Varicose veins are a common venous condition whereby superficial leg veins become twisted, lengthened and dilated. We’re not sure exactly why varicose veins appear, and why some people get them, and others don’t, but there appears to be some genetic and environmental factors that may play a role.
Predisposing factors for varicose veins:
- Age – varicose veins appear more as we age
- Gender – women seem to get slightly more varicose veins than men, but research results have varied
- Oestrogen therapy
- Family history
- Prior leg injury
- Prolonged standing
- Sitting at work
- Iron/blood disorders
Recent research has shed some light on the mechanisms by which varicose veins develop.
In varicose veins, there are issues with the vein walls and the valves that keep blood from flowing the wrong way down the vein – when blood goes the wrong way in a vein, this is called reflux. This reflux is due to valves that are not doing their job, and vein wall dilation. The valves become leaky, which causes ongoing problems that don’t resolve, ultimately resulting in a vein with negative changes to its walls.
The valves may also (either as an alternative or at the same time) become faulty after structural abnormalities are found in the vein wall near the valve junctions. The reflux may therefore be a secondary occurrence, which is seeming increasingly likely.
Increases in venous pressure due to these vein wall changes then causes structural and functional changes in the vein wall, leading to further dilation. An increase in the vein wall tension then changes the activity of special protein-destroying enzymes, causing the degradation of structural components of the vein walls, perpetuating the problem.
The special enzymes have been found to influence tissue in the vein wall, causing other changes to venous constriction/relaxation capacities. When the cells that make up the vein wall (endothelial cells) are injured, an inflammatory cascade is commenced, which leads to further damage to the vein wall.
Vein wall dilation seems to come before valve dysfunction. The enzyme activation, resultant inflammation and fibrosis, then lead to a chronic and progressive condition – varicose veins.
Varicose vein formation is a complex process with multiple factors likely at play. Historically, we’ve been blaming the valves, but the latest thinking is that the valves are a secondary problem – thereis mounting evidence that the vein wall changes and damage come first, with the faulty valves occurring as a result of those changes.
The problems that cause varicose veins could actually be a greater body-wide issue that just appears to manifest visibly in the legs. The way vein cells repair and replace themselves is complex, requiring balance between all features – cell renewal, matrix deposits, remodelling and stability. When cells are damaged, and the balance goes out, the vein wall changes for the worse.
Treatment for varicose veins – sclerotherapy at our Melbourne clinic
The treatment for varicose veins at our Melbourne clinic deals with the veins themselves, getting straight intocausing their disappearance. A special solution is injected into the veins that irritates the vein walls, causing the vein to close over and eventually be scavenged by the body as waste. This treatment is called sclerotherapy, and is the most effective treatment we have for removing varicose veins.
We are experts in varicose veins.