The legs have two systems of veins.  One system lies just under the skin and it is called “superficial” venous system.  The other system lies deeper within the tissues of the leg and is called the “deep” venous system.  These two systems are connected to each other via small “communicating” veins.  The function of the venous system in the legs is to return blood back to the heart.  Veins in the legs have one-way valves that helps pump the blood back to the heart.   If these valves do not work properly, blood is allowed to “pool” in the lower legs, increasing the pressure in the veins.  Veins with such malfunction are called “incompetent” veins.  Most of the varicose veins seen in the legs are caused by incompetence of the greater saphenous vein which is the superficial vein that runs in the inner part of the leg and thigh.   If the greater saphenous vein is incompetent, it will allow pooling of blood into small veins which lie just under the skin. With time, these veins grow larger and bulge over the surface of the skin.  These bulging veins over the surface of the skin are called “varicose veins”.   

Who has varicose veins?

People with abnormal valves in the legs of the vein develop varicose veins.  It is calculated that approximately 20% of the general population have varicose veins.  Hereditary factors play a role in this process, so if there is a family history of varicose veins, the risk is higher.  Hormonal factors also play an important role so women are at a higher risk of having varicose veins.  Other factors include age, obesity, sedentary life-style and some congenital conditions.  It is not unusual for women to develop varicose veins or have worsening of existing varicose veins during pregnancy.

Do varicose veins need treatment?

Varicose veins may cause symptoms such as pain, cramps, fatigue, heaviness and swelling.  Severe symptoms may include severe leg swelling and even the formation of ulcers around the ankle area.   From the medical standpoint, varicose veins are more than a cosmetic problem, they are considered to be abnormal veins and therefore, they need to be treated.