We have all seen them. Most of us know them as those gross, large, lumpy veins that you saw on your parents’ legs when you were growing up. In reality, the term “Varicose” just means a dilated vein. That being said, whether we are talking about those bulging lumps of tangled veins on our parents’ legs or the network of blue veins that map out our legs to even the spider veins that many of us so proudly show off. These are all considered “Varicose veins” by definition because they are all technically dilated veins. When dilated, many of these veins as they near the skin surface, are easily visible at the skin level. Unfortunately, most of us never realize that those dark purple to bluish green veins that we see all over our legs, veins that we in the medical community know as reticular veins, are actually manifestations of a medical condition called Chronic venous insufficiency.
This is a medical condition known by most people as Varicose vein disease. The color of these veins is a reflection of the blood pooling in these dilated vessels. Unfortunately, most people have been incorrectly taught that these veins are just a cosmetic issue, when in fact they are a symptom of a progressively worsening medical condition. Over time, the vein disease will continue to progress until the venous circulation as a whole eventually becomes compromised.
This is when people start to notice their legs more. They’re legs may start to swell or become tender to the touch. Essentially, people begin to appreciate little sensations that progressively seem to worsen over time. These new sensations are symptoms that many of us live with every day without ever realizing that they often represent symptoms of a much bigger underlying problem. Unknowingly, most people just disregard these sensations as a sign of aging or just being on concrete too long when in fact they are your body’s way of letting you know that there is something wrong.
Varicose vein disease is primarily an inherited circulatory disorder. It is a condition that is exacerbated by prolonged standing or sitting in those who carry the trait. It is most commonly associated with women but affect men as well. It is estimated that vein disease affects 30-50 percent of the American population. Unfortunately, despite its significant prevalence in society, vein disease remains a poorly understood medical condition as suggested by its “cosmetic” label within society.
In contrast to the arterial circulation, there is no “heart” present to pump blood thru the venous circulation. Veins, as a result, have evolved over time to become a network of one-way vessels, made possible by the presence of one-way valves build into the lumen of every vein. These one-way valves when working in coordination with the surrounding muscular contractions, enables the blood present within a vein lumen to be propelled up the leg and back towards the heart. These one-way valves also allow the veins to counter the effects of gravity on the body’s venous circulatory system. Without these valves, gravity would take effect and force blood to pool at the feet eventually causing the person to die from a lack of blood flow. In contract, when functioning properly, the venous system becomes the equal counterpart to the arterial circulation. A person cannot live without both sides functioning since this is how the blood circulates.
Medical condition vs Cosmetic condition
Why Varicose Vein disease is a medical condition and not a cosmetic issue resides in the pathophysiology of vein disease. What is the effect of vein disease on the venous circulation? Vein disease, as mentioned before, is an inherited disorder of the venous circulation. What this means is that it can affect any vein in the entire body, not just those within the legs as many people tend to believe. Vein disease causes the valves within the lumen of veins to gradually breakdown. The end result is a decrease in the effectiveness of how the body is able to pump blood back towards the heart on the venous side of the circulation. As a result, venous blood will begin to backflow and pool ultimately causing pressure and congestion to develop within those affected veins. Over time, it is this pressure and congestion that begins to slowly dilate these defective veins. It is this congestion that will impede the venous flow thru your entire venous circulation resulting in a much more congested pathway back to the heart. This effect on the venous circulation is reminiscent the effect of a car accident on the flow of traffic thru a city. The more accidents, the greater the congestion, the slower the traffic thru the city. This is precisely why most people view the symptoms of vein disease to be age related. Vein disease progresses as you age. How rapidly vein disease progresses, is genetically and environmentally determined. Therefore, as a person’s vein disease progresses, there are more accidents forming throughout the venous network. The more accidents, the more congestion, the more symptoms.
One fact that many people also overlook is that venous blood is in fact dirty blood. Unlike its counterpart arterial blood, which is oxygenated and devoid of waste products, venous blood is the vehicle that allows our body to transport the body’s waste products back to be filtered out by the kidneys, lungs and liver. The presence of these waste products makes venous blood a highly corrosive fluid, that when allowed to pool within the varicose veins, promotes the development of inflammation within the vein. As this inflammatory response increases over the course of the day or over time with the progression of the vein disease, a person will begin to notice a level of discomfort within the affected area. The more vein disease a person has, the greater the amount of pressure and congestion, the greater the inflammation present, the more symptoms present. “Cosmetic” issues do not have symptoms. This is why Chronic venous insufficiency or Varicose vein disease is a “medical” condition and not the “cosmetic” issue many people envision it to be.
Factors that Worsen Vein Disease
Since the underlying defect in Vein disease is a progressive breakdown in the valves found within the lumen of veins, any condition that could potentially inhibit the body’s ability to transport blood back towards the heart, can exacerbate the condition. Some such conditions but not limited to are:
- Long periods of standing
- Constipation, especially if it is chronic
Symptoms of varicose veins can vary from person to person. Most people focus on the bluish, purple vessels that are visible below the skin. The more common visible and non-visible symptoms of note are:
- Pain, tenderness, throbbing, or aching in the legs
- Restless legs when at rest or while sleeping
- Leg Cramps at night
- Charley horses
- Swelling in the ankles and calves
- Heaviness and fatigue in the legs
- Venous ulcerations or cuts that are slow to heal.
- Red or brown patches on legs. May resemble a dermatitis rash
Varicose vein treatment is highly variable depending on the severity of the individual’s vein issues. Every person is unique and must have a customized treatment protocol specific to their needs. Determination of disease severity begins with an ultrasound evaluation of the internal venous network. Knowledge of this enables the physician to determine what method of treatment is required. During the era of our parents and grandparents, it was not uncommon for physicians to actually cut varicose veins out of a person’s legs, a procedure called stripping or phlebectomy. STL Vein & Cosmetics has advanced beyond the age of the scalpel. Modern state of the art varicose vein disease treatments and more traditional treatment modalities used at STL Vein & Cosmetics includes:
- Endovenous laser ablation (The gold standard in the treatment of Saphenous vein reflux. This procedure utilizes a laser fiber to burn the lumen of a problematic vein.)
- Ultrasound guided foam sclerotherapy (Utilizes ultrasound to guide the injection of a chemical sclerosant directly into Varicose veins that are not directly visible at the skin level.)
- Visual Sclerotherapy (This procedure involves the injection of a chemical sclerosant into the spider veins and reticular veins that are visible with the naked eye. This technique is also known as cosmetic sclerotherapy)
- Graduated Compression Stockings (Can be used to help minimize symptoms seen in mild cases of vein disease)
- OTC anti-inflammatory medications (Used as an adjunct to medical treatment to help minimize discomfort)
As vein disease progresses, eventually a physician specializing in varicose vein treatment will be required.
STL Vein & Cosmetics specializes in the non-surgical varicose vein disease treatment. Our dedicated staff at STL Vein & Cosmetics is specially trained to address your venous needs and to help fix your underlying venous circulatory problems and cosmetic needs. Treatment of any vein disease problem is a process. It is important to remember that vein disease is an inherited disorder for most. The presence and treatment of one or two large ropey varicose vein never constitutes a comprehensive treatment. Proper vein care should address the entire venous circulation in the leg. Only then can the physician address the person’s venous circulatory problem. For more information or to schedule your appointment today, please contact us today at 314.842.1441.