Common Questions

WHAT CAUSES VARICOSE AND SPIDER VEINS?

A definitive cause is not known; however, a strong family history is a common indication, suggesting that some patients inherit veins that are more likely to deteriorate. Women are more likely to suffer from varicose veins at an earlier age than men. Up to 30% of men and women are affected. In women, varicose veins may worsen with fluctuations of hormones, such as during puberty, pregnancy and menopause, and with the use of birth control pills. It is common for pregnant women to develop varicose veins during the first trimester. Pregnancy results in elevated hormone levels and blood volume, which in turn cause veins to enlarge. In addition, the enlarging uterus causes increased pressure on the leg veins. Varicose veins occurring in pregnancy will often improve significantly within three months after delivery. However, with successive pregnancies, abnormal veins are likely to get worse. Other predisposing factors include ageing, standing occupations, obesity, lack of mobility, previous venous thrombosis and leg injury.

It is thought that the wall of the vein becomes weak in some sections. These sections then widen and become more prominent. If this occurs near a valve then the valve may become 'leaky' and blood may flow backwards. Once this happens at one valve there is extra pressure on the vein, which can cause more widening and more leaky valves. Blood then 'pools' (collects) in the enlarged vein and makes it stand out.

 

DO WE NEED OUR VARICOSE AND SPIDER VEINS?

Varicose and spider veins are unhealthy superficial veins that do not function correctly and fail to return blood back to the heart.

Varicose veins impose an extra burden on the deep veins, which can lead to their deterioration. To compensate for the lack of function in varicose veins, deep veins have to work harder, and in some cases, they become abnormal. Once varicose veins are removed, the blood circulation will improve. In general, varicose veins are not suitable for use in heart by-pass operations, because they are damaged.

Spider veins are unsightly, abnormal veins and do not serve a biological purpose.

 

WHEN DO YOU NEED TO TREAT YOUR VEINS?

Early treatment of varicose veins may reverse the symptoms of venous congestion and minimise the risk of varicose vein-related complications and further progression of the disease. Treatment becomes more urgent if there are coexisting complications such as bleeding, inflammation (phlebitis), clots (thrombosis), dermatitis or ulcers. In general, it is much easier to treat varicose veins when they are smaller, as early treatment tends to be less complicated and less involved. It is recommended that varicose veins be treated before pregnancy, since complications such as clotting and bleeding can develop during pregnancy. Varicose veins that have worsened during pregnancy may not fully recover after pregnancy, requiring more involved and complicated treatment than would have been required before pregnancy. Spider veins should be treated only after the varicose veins have been successfully treated. 

 

HOW CAN A PHELEBOLOGIST HELP?

Phlebologists have considerable expertise in using vascular ultrasound, which assists in achieving a more accurate diagnosis and management of venous disease. New ultrasound and laser technology, along with the introduction of foam sclerotherapy, have significantly advanced the non-surgical treatment of varicose veins. 

 

INVESTIGATIONS

Before treating varicose veins, duplex ultrasound studies are organised to map the abnormal veins. Deep vein thrombosis (DVT) scans may also be required if there is a history of clotting. Patients with a personal or family history of blood clots will require blood tests to assess their relative risk. Patients with concurrent arterial disease may need additional ultrasound studies to assess their arterial blood supply. Once tests arecompleted, the phlebologist will be able to determine the most appropriate course of treatment.

 

WHAT ARE THE POSSIBLE COMPLICATIONS IF I DO NOT HAVE ANY TREATMENT?

With large varicose veins, spontaneous blood clots may develop in the superficial veins and, more rarely, in the deep veins. Clots in the deep veins (deep vein thrombosis or DVT) can dislodge and travel to the lungs, which can cause pulmonary embolism?a life-threatening condition. Skin changes, including increased or decreased pigmentation, hardening of the skin and underlying fat (lipodermatosclerosis) and ulcers, may develop in the lower legs. Ulcers may become weepy, infected and painful, and take longer to heal.

Spider veins may indicate an underlying varicose vein disease, but otherwise are mainly a cosmetic concern.

 

HOW CAN I GET MORE INFORMATION?

A consultation with a phlebologist such as Dr Geoff Olsen will help answer your questions, and he can evaluate your problem, determine what testing is appropriate, and discuss the available treatment options. Please contact us for more information or alternatively visit www.fraserclinic.co.nz to contact Dr Olsen.