In the legs, blood returns from the legs to the heart via large veins. The job of these vessels is to transport blood against gravity all the way back to the heart so the blood can receive oxygen and circulate again through the body. Veins do this through a series of one way valves located within them. Muscles from the leg act as a pump to push the blood upwards, and the valves prevent the blood from leaking back towards the feet.
In many people, however, the valves stop working. We are not sure exactly why this happens, but there are likely many factors working together, which may contribute to this phenomenon.
Once the vein valves stop working correctly, they begin leaking blood back towards the feet, resulting in increased pressure. This often causes symptoms like swelling and achiness initially. If it persists, the branches of the poorly functioning veins start enlarging and becoming more visible in the leg.
Sometimes these veins are small, and are called “spider veins” or “telangectasias”. Sometimes they are bigger (2-3 mm) and are called “reticular veins”. If they are even larger than this (those ropy veins that you can see under the skin), they are called “varicose veins.”
It is important to realize that varicose veins, spider veins, and reticular veins do not happen for no reason. They happen because there are poorly functioning veins in the lower leg, which may need to be treated. Learn more about treatment for vein disease.
A varicose vein is a larger, sometimes bulging vein. The condition is usually the result of problems with valves within the veins of the leg. When one or more of the valves fails to close properly, the veins allow blood to flow backwards into the leg instead of up to the heart. As blood accumulates, abnormal pressures swell the superficial vein system, causing the veins to bulge and become visible – hence the creation of varicose veins!
Approximately 25 percent of women and 15 percent of men in the United States have varicose veins. The tendency to get varicose veins is commonly hereditary and occurs more frequently in women than men.
The most common factors in the development of varicose veins are heredity, pregnancy, and hormones. Other factors include leg injury, sedentary lifestyle, prolonged standing, obesity and hot weather. Varicose veins are typically chronic and progressive.
Symptoms of varicose veins and the physical changes of varicose veins come in many forms and should be taken seriously. All of these symptoms below can be indicative of venous insufficiency. Most vein symptoms are worse at the end of the day, around the time of a menstrual period, in hot weather, and with prolonged standing or sitting. Symptoms can be painful and are often improved with leg elevation, activity such as walking, and with the use of compression stockings.
Swelling (which doctors refer to as “edema”) usually occurs in the lower part of the leg, usually around the ankle or in the feet. This leg swelling is often more pronounced after longer periods of standing or at the end of the day. Sometimes you may not even notice the swelling, but only see telltale signs, such as an indentation in your ankle from your socks. In other cases, the leg swelling may be pronounced and severe, accompanied by changes in the color of the skin. Swelling often indicates vein problems occurring below the surface of the skin.
If your leg swelling involves the tops of your feet, then the swelling could be from a condition we call “lymphedema” which is different from venous insufficiency.
Spider Veins are formed by the dilation of a small group of blood vessels located close to the surface of the skin. Although they can appear anywhere on the body, spider veins are most commonly found on the face and legs. They usually pose no health hazard, but may produce a dull aching in the legs after prolonged standing and indicate more severe venous disease.
Reticular veins are formed by larger veins that are located deeper in the skin’s surface. They are usually blue or purple in color, and frequently feed areas of spider veins which are closer to the surface. These veins are usually about 2 mm in diameter, and often don’t protrude on the skin surface. Reticular veins may form areas of unattractive clusters of veins predominantly located on the inner part of thighs, backs of legs and ankles. They can also be associated with symptoms of pain and discomfort of the legs. Like spider veins, reticular veins don’t exist for no reason. Sometimes (though not always), there is underlying venous insufficiency which caused them to occur.
Spectrum Dermatology is happy to schedule a consultation to discuss vein disease vein treatment options, and help you get a proper vein disease diagnosis. Our experience and reputation make Spectrum Dermatology one of the most sought-after dermatologists in the Scottsdale and Phoenix area. For more information or to set up an appointment please contact us at (480) 948-8400.