Why varicoses veins ?
The venous networks of the legs
The veins of the lower limbs are vessels of different sizes, which move the blood back to the heart. To prevent blood from coming downright, they are fitted with storied valves, with valves that work like valves that open to let blood pass up and close to prevent it from descending.
The venous system of the lower limbs is made up of two parts:
- A deep venous system, composed of veins located in the middle of the muscles (deep). It is the most important network, carrying 90% of the venous blood. It may be the site of a “phlebitis” or thrombosis (the formation of a blood clot in a vein) or malformations, but there are no varicose veins on this system.
- A superficial venous system, composed of veins that are closer to the skin and carry only 10% of the venous blood to normal. The saphene veins are part of this network
- The large saphene vein starts from the inner face of the ankle, travels on the inner side of the leg and thigh and goes up to the groin, where it joins the deep network.
- The small saphene vein starts at the outer side of the ankle, travels on the back of the leg and stops at the back of the knee, where it joins the deep network.
It is on the superficial venous network that varicose veins are formed.
As we have seen, the two venous, superficial and deep networks are therefore connected to each other to the groin and knee, but they also have connections called perforating veins, which when they are sick will cause the blood to flow back to the superficial network instead of the deep network, and will thus also cause varicose veins.
Frequently asked questions
A varicose vein is a vein in the superficial system that is sick. It is always dilated and often tortuous. Due to the dilation of the wall, the valves no longer function, “leak” and, while standing, the blood flows down the leg instead of back to the heart.
Varicose veins can be very different sizes, more or less close to the skin and therefore, more or less visible to the naked eye, in the form of a bluish cord. The saphene veins can themselves be sick, and due to progressive dilation, reach very large diameters. In general, they are not visible; this is why, in common parlion, they have long been called “internal varicose veins.” On the other hand, their branches, closer to the skin are often visible. “Varicose veins” are small, unsightly, very thin, red, purple or blue vessels visible under the skin. They are not classified as varicose veins; the medical term is “telangiectasies.” Between varicose veins and saphenes, all intermediate stages of varicose veins and all sizes are possible, and these can be connected or not to the saphene veins.
Since not all varicose veins are visible to the naked eye, it is important to specify the state of your venous network with a phlebologist. This will do a clinical examination and a venous echodoppler (ultrasound with study of the flows, which appear in color), and if necessary, a mapping of your veins (drawing your venous network on a folder), which will serve as a reference. Depending on the stage of the disease and your symptoms, he will advise you on the rules of lifestyle, and inform you of the different treatment options, if this is to be considered.
There are a number of reasons, known as risk factors, that can encourage the development of varicose veins.
- Heredity (varicose veins in the family)
- Lack of sport
- Trades in a prolonged motionless position, standing or sitting. Some occupations are particularly vulnerable to varicose veins (hairdressing, catering, etc.)
- Repeated pregnancies menopause
However, even in the absence of a risk factor, varicose veins can be found. Varicose veins are more common in women than in men in the less evolved stages, but for the advanced stages of the disease, it appears that the frequency is similar for both sexes.
A varicose vein never goes away on its own. The more time passes, the bigger it gets, the greater the risk of having other varicose veins. This development can be slow or rapid. In the absence of treatment, the progression is also often towards a worsening of symptoms (heavyness, pain, swelling sensations, nocturnal cramps).
Complications can sometimes occur: pigmentation of the skin with brown or ochre appearance, eczema, inflammation, weakening of the skin up to the ulcer (a sore appears and delays healing, over more than’a month),, superficial phlebitis (venous thrombosis) (blood clots inside a varicose vein), which can more exceptionally extend to deep veins; ruptures of varicose veins with hemorrhage, rare but possible, even in the absence of trauma.
Depending on the outcome of your assessment including echodoppler, the phlebologist will give you advice on prevention, lifestyle rules (especially regular sports activity), and, if necessary, treatment. Elastic compression et stockings and veinotonics may be prescribed, but if treatment of varicose veins themselves is necessary, sclerotherapy, sometimes with sclerotic foam, thermal ablation (endocrine or radiofrequency laser), or surgery (stripping or phlebectomies) should be used. Medications only work on symptoms: Heavy legs, swelling, etc., there is no cream to cure varicose veins.