What are Varicose Veins?
If you’re over 40, you probably see them; those little purple veins that suddenly seem to appear on your legs. Varicose veins frequently occur in women in their 20s and 30s just after pregancy. Veins are the soft, thin-walled tubes that return blood from the arms and legs to the heart. Because veins work against the force of gravity, they have valves that allow forward blood flow, but not reverse. Your legs and arms have two major types of veins: superficial and deep. The superficial veins are near the surface of the skin and are often visible. The deep veins are located near the bones and are surrounded by muscle. Connecting the deep and superficial veins is a third type of vein, the perforator vein. Contraction (squeezing) of the muscles in the arms and legs with exercise helps blood flow in the veins.
Varicose veins are enlarged, bulging superficial veins that can be felt beneath the skin, generally larger than 3-mm in diameter. They are usually located on the inside of the calf or thigh and develop due to weakness of the vein wall and loss of valve function. Under the pressure of gravity, they continue to enlarge, and in the course of time, they may become elongated, twisted, pouched, and thickened.
Spider veins or telangiectasia are tiny dilated, veins, usually less than 1-mm in diameter, located at the surface skin layers. Spider veins cannot be felt. Veins larger than the spider veins, but still under 3-mm are called reticular veins.
How Common are Varicose Veins?
Venous problems are probably among the most common chronic conditions in North America and Western Europe . They are less common in the Mediterranean, South America, and India , and even less so in the Far East and Africa . In one study from Southern California , venous problems were present in 33 percent of women and 17 percent of men. Varicose veins occur almost as often in women as in men, however, spider veins were more frequent in women. A large U.S. survey, the Framingham study, reported that 27 percent of the American adult population had some form of venous disease in their legs. It is estimated that at least 20 to 25 million Americans have varicose veins.
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We appreciate these authors for their assistance with writing the varicose veins section.
About the authors:
Konstantinos Delis, PhD, FRCSI, is the Marco Polo Fellow of the European Society for Vascular Surgery currently at the Mayo Clinic in Rochester, Minnesota.
Peter Gloviczki, MD, FACS, is Professor of Surgery, and Chair, Division of Vascular Surgery, and Director, Gonda Vascular Center, Mayo Clinic, Rochester, Minnesota. Dr. Gloviczki is also past president of the Vascular Disease Foundation.