For many women the arrival of a new baby can be preceded by the development of varicose veins. Varicose veins are not just a problem that develops later in life, and pregnancy can be the triggering factor that leads to varicose veins earlier than you thought would happen at your age.
varicose veins are the normal veins swollen
Thread veins or spider veins are not really varicose veins. These red or blue veins are very fine and are found within the layers of the skin itself, unlike true varicose veins that are found under the skin.
Varicose veins develop from normal veins in the leg that have become swollen and twisted. Typically, varicose veins are large, knobbly blue veins that are usually easy to see.
There may be some bluish bulges under the skin, most commonly along the inside of the calf and thigh, although varicose veins can develop almost anywhere in the leg. There may be finer spider veins in the skin which are visible, but don’t bulge.
varicose veins in pregnancy
During pregnancy the growing baby places extra pressure on all the veins in the pelvis. This can hinder the return of blood from the legs and cause an increase in the pressure in the leg veins. These changes take place in all women in pregnancy, but not all women develop varicose veins.
not all women get varicous veins
It’s probably all in the genes. Most patients with varicose veins have a close relative with the same problem. If you already have an inherited tendency to develop varicose veins, then anything that puts extra stress on the veins, such as pregnancy, is likely to trigger their enlargement.
Inside normal veins there are tiny valves that allow blood to flow in only one direction – upwards to the heart. In patients with varicose veins, these venous valves become faulty and allow blood to travel both upwards and downwards away from the heart. We do not know exactly why the valves in the veins become faulty, but there is probably an inherited weakness in the supporting tissue in the valves.
symptoms of varicose veins
Often varicose veins will cause no symptoms at all and are merely a nuisance because of their unpleasing appearance. Varicose veins do not usually cause significant pain, but they can cause:
- Heaviness or tension in the legs
- Swelling
- Aching
- Restless legs
- Cramps
- Itching
Symptoms are often worse after a long day of standing and in hot weather, when the veins may stand out more as they swell with the heat. Many women notice that their symptoms are worse during their periods or after exercise. During pregnancy symptoms from pre-existing varicose veins may worsen.
Thread/spider veins alone to do not cause symptoms, but can be unsightly.
preventing varicose veins
There is not much anyone can do to prevent varicose veins. It would be impossible to remain permanently off your feet, which is a good way to reduce the pressure in the veins. If you are on your feet the best thing to do is to keep moving, as walking tends to lower the pressure in the veins.
If your veins are symptomatic then support tights or Class 1 graduated compression stockings, obtainable from pharmacies, can be useful to ease symptoms while on your feet.
Periods of rest with the legs elevated can be helpful as can a warm bath. Horse chestnut extract is a natural remedy that can help in the relief of symptoms.
It is probably best to avoid using hot wax for hair removal on the legs if you have prominent veins.
medical help
If your varicose veins are causing you concern for any reason, then it is a good idea to seek a medical opinion. If you wish to have treatment for your varicose veins then it is essential you have a consultation with a vascular surgeon.
completing family first
It is not necessary to wait until you have completed your family before having your veins treated. Varicose veins may be a source of trouble in a future pregnancy. It is perfectly reasonable to have them treated, whether or not you are planning another child.
various varicose vein treatments
Many treatments are available to eliminate varicose veins, but the vital first step is a detailed and accurate assessment. This will usually include an ultrasound scan of the legs. It is only by planning your treatment carefully, based on the assessment, that the best results can be achieved.
Surgery is a very effective treatment, but cannot be used for spider/thread veins. Surgery removes the varicose veins and also the sites of abnormal flow in the veins. Once these veins have been physically removed they cannot return. Newer surgical techniques are becoming available, but none of these have any proven advantage over the modern conventional techniques.
Ultrasound guided foam sclerotherapy is an updated version of traditional injection treatment. It can be used in a wide variety of varicose veins including thread veins. This technique does not leave any scars but does not physically remove the veins. Three or more injection treatment sessions may be required to eliminate varicose veins, unlike surgery, which is usually a single session. Sclerotherapy can produce good early to medium term results, but the longer term efficacy has not been established.
Thread/spider veins can be difficult to treat. Microinjection sclerotherapy and laser treatment can be effective, but often do not eliminate veins completely. Camouflage cosmetics or a false tan can be just as effective as other treatments for small veins.
Unfortunately, treatments do not remove your underlying tendency to develop varicose veins, and further veins can continue to develop in later years.
Damien Mosquera, Consultant General and Vascular Surgeon
