The exact causes of spider veins and varicose veins are unknown, but there are factors that cause you to be more likely to develop them. Heredity is the greatest factor. If both of your parents have varicose veins, your chance of having them is about 90%. There is nothing that can be done about your genetics, but it is important to understand that this is the most common cause.
Changes in your hormone levels, like those that occur during puberty, pregnancy and menopause, can contribute to a woman developing varicose veins or spider veins. Other factors may include aging, obesity, leg injury and/or prolonged standing. Pregnancy itself, by mechanical means of the baby putting pressure on your internal veins, may be a contributing factor.
When your heart pumps, the left side of the heart pushes blood to your brain, your hands, and your feet. The heart muscle is very strong, and beats about every second, 24/7. Your heart pushes oxygen rich blood cells, nutrients, and fluid to all parts of your body.
The blood then gets to the target tissue. Once the blood arrives at the target tissue, the blood cells and fluid pass through a series of capillaries to deliver oxygen and nutrients, then goes to the venous (vein) side. The blood has to get all the way back to the heart. There is no similar heart pump in your feet, so your body has other ways of sending it back. The vein system relies on a series of valves, gravity and your muscles to get the blood back to the heart.
The blood gets pumped to your head from your heart. The veins in the head and neck rely entirely on gravity to get the blood back to your heart. There are no valves or muscles involved. It basically drains out. If you hang upside down, gravity is lost, the blood will pool in your head, your face will get red, you will feel swollen and will actually get swelling in your face if you stay that way!
Your arms and upper body have a series of one way valves that help the blood makes its way through your veins into the deep veins of the muscle. The muscle’s pumping action helps push it back to the heart. Because your arms are almost at the same level as your heart, there is not a significant effect of gravity, and rarely do varicose veins develop in the arms.
The blood in your lower legs has traveled a significant distance from your heart, and has a bit of a journey to get back. The blood goes from the left ventricle of the heart all the way to your toes, gets into the capillary system, delivers oxygen and nutrients, and has to get all the way back to the heart. To accomplish this, our bodies have a series of one-way valves that are suppose to direct the blood to the stronger vessels inside the muscles in a one way fashion back to the heart. The pumping action of the leg muscles account for the mechanical force that pushes the blood back while we walk. When you contract your muscles (which happens every time you take a step) the muscle squeezes the vein, emptying the blood into the next valve that is above the muscle, and works the blood all the way back to the heart. This is largely because of the milking effect of the muscles through the one way valves.
Venous insufficiency is when the valves are not working properly, or something is blocking the blood flow. In most cases, the primary failure is because the valves no longer work in a one way fashion. Instead, they allow the blood to back flow into the veins downstream, or lower in the body. When the calf muscles contract, the blood is suppose to get squeezed into the thigh and then transported or pushed eventually back to the heart. In VI, it may squeeze into the varicose vein developing in your leg, where it gets trapped, swells, and eventually causes pain or other symptoms.
Leg pain is common in VI. It may occur as general leg tiredness, fatigue, or heaviness. Some varicose vein patients may experience itching, burning and throbbing. Restless legs may be a sign of VI, and the association is not clear, but we know that people with symptoms of restless legs get better when the VI is treated.
Swelling of the leg is common, particularly after prolonged standing or sitting. When you are not walking, the calf and leg pumping system is not working, so you have more reliance on your leg valves, which are the point of failure in the condition of VI.
Prolonged and untreated VI may result in skin changes. Discoloration, eczema, broken capillaries, and even wounds may occur in VI. A condition known as Corona Phlebectasia, which are clusters of spider veins at or just below the medial or lateral ankle, is characteristic of longstanding mild to moderate VI. Dark patches, which is staining from stagnant blood, is called hyperpigmentation. As it progresses, the skin texture changes, becoming more firm, less fleshy feeling, and has poor healing qualities, known as lipodermatosclerosis. As this progresses, the skin may break down into what is called a venous stasis ulcer.
The treatment for VI is the same as described for varicose veins. Recommendations for aftertreatment include compression (support) stockings, avoidance of prolonged standing (take frequent walks), weight maintenance and periodic leg elevation. In more severe cases, a type of compression known as inelastic compression is used. Ablation, laser ablation and radiofrequency ablation (CTEV, EVLT, EVLA, VNUS Closure) are all effective for treating VI.
Allure Medical is a leading provider of laser vein treatment and removal procedures. Led by Dr. Charles Mok, the practice is proud to offer advanced, non-surgical treatments to help alleviate the appearance and symptoms of vein disorders.