Developing varicose veins or even spider veins is something of a great concern to many people, particularly during their early adulthood. It could be that they notice a new superficial vein appearing or one previously present, looking more prominent than usual, especially when associated with symptoms like leg pain or swelling.
There are many factors that have been found responsible for the development of varicose vein. However, a few of these factors may be beyond the patient’s control but others may be amenable to removal or mitigation through sensible life choices.
A Brief Introduction to Varicose Veins
Varicose veins are enlarged, distorted, thin-walled veins which can form anywhere in the body but are commonly associated with the lower extremities. Most examples of varicose veins are the result of chronic venous insufficiency (CVI), which is a condition whereby damage or impairment in structure of the one-way leaflet valves leads to incompetence, resulting in reflux (back-flow) of blood from the inner, deeper veins of the pelvis and lower extremities downwards and outwards, towards the veins under the skin. Normally veins contain delicate one-way valves, which direct the flow of blood deeper towards the center of the limb and upwards towards the heart.
Risk Factors behind Varicose Vein Development
Age is one of the main risk factors behind the appearance of varicose veins and that is clearly something over which we have no control. As we get older, our veins become less elastic and become more easily distensible out of shape, while the valves which prevent venous reflux may weaken or get damaged or distorted over time. These two factors exacerbate each other with the excessive reversed flow of blood distorting the shape of the vein, which then impairs further the function of the leaflet valves. Turbulence with reflux also adds to further damage of the wall.
Gender is another factor which affects the likelihood of developing varicose veins. In this case, women have a distinct disadvantage, largely due to naturally higher levels of certain hormones in their blood, notably estrogen and progesterone, particularly during certain times of their menstrual cycles. Some of these chemicals affect the distensibility of the veins, making them more prone to becoming distorted. Taking oral contraceptives and receiving HRT are also linked to varicose vein formation while, unsurprisingly, pregnancy is another risk factor given the combination of hormone changes, increased blood volume and increased pressure from the gravid uterus on the vasculature in the pelvis, impeding return and increasing the pressure within the lower extremity veins and, perhaps, damaging their valves. Varicose veins, which develop during pregnancy may improve or they may be ephemeral. However, many patients date the development of their varicose veins to a pregnancy or two.
Then there is the risk factor of being born into a family with a history of venous insufficiency and/or varicose veins: around half of the sufferers have relatives with the condition. So there must be a genetic predisposition with resultant hypo-plastic, flimsy or absent valves.
We now move on to those risk factors which can be reduced through lifestyle changes. Obesity, for example, causes increased venous blood pressure which can place stress upon the veins of the legs; so any effort to lose weight is likely to reduce the chances of developing varicose veins. Obesity also works by the intra-abdominal fat compressing the iliac veins, on their way back from the lower extremities, impeding venous return and chronically distending the veins and damaging their valves. Excessive fat stores also play a part in elevating female hormones, further distending the veins.
Long periods of inactivity – whether standing or sitting – are also implicated in varicose vein formation. When walking or running, our leg muscles act as pumps (part of the skeletal-muscle pump), helping with venous return, which also maintains tone in the venous walls. This assistance is lacking when people are inactive for long periods of time. Sitting or standing for a few hours daily, especially in predisposed individuals, causes distention of the veins in the legs by increasing hydro-static pressure, which often results in a little swelling of the ankles towards the end of the day. Sleeping flat at night reverses this elevation in tissue pressure and reverses the swelling. Observe how the distended veins in your legs or at the back of your hands deflate and disappear when you elevate the limb from the dangling to the horizontal position or higher.
Sun Exposure and Spider Veins
While many of the risk factors mentioned above are equally applicable to spider veins – which are miniature varicose veins and may represent the tip of the iceberg – there is also evidence that sun exposure can be an additional stimulus for the development of spider veins. UV radiation from the sun breaks down collagen in the skin, including tissues supporting the walls of blood vessels, which can reduce the containing pressure around the vessels and cause them to become more distensible and bulgy. In addition, warm temperatures lead to vasodilation in the vessels near the surface of the skin. This increases the volume of blood in spider veins (and larger varicose veins), making them more prominent. However, sun exposure is not in itself regarded as a risk factor for developing varicose or spider veins except by damaging the supporting collagen, and collagen in the wall of the vessels.
Are you currently troubled by the appearance of varicose veins or spider veins? These can often be removed using various state-of-the-art and non-surgical techniques. Visit our website at www.springofyouthmedical.com to find out more. You can book a consultation, and receive a free compression stocking, by calling (228) 875-0885.