WHAT TO DO ABOUT UNSIGHTLY VEINS

MONDAY, DECEMBER 24, 2012
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It's popular now to take 10 years off of one's age. How many times have we all read or heard that "being 40 is the new 30"?

With a healthy lifestyle and access to health care, many people are living longer, healthier lives. However, this doesn’t mean that our bodies have agreed to stop ageing. And there are a few telltale signs of ageing that alert us to the fact that the 40s have indeed arrived. 

For most of us, it’s something subtle that first tips us off. It can be a wrinkle, a sun spot on the back of the hand, hair going greyer or varicose and spider veins that you swear were not there the day before!
Not everyone will develop spidery veins, and people who do will do so to different degrees. For some, varicose veins will be a simple cosmetic inconvenience. Individuals might refuse to wear shorts, skirts or bathing suits due to the evident veins on their legs, considering them to be their “tell tale” sign of ageing. However, for others, varicose veins will become a significant health concern.
Why does it feel 
like your legs have aged overnight?
The job of the veins is to carry blood from around the body back to the heart and lungs. Unlike the arteries that have the heart to push blood forward through them, the veins rely on valves whose job it is to ensure blood flows one way. 
Surrounding muscles help move blood forward by squeezing the veins. If the valves aren’t working properly, blood has the opportunity to flow backwards and the affected veins swell in order to accommodate for the extra blood volume. 
Many things can cause these valves to fail, with age and family history being the biggest predictors. By the time individuals reach their 60s, approximately 41 per cent will have varicose veins. Moreover, if both parents have or were known to have varicose veins, then the likelihood that their children will develop varicose veins is 90 per cent. Likewise, family history is a contributing factor in 80 per cent of spider-vein cases. 
 Pregnancy, a history of deep vein thrombosis (DVT) and trauma are also believed to be strong contributing factors for varicose and spider veins. During pregnancy the hormones oestrogen and progesterone are elevated, causing the veins to relax in order to compensate for the added blood volume created during pregnancy. 
The extra pressure caused by the added blood volume and a growing uterus can build up in the veins to the extent that the valves in the lower limbs are damaged. DVT and trauma can cause direct damage to valves within a specific area or limb. Regardless of how the damage to the valves is caused, blood from the lower limbs is no longer returning to the heart as efficiently as it was before.
Contrary to a common myth, crossing your legs does not cause varicose or spider veins. 
Even though varicose and spider veins share the same underlying causes, they differ in appearance and health implications. 
Varicose veins are thicker, can appear bulgy, and are often described as rope-like. Depending on how significantly the circulation is compromised, the veins can become painful or itchy and might even lead to open sores on the skin. Moreover, the affected leg can become swollen, feel heavy, and the nearby muscles may suffer from cramping pain at night. 
Spider veins look more like purplish threads close to the skin’s surface. They generally aren’t painful or itchy, and their presence doesn’t lead to any swelling or cramping in the affected leg. 
If you suffer uncomfortable symptoms or want the unsightly veins removed for cosmetic reasons, see a physician with experience in this area, such as a vascular or plastic surgeon. 
The doctor might recommend a duplex ultrasound to assess blood flow and show which valves are not functioning. 
Treatment options can vary widely depending on your wishes and the severity and location of the veins. If they’re not a cosmetic concern or physically bothersome, you could start wearing pressure stockings and regularly elevate your legs to prevent blood from pooling, encouraging it to flow toward the heart. 
If you want smaller veins removed for primarily cosmetic reasons, you could be injected with a substance to destroy them, and the remnants would be safely reabsorbed. If you want larger veins removed, the recommendation is generally surgical, with or without the aid of laser or radiofrequency.
Definitive treatment works 95 per cent of the time, but be aware that new varicose or spider veins can develop over time. 
Varicose and spider veins don’t need to be a “telltale” sign of ageing. A visit to the physician can potentially take that 10 years off your legs and improve your circulation.
 
Khamin Chinsakchai, MD
Vascular Surgeon
Samitivej Sukhumvit Hospital