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Varicose Vein Common Questions and Answers

What is a Varicose Vein?
What Causes Varicose Veins?
Why Do My Varicose Veins Hurt?
I Notice My Varicose Veins Hurt and Swell More During My Periods.
Will I Have Scars Where You Remove the Veins?
Don't I Need Those Veins?
Will These Veins Come Back After the Endovenous Laser or Removal?
How Long Will I Be Out of Action and Unable to Exercise?
I Read that I Need to Wear Surgical Stocking. How Long and Why?

What is a Varicose Vein?

Varicose vein are small or large vein that bulge above the surface of the skin and can range from skin colored to red, blue or purple. Most commonly they are seen on the inside or back of lower legs but are also found on other parts of the legs and body. The veins of the lower legs must bring the blood back up to the heart for reoxygenation using the valves inside. The effect of gravity make the task even more difficult. Failure of these valves causes the blood to “pool” in the veins of the lower legs (chronic venous insufficiency). These varicose veins can appear like bulging twisted ropes or raised and straighter in appearance. Varicose veins can be a single ropey vein or multiple veins branching off. Varicose veins are also found on the upper thighs, genital areas (especially in pregnant women) and abdomen.

What Causes Varicose Veins?

A strong family history of varicose veins will predispose a person to developing them in both men and women. This is an inherited weakness of the valves within the veins. Most often then stem from weak valves in larger, deeper veins (venous insufficiency). The surface veins are the lower branches of these veins and are the ones that cause the painful symptoms.

Injuries from sports such as kicks, balls or bats can cause a disruption of the normal veins and the valves within them. Other types of traumatic injury such as leg fractures can also damage these valves. These are usually “non-truncal” meaning that they often don’t stem from valve problems in deeper veins.

Hormonal changes occurring with puberty, birth control medication, pregnancy and menopause (especially with hormone replacement therapy) increase the risk or varicose and spider veins.

Pregnancy causes a large increase in the circulating blood volume of a woman. Along with hormonal changes, this causes vein to expand to accommodate the extra volume. Combine this with the expanding size of the uterus and the pressure it exerts inside the lower abdomen, varicose veins can develop. Usually the vein will return to normal size and function within 3 months of delivery or cessation of breast feeding. Subsequent pregnancies can cause permanent damage to the valves within these vein and often they will not return to normal and can increase in severity with advancing age.

Obesity, while not a direct cause of varicose veins, can place additional pressure of malfunctioning veins. Most overweight patients we see usually have a strong family history of varicose veins or multiple pregnancies. We very often see people who have had dramatic weight loss showing increased symptoms and more noticeable varicose veins.

Prolonged standing can aggravate existing conditions of venous insufficiency (broken valves in the veins) and will cause increasing symptoms over time in these people.

Why Do My Varicose Veins Hurt?

Because of valve breakdown, the blood pools in these vein due to gravity when you stand or sit. It causes irritation and inflammation in the lining of the vein.

I Notice My Varicose Veins Hurt and Swell More During My Periods.

Female hormones fluctuate in the monthly cycle and cause dilation (enlargement) or the veins similar to that in pregnancy. This in turn prevents valves from closing correctly to keep blood flowing upwards back to the heart. Inflammation follows.

Will I Have Scars Where You Remove the Veins?

Surface varicose veins are removed cosmetically through tiny punctures (mircrophlebectomy) which will leave a small “dot” at the most. Of course, everyone heals differently but normally after time the areas are not noticeable. Sun exposure should be avoided while in the healing process to reduce the change of hyperpigmentation (brown marks).

Don’t I Need Those Veins?

No. The veins you see are damaged and the blood doesn’t flow through them as it should. The blood is already being diverted by healthy veins into your deep venous system. If the long saphenous vein is damaged, it won’t be used, if ever needed, for heart by-pass surgery. Today, surgeons mostly use arteries or stents for this procedure, not veins.

Will These Veins Come Back After the Endovenous Laser or Removal?

The veins we treat will not return. Most people have inherited this vein disease; it is possible they may develop new varicose veins in the future. However, it is easier to treat new and smaller veins as they start to appear and before they become symptomatic.

How Long Will I Be Out of Action and Unable to Exercise?

Most people can resume normal activity the next day with walking, treadmill and short workouts on an elliptical machine. We usually recommend gradually working back into a full routine over a couple of weeks and avoiding heavy lifting and abdominal crunches for the first two weeks.

I Read that I Need to Wear Surgical Stocking. How Long and Why?

Firstly, for symptomatic vein problems patients must do a “Trial of Conservative Therapy” to be eligible for insurance coverage. This varies according to your insurance plan, anywhere from 6 weeks to 4 months. This involves exercise, elevating legs, taking pain medicine if needed and wearing medical grade compression hose. These are lighter and more comfortable than they were in the past and must be fitted to your legs. These hose are also used to secure light dressings after your treatment for 48 hours and then daily for 3 weeks.

The function of the hose is to compress down the damaged superficial veins to prevent the “pooling” effect caused by damage varicose veins and reduce the inflammation and therefore the symptoms. It will also give you an idea of how good your legs will feel after the varicose vein treatments.

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