Varicose Veins – Risks, Causes, and Symptoms

Varicose veins are enlarged, swollen, or twisted veins that occur when veins get oversaturated with blood. Blue or dark purple in colour, these veins are seen almost always on the legs and feet. This is a common condition that affects almost 1 in 3 adults worldwide, and are for many a family trait. Women are more likely to develop varicose veins, with them being at twice as much risk to develop this condition.

These superficial twisted and swollen veins can be also be accompanied by patches of flooded capillaries called spider veins. Although they can seem unattractive, they are usually harmless. However, when inflamed, they can be painful and be tender to touch. In such cases, these veins can hinder the circulation of blood in the lower extremities, causing itchiness, swollen ankles, and aches in the affected leg.

Besides developing superficially, on rare occasions, interior leg veins can also become varicose. The deeper venous network of the legs is usually not visible. Such varicose veins can cause aches and inflammation throughout the limb and even blood clots.

What causes varicose veins?

Circulation of oxygen-rich blood throughout the body requires arteries and veins working together to pump blood from the heart and back to it. To push back blood to the heart, veins rely on the surrounding thick layers of elastic tissue and muscles. Cup-like valves in veins allow a one-way flow of blood to prevent backflow. For proper circulation, it is important the veins in the extremities function properly.

If these veins become varicose, one-way valves can get damaged or become faulty, allowing the blood to pool in the veins. This makes it hard for the supporting muscles to push the blood (especially in the legs) against gravity. As less blood flows from one valve to the next back to the heart, more of it continues to pool in the veins. This incremental pooling increases congestion and pressure in the veins, making them twist and bulge. Because of these tendencies, varicose veins tend to develop mostly in the veins farthest from the heart – in the legs, where the muscle support for the veins is much less than that for interior veins.

What are the risk factors?

Physical conditions that put excessive pressure on the abdominal area and legs can cause varicose veins. Potential factors that can cause varicose veins include:

• Pregnancy
• Menopause
• Obesity
• Sedentary lifestyle: Weak muscles offer poor support for pumping blood through the veins. A lifestyle that results in poor muscle tone and condition increases the risk of varicose veins.
• Tumours
• Standing for prolonged durations: People whose occupations require them to stand for long periods are at a greater risk of varicose veins.
• Chronic constipation
• Leg injury: Damaged valves from a prior injury can cause varicosity.
• Genetics: If there is a family history of varicosity, the risk of your suffering from varicose veins increases.
• Age: The risk of varicose veins also increases with age. Muscles weaken, daily activity reduces, arterial walls become stiffer and less elastic, and vein valves suffer more wear and tear with time. All these contribute to increasing the risk of varicosity.
• Venous insufficiency: This can occur when nutrients, blood, and waste is not exchanged between the skin and blood properly because of weak blood flow.
• Tobacco consumption
• Deep vein thrombosis (DVT): A blood clot forming in a deep vein can block blood flow and cause varicosity. This medical condition is called DVT. These clots usually develop in the lower leg and thigh.

Pregnancy and Varicose veins

Pregnant people are at a greater risk of developing varicose veins due to various factors, making them more likely to develop varicose veins than at any other point in their lives. These include:

• Additional pressure is put on the circulatory system with pregnancy. Pregnant people have a lot more blood in their bodies, and this added burden of pumping more blood from the lower limbs adds to the risk of varicosity.
• Changes in hormone levels can also cause the relaxation of the walls of blood vessels.
• As the pregnancy progresses, the pressure on the pelvic region increases with the growing womb. While varicose veins resulting from advanced pregnancy usually dissipate after the pregnancy, this is not always the case. Sometimes, even though varicosity improves, visible markers of the condition remain.

What are the symptoms of varicose veins?

• A sensation of heaviness in the legs, especially after physical exertion or during sleep.
• Swelling in ankles
• Longer bleeding than usual in the area (caused by an injury)
• Pain or ache in legs
• Spider veins or telangiectasia
• Hardening or tapering of the skin above the ankles with inflammation of fat under the skin.
• Cramping in legs upon standing suddenly
• Redness, dryness, and itching in the affected area. This condition is called venous eczema.
• Shiny discolouration of the skin near the varicose veins
• Scar-like irregular, whitish patches near the ankles.
• Restless leg syndrome: A nearly uncontrollable urge to move the legs due to the feeling of some discomfort, usually in the evenings.

Are they dangerous?

Varicose veins can appear quite sickly – swollen, twisted, or bulging with a dark purple or blue colour. Though these veins on the legs may be unpleasant to look at, they are seldom painful by themselves.

However, they can sometimes be dangerous if left untreated:

• Untreated varicosity can lead to the formation of blood clots in the interior or deep veins (deep vein thrombosis).
• Varicose veins can also burst, causing a medical emergency.
• Varicosity in the testicular veins can lead to infertility in men.

When should I consult my doctor about varicose veins?

If you are concerned about varicose veins, how they look, or if they are uncomfortable, a consultation with your healthcare provider will be helpful.

You should seek a professional consultation if you see that the veins or your skin are:

• Swollen and painful
• Inflamed, red, and warm to touch
• Bleeding
• Discoloured

For more information about varicose veins, consult the best vascular surgeons in Bangalore at the Department of Vascular and Endovascular Surgery in Sagar Hospitals.