You will all have seen Emma Thompson, a British actress who used to wear long dresses to hide the dilated purple veins on her legs. Not only her, but also other public figures like Kristin Davis, Britney Spears, Jessica Alba, Serena Williams and Sydney Leroux also suffer from the same problem. What is this aesthetic problem? Let’s talk about it.
What are varicose veins?
A good way to explain what varicose veins are is by comparing them to stockings . Initially they have a very limited and compressed shape, but when the foot is inserted into them they stretch and dilate. Similarly, increased pressure in the lower extremity causes dilation, twisting and tortuosity of the veins , giving them that characteristic appearance.
Varicose veins are superficial, violaceous, dilated and tortuous veins that appear in the lower extremities. For some people they can be painful, but generally they are only a cosmetic concern.
What are the causes of varicose veins?
Veins have valves that prevent backflow of blood into the legs and pushing blood back toward the heart. These valves are unidirectional, that is, they prevent blood from returning to the starting point, and they move the blood against gravity with the help of muscle contraction. The weakening or alteration of these valves causes the accumulation of blood in the veins of the lower extremities, which leads to varicose veins.
How do varicose veins appear?
Varicose veins present as dilated dark purple or blue rope-like or cord-like veins that can be painful or painless.
Painful varicose veins are associated with heaviness in the legs, itching, rashes, shooting and burning pain, and muscle cramps in the lower extremity. In addition, chronic conditions cause skin changes such as eczema, pigmentation, and venous leg ulcers. Varicose veins near the surface of the skin change the normal color of the skin to reddish.
What are the risk factors for varicose veins?
Risk factors for varicose veins include older age , pregnancy, female gender , obesity , smoking , leg trauma, family history, and prolonged standing . In addition, birth control pills and hormonal treatments can also increase the risk of varicose veins.
During pregnancy , the veins dilate and pressure increases in the lower limbs, which causes the appearance of varicose veins. In old age , the valves become weaker: they cannot resist the backflow of blood due to gravity, which contributes to blood pooling in the lower extremity.
Diagnosis and treatment
Varicose veins are diagnosed clinically through a detailed medical history, examination, and diagnostic procedures. Diagnostic procedures include Doppler or vascular ultrasound, which involves checking blood flow and the structure of the veins.
Treatment of varicose veins is highly cost-effective, and options include endothermic ablation, endovenous laser treatment (the long saphenous vein is used in this procedure), ultrasound-guided foam sclerotherapy, and surgery.
Something to keep in mind is that the treatment of varicose veins is not permanent . Varicose veins can always come back, especially in places where varicose veins have been previously. You may need more than one treatment session for these recurrences.
Compression stockings are often used for varicose veins, especially by people who work long hours on their feet and by pregnant women, but they do not provide a permanent solution.
What are the complications of varicose veins?
Varicose veins can cause painful leg ulcers . They start as a discolored patch on the skin, and little by little the correct blood supply decreases, until it leads to the formation of ulcers. These ulcers should never be ignored . It is better to consult the doctor before further complications occur.
In addition, blood clots can also form due to blood pooling in the lower extremities, increasing the risk of deep vein thrombosis and embolism. Dilated superficial veins can also burst, causing small hemorrhages in the legs.
In short, varicose veins are simply an aesthetic problem when they are painless, since they are twisted, bulging and dilated veins, but when they are painful , they cause discomfort, palpitations and burning in the lower extremities, and it is no longer something merely aesthetic. Risk factors include obesity, older age, smoking, pregnancy, and prolonged standing. Treatment options are inexpensive, and the recurrence rate is high . It is better to consult a doctor in the early stages for proper medical or surgical treatment. If they are painless and you have no cosmetic problems, you can live with them.
References:
Brazier, Y. (2021). How to treat, what causes, and how painful are varicose, or spider, veins? Medical News Today. https://www.medicalnewstoday.com/articles/240129
Erickson Gabbey, J. (2012). Varicose Veins. Healthline Media. https://www.healthline.com/health/varicose-veins
Raetz, J., Wilson, M., & Collins, K. (2019). Varicose Veins: Diagnosis and Treatment. American family physician, 99(11), 682–688. https://pubmed.ncbi.nlm.nih.gov/31150188/
Varicose Veins (s.f.). Â Johns Hopkins Medicine. https://www.hopkinsmedicine.org/health/conditions-and-diseases/varicose-veins
Varicose veins (2022). Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/varicose-veins/symptoms-causes/syc-20350643
Â
