Updated: Sep 28, 2020
Varicose veins are gnarled, bulging veins that occur most commonly in your legs.
What causes these unsightly and often painful vessel to appear?
The veins in your legs are fighting an uphill battle as they carry blood from your toes to your heart. To counteract the effects of gravity, your veins have one-way valves built into them. Over time, in some people, the valves begin to leak, causing blood in the veins to flow backwards. This backflow causes an increase in venous pressure which can eventually lead to the appearance of bulging varicose and spider veins.
In recent years, there have been many advances in our understanding of varicose veins. To help you understand more about varicose veins, we're setting the record straight about some common statements you may hear about them.
1. Varicose veins are a cosmetic issue.
This statement is false; varicose veins are not solely a cosmetic issue. What classifies varicose veins as cosmetic versus medically necessary, is the severity of the underlying disease which causes them - venous insufficiency.
Venous insufficiency is a chronic disease that can lead to severe side effects if left untreated. While varicose and spider veins may at first present as a cosmetic issue, if the symptoms are not well controlled, the disease will almost always continue to progress.
People with advanced stages of venous insufficiency will often develop severe side effects, like skin discoloration or ulcers. Having varicose veins puts you at a greater risk for bleeding, blood clots, or infections. Therefore, if you have varicose veins, it is very important to have them evaluated by a vascular expert.
2. Varicose veins happen to everyone - they are a normal sign of aging.
Varicose veins are an abnormal process. While you are more likely to develop varicose veins as you age, due to the degenerative nature of the disease, not everyone will develop varicose veins.
Varicose veins are caused by gravity. There are certain risk factors which put people at a higher risk for developing varicose veins. These factors are typically related to your lifestyle or genetics. People who sit or stand for long periods of time at work, people with a family history of venous insufficiency, people who are overweight, and women who have had children are all examples of factors which increase a person's likelihood of developing varicose veins.
3. Only women develop varicose veins.
Varicose veins are more prominent problem among women, but men can also suffer from varicose veins.
Hormones within the female blood stream and pregnancy make women more susceptible to developing varicose veins. However, there are millions of men with varicose veins. Dr. Esposito says, "In my experience, usually men's varicose veins tend to be worse than women's.'' He says this is often the case because men are more likely to allow the disease to progress further.
4. Running can cause varicose veins
Exercise is usually a good thing for your veins. However, Dr. Esposito says that, in a way, running can cause varicose veins due to the trauma running inflicts on the veins.
Walking is the best treatment for your veins. Moving your legs and allowing your muscles to contract typically allows for improved circulation toward the heart.
Weightlifters, runners who are really pushing themselves, and other athletes who are really straining during exercise do put themselves at a higher risk for developing varicose veins.
5. Varicose veins are always visible
This is not true. Dr. Esposito says closer to 90% of venous disease occurs below the skin.
"Venous disease is like an iceberg; what you see on the tip, the varicose veins that you see on the surface, represent a network of abnormal veins that are underneath the surface. It's that pressure underneath the surface that is causing those superficial veins to come out."
Although we only see what is on the surface, varicose veins are typically an indicator that there is a lot more going on in your deep venous system.
6. Varicose veins can be cured
Varicose veins can be removed or injected; however, as Dr. Esposito explains in our "Weeding the Garden" analogy, without proper follow up varicose veins will almost always come back.
Venous insufficiency is a chronic disease. Once the valves in your deep venous system become defective, they will continue to cause new varicose veins to develop. Therefore, there is no cure for varicose veins. However, with routine follow up you will most likely not require surgery to treat your varicose veins again.
7. Crossing your legs can cause varicose veins.
This may be true - crossing your legs can cause an increase in venous pressure at the knee. However, crossing your legs would be very low on Dr. Esposito’s list of "Things that cause varicose veins."
As long as you stay healthy, walk regularly, and maintain a healthy weight, crossing your legs will not significantly increase your chances of developing venous insufficiency.
8. Varicose vein treatment is painful
Varicose vein treatments of today are very different than your parents’ or grandparents’ varicose vein treatments. In the early 2000s, alternatives to vein stripping started to become the common practice for varicose vein treatment.
Vein stripping was a process of making multiple incisions in the leg and completely removing the greater saphenous vein. The procedure was done in an operating room and sometimes required an overnight stay in the hospital. This procedure was painful and carried a greater risk for bleeding and nerve damage. Recovery from this procedure typically took 4 to 6 weeks.
Varicose vein treatment does not look like this anymore. We now use a method called an endovenous ablation. During this procedure, a laser or catheter is inserted into the malfunctioning vein. The laser uses heat energy to cause the vein to collapse and seal shut. This procedure is relatively painless - the only pain you should feel is from the needle used to inject the local anesthetic. The procedure takes less than an hour and you will walk out of the office the same day. There is little to no downtown associated with this form of varicose vein treatment.
There are many misconceptions about varicose vein treatment. If you ever have any questions about venous disease, call Milford Vascular Institute at (203)882-8346.