the movement of blood through your veins while movement of the calf muscle helps to empty leg veins. This minimizes retention and enlargement of the vein. Try frequent use of leg exercises when sitting at your desk or when standing for long periods.

• Keep a healthy weight.
  Excess weight can make varicose veins worse and can contribute to both lymphatic and venous problems.

• Antioxidants / Vitamins

These measures may afford some tissue protection at the cellular level however are unlikely to reverse the gross changes of diseased incompetent veins.