The varicose veins are veins damaged in which the blood circulates poorly. They are bluish, dilated and twisted and can be more or less prominent.

It is estimated that 15% to 30% of the population has varicose veins. The women are 2 to 3 times more affected than men.

Most often, varicose veins form on the legs. They can also appear in the region of the vulva (vulvar varicose veins) or scrotum (varicocèles).

The varicose veins are permanent. They cannot be “cured” but most can be eliminated through various interventions. In addition, it is possible to relieve symptoms associated with it and prevent the formation of other varicose veins, as well as the problems that may arise from them.

Types of varicose veins

In 95% of cases, varicose veins affect the saphenous veins, that is to say the superficial veins that go up the leg and their collateral veins. These varicose veins are the result of a set of risk factors (heredity, excess weight, pregnancy, etc.).

In a minority of people, varicose veins are caused by the inflammation of a deep vein (deep phlebitis) which ends up reaching the network of superficial veins.

Evolution

People with varicose veins suffer from chronic venous insufficiency. This means that their venous system is having difficulty getting blood back to the heart.

• First signs: pain, tingling and feeling of heaviness in the legs; calf cramps, swelling in the ankles and feet. You may also feel itchy. These symptoms are amplified when standing or sitting for a long time without moving;
• Appearance of spider veins then varicose veins : The spider veins affect very small veins. They are not very protruding and look like a Spider web. They are usually not painful. As for varicose veins, they are larger and more dilated veins. They are often accompanied by symptoms related to the first signs of venous insufficiency: tingling, heaviness, swelling, pain, etc.

Possible complications

Poor circulation in the superficial veins can lead to:

• Brownish skin. The rupture of small blood vessels causes blood to escape and invade nearby tissues. The blood thus released gives areas of the skin a color varying from yellow to brown, hence its name: ocher dermatitis or stasis dermatitis;
• Ulcers. Very painful ulcers can form on the skin, most often near the ankles. The skin takes on a brownish color beforehand. Consult a doctor without delay;
• A blood clot. A blood clot in a vein (or phlebitis) can cause local pain if the affected vein is a superficial vein. It is an important warning signal, because more advanced venous insufficiency can lead to deep phlebitis and pulmonary embolism. For more information, see our Phlebitis sheet.

Causes

The veins carry blood to the heart from the rest of the body. The varicose veins appear when certain mechanisms or elements of the venous system deteriorate.

Weakened valves

The veins are provided with many valves that act like flaps. When the veins contract or are subjected to the action of the surrounding muscles, the valves open in one direction, causing blood to flow to the heart. By closing, they prevent the blood from flowing in the opposite direction.

If the valves weaken, the blood circulates less well. It tends to stagnate or even descend into the legs, for example. The resulting accumulation of blood dilates the vein, and it becomes varicose.

Loss of muscle tone

During walking, the return of blood to the heart is favored by leg muscles, which act as a pump on the deep veins. Poor muscle tone in the legs is therefore a contributing factor to the formation of varicose veins.

Deterioration of vein walls

At rest, the walls of veins also play an important role in returning blood to the heart. Their effectiveness depends on their ability to contract (tone), elasticity and tightness. Over time, they can lose their elasticity and tone.

The walls can also deteriorate to the point of becoming semi-permeable. They then allow blood fluids to escape into surrounding tissues, causing a swelling legs or ankles, for example.