Varicose veins

At least half of adults have some kind of venous enlargement problem. For many people, this common condition is a family problem. Women are at least twice as likely as men to develop varicose veins. It affects 25% to 60% of adults in both genders, depending on age.Dilated veins don't always look like bulging blue lines; sometimes varicose veins look like a thin network of blood vessels under the surface of the skin. It almost always affects the legs and feet. Visible swollen and tortuous veins - sometimes surrounded by patches of engorged capillaries that resemble spider webs or spider veins - are superficial varicose veins. Although they are often painful and disfiguring, they are usually harmless. When inflammation occurs, these veins become dense to the touch and can impede blood circulation, causing swelling in the ankle, itching, and pain in the affected limb.In addition to the superficial vein network, the legs also have an internal or deep vein network. In rare cases, the deep veins in the legs can also be affected by varicose veins. These deep varicose veins are usually not visible, but they can cause swelling or pain throughout the leg and, most dangerously, can be the site of blood clots.To help circulate oxygenated blood from the lungs to various parts of the body, arteries have a thick muscular lining. In order for blood to flow backward through the venous system, surrounding muscles need to be used. The muscle layer at the vein wall is weak, but veins are equipped with internal valves that only allow blood to flow in one direction - towards the heart. Valves are needed to prevent blood from flowing backward.With varicose veins, the valves don't work properly, causing blood to pool in the veins, making it difficult for the muscles to "push" the blood up. Instead of flowing from one valve to another, blood continues to pool in the veins, increasing venous pressure and further damaging the valves, causing the veins to bulge and become tortuous. Because superficial veins lack muscular support than deep veins, they are more likely to develop varicose veins.

What factors lead to the development of varicose veins?

Any situation involving excessive tension and pressure in the legs or abdomen can lead to varicose veins. The most common factors that cause intra-abdominal pressure are pregnancy, obesity, and jobs that require standing for long periods of time or lifting heavy objects. Chronic constipation, straining during defecation and urination, prostate adenomas, and in rare cases, tumors can also cause varicose veins. A sedentary lifestyle can lead to varicose veins because muscles that are not working cannot pump blood well.As you age, muscles and veins weaken, and the likelihood of varicose veins increases. Previous leg trauma may damage the vein valves and lead to the development of varicose veins. Genetics also play a role, so if other family members have varicose veins, you are more likely to have varicose veins as well. Contrary to popular belief, sitting cross-legged does not cause varicose veins, although it may aggravate an existing condition.

Can you prevent varicose veins?

Although genetic factors can affect your risk of developing varicose veins, there are things you can do to prevent them:

• Exercise regularly because staying in good shape is the best way to keep your leg muscles toned, improve circulation, and control your weight. Swimming and water aerobics are thought to have the greatest preventive effect of all types of fitness;
• Healthy weight support; if you are overweight or even obese, losing weight will reduce your risk of varicose veins, as normal weight prevents excessive pressure on the veins in your legs;
• Avoid wearing tight clothing. Tight clothing can restrict blood flow to the thighs, groin, and legs;
• Avoid wearing high heels frequently and for long periods of time as they can impede blood circulation. Completely flat-soled shoes are also not advisable; it is best to choose low-heeled, stable shoes or shoes with elastic elastic soles, which are more conducive to blood circulation and can also improve the tension of the calf muscles.
• move! Sitting or standing for long periods of time should be avoided to promote blood circulation. If your daily life requires a lot of standing, consider wearing an everyday support jersey. Stretch your legs and exercise as much as possible to improve circulation and reduce venous pressure.
• Fight smoking. Research shows that smoking may contribute to the development of varicose veins.
• During pregnancy, you should sleep on your left side, not your back. This reduces the pressure of the uterus on the veins in the pelvic area and even improves the blood supply to the fetus;
• If you have risk factors for developing varicose veins, ask your doctor to choose compression stockings for you - these can be special socks, stockings or tights.

spider veins and varicose veins

As we age, many of us will notice bumpy blue stars under our skin or cords of swelling running down our thighs and calves. After age 50, 60% of adults develop these deformed blood vessels.  

What are spider veins?

Spider veins are small, tortuous blood vessels that run through the skin. They can be red, purple or blue in color and most commonly appear on the legs or face.  

What are varicose veins?

These are larger blood vessels that lose elasticity, swell, and develop a tortuous course due to changes in the vein walls. These veins are blue and raised above the surface of the skin. Varicose veins can appear anywhere, but most commonly appear on the calves, thighs, and feet.  

What are the causes of spider veins and varicose veins?

Healthy veins collect blood from a network of capillaries and transport it from the periphery to the heart through a system of one-way valves. These valves guide blood in the desired direction from superficial to deep veins and toward the heart. The blood vessels are surrounded by muscles, which contract and help pump blood to the heart. Normally, healthy vein valves prevent blood from backing up. However, problems with the valves, muscles, or blood pressure may cause blood to pool in the veins. When blood pools in the veins, pressure increases and the vein walls weaken. As a result, the veins become bulging and curved. As a result, a network of spider veins or varicose veins forms, depending on the caliber of the blood vessels and the degree of swelling.

Who is at risk of varicose veins?

Spider veins, or large varicose veins, can appear in anyone, but women are twice as likely to develop the problem as men. The problem is also common for people with jobs that require them to be on their feet constantly, including nurses, hairdressers, lecturers and teachers. Other factors that can cause varicose veins include aging, obesity, pregnancy, leg injury or surgery, and a family history of varicose veins.

What symptoms are associated with varicose veins?

Often, spider veins and/or varicose veins are more than just unpleasant cosmetic blemishes. Varicose veins are a condition that can cause unpleasant symptoms and dangerous complications, particularly pain or cramping, heaviness, throbbing, or tingling in the legs. Severely inflamed veins become difficult to touch and reduce blood circulation, causing itchiness and swelling in the ankle. Additionally, over time, the skin and subcutaneous tissue undergo nutritional changes such as thickening, pigmentation, and ulceration.

Complications of varicose veins

Although spider veins and varicose veins can disfigure the appearance of the legs and cause uncomfortable symptoms, they rarely pose a serious threat to health. However, in some cases, complications may occur that require a visit to the doctor or even hospitalization.The most common complication of varicose veins is trophic ulcers caused by long-term venous insufficiency; these ulcers most commonly form in the ankle area and heal poorly. The second common and more dangerous complication of varicose veins is thrombophlebitis - thickening and inflammation of the vein walls, which in turn can lead to venous thrombosis - a dangerous complication that requires hospitalization and intensive treatment. If a thrombosis forms in the deep venous system, there is a risk of migration of the blood clot, a so-called thromboembolism, and due to thrombophlebitis, chronic post-thrombophlebitis disease can develop, which significantly affects the patient's quality of life and performance.  

Diagnosis of varicose veins of lower limbs

Diagnosing spider veins and superficial varicose veins is easy - a visual inspection is enough. However, the major diagnostic complication always involves ultrasonographic examination of the deep venous system, since superficially dilated veins may indicate insufficiency of the deep venous valves of the lower extremities, which requires a serious therapeutic approach. During the examination, the doctor always pays attention to the swelling of the ankle, the symmetry of the swelling (if any), the compaction of the vein wall and subcutaneous tissue, changes in skin color, pigmentation, pain, and the presence of trophic ulcers.Most cases of spider veins and varicose veins, unless associated with venous insufficiency, do not require surgical treatment but can be removed for cosmetic purposes. If varicose veins are accompanied by symptoms such as leg heaviness, pain, muscle fatigue or cramping, and swollen ankles, treatment recommendations can relieve symptoms and slow the progression of the disease.   

Treatment of varicose veins

Treatment for varicose veins can be conservative or surgical. The choice of treatment can be made by a phlebologist based on examination and examination. The purpose of a varicose vein examination is to determine the stage of the disease and the risk of possible complications. This workup includes a thorough examination, ultrasound of the veins in the lower extremities, and in some cases, laboratory tests.  

Who treats varicose veins?

Phlebologists treat venous disease of the lower extremities. A phlebologist is a physician with a surgical specialty who is trained first in general surgery and then in cardiovascular surgery. Phlebology is a branch of vascular surgery devoted to the study and treatment of diseases and malformations of the venous system. A venous surgeon must be proficient in the various techniques used to treat venous disease.

Conservative treatment of varicose veins

Conservative treatment of varicose veins aims to slow their progression and prevent complications. Usually it includes advice on lifestyle changes (weight loss, appropriate physical activity, elimination of static loads that lead to disease progression), choice of compression stockings, prescription of drugs to nourish the walls of venous vessels, and prescription of physical therapy procedures. Compression Sweatshirts – Support Socks, Stockings and PantyhoseThe easiest way to prevent varicose veins from getting worse is to wear support stockings. Also called compression stockings, they improve circulation and relieve leg pain and discomfort. They can be found in pharmacies and specialty medical supply stores. Such stockings are especially necessary during pregnancy and during long-haul flights.lifestyle changesIt may also help prevent the rapid development of varicose veins. First, you need to normalize your weight and introduce physical activity into your life, such as walking or swimming; exclude regular wearing of high heels, static loads and a sedentary lifestyle.drug treatment– There are many medications, whether in gel, cream or tablet form, that have a venous tonic effect that affects the rate at which varicose veins progress, slowing down their progression. However, their actions are only effective if combined with other preventive measures.physiotherapy– For varicose veins, whether in the early or late stages of the disease, compression therapy is most often used – a physical therapy procedure that uses compression – continuous compression of the veins with specialized round pads, with the pressure spread from the feet to the buttocks, improves blood flow, stimulates vessel walls and normalizes venous valve function. This treatment is performed 2-4 times a year in 10-12 sessions. It is also recommended after sclerotherapy and laser treatment for varicose veins. This physical therapy can be done alone or in combination with specialized electrical stimulation of the leg muscles, with the goal of mutually reinforcing the therapeutic effects.Other cases in which physical therapy yields good results are nutritional changes in the skin caused by advanced varicose veins; in these cases, laser therapy, magnetic therapy, sound wave therapy and electrophoresis therapy (→ and other methods) can be used. A 100% contraindication to varicose vein physiotherapy is the presence of thrombosis or thrombophlebitis, therefore, before undergoing a physiotherapy procedure, you should have an ultrasound examination of the veins of the lower extremities.

Surgical and minimally invasive treatment of varicose veins and their complications

Patients, the majority of whom are women and girls, because varicose veins most commonly affect half of the human population, come to see a phlebologist because of an external cause of the disease - they are troubled by unsightly spots and cords on their legs. In this case, treatment of varicose veins usually involves eliminating the cosmetic defect. For this purpose, minimally invasive methods of treating varicose veins are used - sclerotherapy and endovenous laser coagulation (EVLC).The term "minimally invasive" in relation to medical procedures means "low trauma" and "gentle". The fact that this treatment is performed on an outpatient basis is minimally painful compared to regular injections and allows you to achieve excellent results. This treatment involves destroying the lining of the vein with medications (sclerosants) or lasers, thereby causing the lumen to stick together and eliminate cosmetic defects.  In each case, treatment is determined by a doctor based on examination and examination. For complex varicose veins, surgical treatment can be performed in the hospital.