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Varicose Veins and Spider Veins

(Also Called 'Spider Veins')

Varicose Veins and Spider Veins

Varicose veins are abnormal, dilated blood vessels caused by a weakening in the vessel wall. They might appear as clusters of blue or purple veins and are sometimes surrounded by thin red capillaries known as spider veins (group of small blood vessels located close to the surface of the skin).

Varicose and spider veins can appear anywhere, but most often appear on the legs and in the pelvic area. Most varicose veins develop near the surface of the skin. Deeper varicose veins can't be seen but might cause the skin above them to swell, or become darker or hard.

Nearly 80 million Americans suffer from benign vascular lesions – those crooked purple and blue lines that appear on the surface of the skin. The most prevalent types are varicose veins and spider veins found in the legs. Almost 50 percent of women between 40 and 50 years of age, and nearly 75 percent of women between 60 and 70 years of age have these surface leg veins. Varicose veins are less common in men. Still, approximately 25 percent of men 30 to 40 years of age, and almost 50 percent of men age 70 and older have benign vascular lesions. Varicose veins are not just a cosmetic nuisance. Half of all patients who seek treatment do so because of pain and discomfort.

Symptoms of varicose veins

Symptoms usually appear before the age of 40 and might include:

  • Swollen, twisted clusters of purple or blue veins
  • Swollen legs
  • Muscle cramps, soreness, or aching in the legs
  • Soreness behind the knee
  • Itching around the vein
  • Leg muscles that tire easily
  • Brown discoloration of the skin
  • Ulcers

A number of factors predispose a person to varicose and spider veins

These include:

  • Heredity
  • Occupations that involve a lot of standing (These include nursing, hair styling, teaching, and working in a factory.)
  • Obesity
  • Hormonal influences during pregnancy
  • The use of birth control pills
  • Post-menopausal hormonal replacement
  • A history of blood clots
  • Conditions that cause increased intra-abdominal pressure including tumors, constipation, and externally worn garments like girdles

Other reported causes include topical steroids, trauma or injury to the skin, previous venous surgery, and exposure to ultraviolet rays. Varicose veins occur when healthy veins swell and cause blood to back up and pool inside the vein. (Normally, blood flows through the vein in one direction toward the heart.) Varicose veins become a new route for blood to flow.The exact cause of varicose veins is unknown, although heredity, pregnancy, obesity, and hormonal changes are contributing factors to this condition. Standing for long periods of time and wearing tight underwear or clothing might also cause varicose and spider veins.

How are varicose veins diagnosed?

During a physical exam, the doctor will check your legs while you are standing. Your doctor also might 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.

Should I be concerned?

Varicose and spider veins might not always require medical treatment. If varicose veins make walking or standing painful, you should call your doctor for advice. You also should call your doctor if a sore develops on or near a varicose vein, or if your feet or ankles swell.

In some cases, varicose veins can be harmful to your health because they might be associated with the development of:

  • Venous statis ulcers -These are ulcers that result when the enlarged vein does not provide enough drainage of fluid from the skin. As a result, the skin does not receive enough oxygen and an ulcer (skin sore) might form.
  • Phlebitis - This is inflammation of the vein.
  • Thrombosis - This is the development of blood clots that form in the dilated vein.

How can I prevent varicose and spider veins?

  • Avoid wearing girdles, control-top pantyhose, garters, and any other tight-fitting clothing
  • Avoid crossing your legs while seated
  • Avoid sitting or standing in one position for a long time
  • Exercise regularly to increase circulation
  • Lose weight if you are overweight
  • Sit or lie down and elevate your legs at least twice a day for 30 minutes at a time

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