Science / Medicine : Unsightly Varicose Veins Put Health--and Vanity--at Risk
Our prehistoric ancestors’ innovation of walking upright may have helped us create civilization, but it also put a lot of stress on our legs--particularly on their thin-walled veins.
Blood is pumped under pressure out of the heart into arteries, and gravity helps it reach its destination in the lower extremities. But the return trip through the veins against gravity is not so easy. By the time blood has traveled through the tiniest arteries, through the capillaries and into the tiniest veins, the force provided by the heart is exhausted. Veins must rely on the surrounding skeletal muscles to push and squeeze blood through as they flex.
Valves along the interior of veins permit blood to flow in one direction only. When we stand upright, these valves have to bear the weight of a long column of blood--perhaps more than we are evolutionarily equipped to handle. Sometimes the load becomes too great and the valves fail, allowing blood to flow backwards and accumulate in one spot, causing the vein to balloon outward (see illustration). The result: the telltale knotted clusters of swollen blood vessels known as varicose veins.
It is impossible to say just who will develop varicose veins, but there seem to be several contributing factors:
Sex. Women are four times more likely than men to have varicose veins. During pregnancy, heightened hormone levels weaken vein walls and lead to valve failure. For women already genetically predisposed to varicosity, the hormones in birth control pills seem to promote it.
Genetics. People of Irish and German descent seem to have a predisposition to varicosities. It is not uncommon for a daughter to develop varicose veins identical to her mother’s.
Sedentary life style. The large muscles in the calf are sometimes referred to as the “peripheral heart,” since their motion serves to pump blood back up through the veins. Long periods of inactivity stifle this pumping action, allowing blood to pool in the veins and causing them to swell.
Age. As veins and skin lose their elasticity, the veins become more susceptible to varicosity.
Usually varicose veins pose more risk to vanity than to health. However, they may cause swelling in the calf, dull pain (particularly after standing for long periods), itching and even skin ulcers. Although rare, phlebitis (inflammation of the vein), often in association with a blood clot, can occur. Such clots cause local pain but rarely travel to the heart or lungs.
Fortunately, varicose veins can be safely remedied, whether for the sake of health or appearance. Currently, there are two methods: surgery and sclerotherapy--and sometimes a combination of both is used for optimal cosmetic results.
Surgery, the more drastic of the two, is being increasingly done on an outpatient basis. In most cases, a branch of the main saphenous vein, which runs down the inside of the thigh and calf, causes most of the backward flow. These branches can be disconnected surgically, so that blood is forced to flow through veins with good valves. Only under exceptional circumstances, where the main vein itself lacks valves, is “vein stripping” used because the saphenous vein is the best one to use for a graft in heart bypass procedures, should this ever become necessary.
In sclerotherapy, a chemical solution is injected to kill the cells lining the vein. This turns the vein into a useless but innocuous fibrous cord. After either surgery or sclerotherapy, blood reroutes itself into healthy veins of the leg, lessening the pressure on veins with broken valves. This makes the varicose vein less noticeable.
TIPS FOR PREVENTION
* Avoid standing or sitting for long periods.
* Put your feet up above hip level periodically during the day. This facilitates blood flow out of the veins, back to the heart.
* Maintain proper weight--excess pounds are a strain.
* Avoid repeating heavy lifting or straining while seated. These activities induce backflow of blood in the veins.
* Don’t smoke. A possible correlation has been found between smoking and incidence of varicose veins.
* Don’t wear tight shoes, garters, belts or other restrictive clothing.
* Exercise. Action in the calf muscles staves off pooling of blood and improves circulation in the lower leg. Regular aerobic exercise will also help keep weight down.
