The veins are veins damaged in which the blood circulates poorly. They are bluish, dilated and twisted and may be more or less prominent.
It is estimated that 15% to 30% of the population has varicose veins. The women are 2 to 3 times more affected than men.
Most often, varicose veins form on the legs . They can also appear in the region of the vulva (vulvar varices) or the scrotum (varicoceles).
The veins are permanent. They cannot be cured, but most can be eliminated through various interventions. In addition, it is possible to relieve the associated symptoms and prevent the formation of other varicose veins, as well as the problems that may arise.
Types of varicose veins
In 95% of cases, varicose veins affect the saphenous veins, that is to say the superficial veins that go up along the leg and their collateral veins. These varicose veins are the result of a set of risk factors (heredity, excess weight, pregnancy, etc.).
In a minority of people, varicose veins are caused by inflammation of a deep vein (deep phlebitis) which eventually reaches the network of superficial veins.
People with varicose veins suffer from chronic venous insufficiency . This means that their venous system has difficulty getting the blood back to the heart.
- First signs: pain, tingling and feeling of heaviness in the legs; cramps in the calves, swelling in the ankles and feet. It can also be itchy. These symptoms are amplified when standing for a long time or sitting without moving;
- Appearance of varicosities then varicose veins : varicosities affect very small veins. They are not very prominent and look like a spider’s web . They are not usually painful. As for varicose veins, they are larger and more dilated veins. They are often accompanied by symptoms related to the first signs of venous insufficiency: tingling, heaviness, swelling, pain, etc.
Poor circulation in the superficial veins may result in:
- Brownish skin The rupture of small blood vessels causes blood to escape and invade nearby tissues. The blood thus released gives to skin areas a color varying from yellow to brown, hence its name: ocher dermatitis or stasis dermatitis;
- Ulcers. Very painful ulcers can form on the skin, most often near the ankles. The skin takes a brownish color beforehand. Consult a doctor without delay;
- A blood clot . A blood clot in a vein (or phlebitis) can cause local pain if the affected vein is a superficial vein. It is an important warning sign, as more advanced venous insufficiency can lead to deep phlebitis and pulmonary embolism . For more information, consult our Phlebitite sheet.
|Warning! A feeling of warmth accompanied by sudden swelling and dull pain in the calf or thigh requires emergency medical consultation.|
Causes varicose veins
The veins carry blood to the heart from the body. The veins appear when certain mechanisms or parts of the venous system deteriorate.
Weakening of the valves
The veins are provided with numerous valves that act as valves. When the veins contract or are subject to the action of the surrounding muscles, the valves open in one direction , forcing the blood to flow towards the heart. By closing, they prevent the blood from circulating in the opposite direction.
If the valves weaken, the blood circulates less well. It tends to stagnate or even go down in the legs, for example. The resulting accumulation of blood dilates the vein, and the vein becomes varicose.
Loss of muscle tone
During walking, the return of blood to the heart is favored by the leg muscles , which act as a pump on the deep veins. Low muscle tone in the legs is therefore a contributing factor to the formation of varicose veins .
Deterioration of vein walls
At rest, vein walls also play an important role in returning blood to the heart. Their effectiveness depends on their ability to contract (tone), their elasticity and their tightness. Over time, they may lose their elasticity and tone.
The walls can also deteriorate to the point of becoming semi-permeable. They then leak blood fluids into the surrounding tissues, causing swelling of the legs or ankles, for example.
Symptoms of varicose veins
- Of spider veins spider, the blue veins , dilated and prominent, usually on the legs;
- Of pain , tingling and a feeling of heaviness in the legs; calf cramps and swelling in the ankles and feet. It can also be itchy.
These symptoms tend to get worse in the evening .
In women, they increase during the days preceding menstruation.
People at risk for varicose veins
- People predisposed by their inheritance. Hereditary factors are predominant. Having a mother, father, brother or sister with or having varicose veins increases the risk;
- The women. Hormonal changes related to pregnancy, premenstrual periods and menopause contribute to the appearance of varicose veins;
- People over 50 years old. The process of degeneration of the veins and their valves may, however, begin in their thirties;
- Pregnant women . At the time of pregnancy, expansion of the uterus compresses the large abdominal veins, which hinders venous return. In addition, the hormones secreted during pregnancy cause a loosening of the muscles of the veins. Fortunately, varicose veins that are uniquely pregnancy-related often resolve on their own within 3 months of delivery;
- People who work standing up . Cashiers, nurses, waiters, teachers, etc. are particularly affected but only if they have a hereditary predisposition to varicose veins.
- Obesity. Excess weight puts increased pressure on the venous system of the lower limbs;
- Stationary standing or trampling;
- The base station for long periods;
- Lack of exercise ;
- Exposure to heat (sunbathing, very hot baths, etc.);
- The repeated uprising of heavy objects, as in the case of people who work in handling or who practice weightlifting.
Prevention of varicose veins
|Can we prevent?|
|When heredity predisposes a person to varicose veins, it is not easy to escape. Nevertheless, maintaining a good muscle tone and good physical shape , we can reduce the risk of varicose veins appear or delay the onset. The risk of complication is also decreased.|
|Basic preventive measures|
|Move. Leg exercises, such as walking, swimming and biking, are particularly suitable for preventing varicose veins. Compression of the muscles adjacent to the veins facilitates venous return.
Keep your weight healthy. Excess weight exerts excessive pressure on the veins of the legs, which hinders the return of venous blood to the heart.
Watch his diet. By consuming little salt, it helps prevent swelling caused by water retention. By eating high fiber foods, constipation can be prevented. It must be known that forcing a bowel movement can increase pressure in the venous system.
|Tips to relieve symptoms and prevent worsening of varicose veins|
|Raise his legs . It is recommended to do it 3 or 4 times a day, 15 to 30 minutes each time. The legs should be placed higher than the heart. For example, you can lie on a bed or on a lounge chair by placing pillows under your legs.
Vary his posture. Avoid standing or sitting too long. When working standing, it is good to think about stretching, moving and sitting occasionally to stimulate circulation in the legs. When working seated, avoid crossing your legs and leaning your bust forward for long periods.
Move your feet and ankles. When sitting or standing for long periods of time, it is good to think of pointing the toes down and up to encourage venous return. Repeat several times a day.
Move during a trip. During a long flight, it is recommended to get up and stretch regularly for a few minutes. You can, for example, slowly raise the heels to contract the calf muscles.
Apply cold water to the legs. This helps to relieve and reduce their swelling.
Avoid sources of heat. The heat dilates the veins. To avoid: showers and hot baths, saunas, sunbathing, tanning salons, as well as hot waxing.
Avoid tight clothing. These can affect the venous circulation. Watch out for sheaths, tight jeans, elastic socks that grip your ankles or knees, and shoes that are too narrow.
Wear flat-heeled shoes. The high heels contribute to the sagging of the arch and therefore affect the circulation. The shoes with small heels make more work the muscles of the calves, which helps the veins to do their work.
Wear compression stockings . They can be used preventively by people who work standing up and flying.
Medical treatments of varicose veins
The care varies according to the severity of varicose veins . The basic treatment includes the following: elastic compression, sclerotherapy (see below), elevation of the legs and preventive measures to avoid aggravation of the problem. In terms of varicose spider, sclerotherapy may suffice.
Treatment of varicose veins usually needs to be repeated, usually every year or every 2 years, because new varicose veins are forming.
Socks, stockings or elastic compression tights serve as much to relieve existing varicose veins as to prevent the appearance of new varicose veins. They act as a “second layer” of muscles that exerts active pressure on the superficial veins. The pressure is stronger at the ankle than at the thigh, which facilitates the venous return. They also prevent varicose ulcers . However, as they do not cure varicose veins, as soon as they stop wearing them, the affected veins remain dilated, which brings back the initial discomfort.
To maximize the comfort of these stockings, it is better to put them in the morning before getting up . By putting them in a supine position, it is avoided that a quantity of blood falls and stagnates, at least in part, in the legs. Ideally, they should be worn all day.
Their degree of compression is variable. It is measured in millimeters of mercury (mm Hg) and it is the doctor who determines it. Compression greater than 20 mmHg requires a prescription from a doctor.
This treatment, which does not require anesthesia or recovery time, is ideal for new varicose veins . The doctor injects an irritating solution into the affected small surface veins , which causes them to close. The blood is forced to flow back to other non-varicose veins. The sclerotic veins gradually subside. They do not usually leave traces. There is no problem in destroying varicose veins, since they no longer fulfill their functions.
For the treatment of spider veins spider veins , microsclerotherapy is used (use of very fine needles for injection).
The sclerotherapy may require to be treated the same vein several times but it generally works well. It does not prevent, however, the formation of new varicose veins in neighboring veins.
It is possible to treat varicose veins of medium size by sclerotherapy. The doctor can then be guided by ultrasound imaging.
Surgery is often preceded by an ultrasonic ultrasound scan of the veins to determine the severity of the injury.
Ambulatory veinotomy. During this procedure, the small affected veins are extracted by micro-incisions using a special hook. Local anesthesia is practiced.
Laser surgery. A variety of laser treatments are offered. One intervenes on the surface of the skin and inside the vein (endovenous laser). A laser fiber is inserted into the sick vein. The heat generated forces the vein to close on itself.
Venous surgery by endoscopy. This intervention is used in more serious cases. It requires anesthesia. It is performed using a tiny video camera that is inserted into the leg through a small incision to see and close the veins. These are then extracted by making small incisions.
Stripping. This classic procedure, also called “stripping”, is used in severe cases: it involves extracting the affected veins of each leg by making small incisions. Depending on the age and severity of the problem, treatment may require hospitalization for 1 to 5 days followed by convalescence of 3 to 21 days.
CHIVA (Hemodynamic surgery of venous insufficiency in ambulatory) . This operation reduces venous pressure without ablation. The affected superficial veins are ligated , forcing the blood to pass through the deep ones. The ligated veins are no longer filled, deflate on their own, and become less visible and less painful.