What causes varicose veins on legs?

12 Feb

What causes varicose veins on legs? Believe it or not, but it won’t be long before you start thinking about wearing shorts. But many people hesitate at baring those calves because of varicose veins, or unsightly and swollen veins in the legs. Varicose, or spider veins, are more than just a cosmetic problem though. They can lead to swelling, discomfort and fatigue, especially for folks who spend a lot of time on their feet.

Science Life recently spoke to vascular surgeon Robert Steppacher, MD, about what causes varicose veins, who is most at risk and why treating them isn’t all that different from wearing yoga pants.

Varicose and spider veins are the same disease process, it’s just a matter of severity and size. Spider veins are small blue or red veins under the skin. They’re called spider veins because they look like a spider web, and a lot of patients will find those unsightly.

Varicose veins are larger, more dilated veins. We have a grading system, and we make the cutoff based on size. So spider veins would be smaller, like 1 to 3 millimeters, where varicose veins are larger, and they typically bulge out above the skin level.

What causes varicose veins?

They’re both caused by the same thing, which is called venous hypertension, chronic venous insufficiency or venous reflux disease. Those three terms are used interchangeably, but they all basically mean the same thing. It’s increased pressure within the vein because of a failure of what’s called the venous valvular system. So normally you have to have a way of getting blood, against gravity, out of your legs and back to your heart.

The way that works is every time you take a step, the calf muscles contract, and that squeezes on the veins in your leg and pumps the blood out of your leg back to your heart. When you relax, gravity wants to pull the blood back into your leg. To prevent that from happening, in normal veins you have a valve that looks like a little triangle.

Every time you take a step, the valve pops open, the blood exits the leg, and then when gravity wants to pull the blood back in the leg, the valve snaps shut. For various reasons like family history, weight, having jobs where you sit or stand for long periods of time, these valves stop working, and that allows gravity to continuously pull the blood back into the leg. This causes pressure on all the superficial veins, which causes them to dilate over time and grow larger.

Varicose veins develop as blue and purple sinuous lines under the skin. Varicose veins are found on the calves and shins, thighs and feet. Not a technical term, spider veins can appear anywhere on the body but are generally found on the arms, stomach, back, face, neck and buttocks. With an appearance of broken glass or a non-uniform spider web, varicose and spider veins affect between 50 and 55 percent of women and 40 to 45 percent of men.

Spider veins and varicose veins have different causes. Varicose veins are caused by valve failure in the veins, while spider veins are caused by the rupture or hemorrhage of a blood vessel or vein. While varicose veins can only appear on the legs, spider veins can appear almost anywhere on the body.

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