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Varicose Veins Information Los Angeles

The distended tributaries or ‘branches’ of the major veins in the leg are known as varicose veins. These are the visible, twisted, sometimes “rope-like” bulging blue veins that are located just under the skin of the leg and feet. Up to 30% of men and women are affected, but women are more likely to suffer from varicose veins at an earlier age than men.

It is interesting to note that other than in humans, varicose veins are virtually non-existent. It is believed that the upright position of humans and the absence of firm fascia around the superficial veins are the two main reasons. The giraffe, for example, a much taller animal, has a firm fascia in the legs that function as compression stockings and prevents the formation of varicose veins on the legs. For the same reason, varicosities rarely occur in the deep venous system supported by muscles.


Forms of varicose veins
*Individual results may vary.

Healthy veins have unidirectional flaps called venous valves that direct the blood flow upward and prevent blood from flowing back and pooling in the lower extremities due to the effect of gravity. The return of blood to the heart is assisted by the action of the positive pressure generated by the skeletal-muscle pump, and the negative pressure pumping action ( i.e. sucking ) of breathing. Over the years, the breakdown of the faulty one-way-valves and increase in the diameter of saphenous and perforator veins results in the leakage and pooling of blood into the superficial veins, forcing branch veins to enlarge and become visible varicose veins. Accordingly, any effective and long lasting treatment of bulging varicose veins should start with the treatment of the source of the problem; that is, the reflux in saphenous and perforator veins.

Factors that Contribute to the Appearance of Varicose Veins

Varicose veins do not occur suddenly. It usually takes years for signs and symptoms to develop and the frequency increases with age. Although anyone can develop varicose veins, an inherited weakness of the vein walls and valves(genetic) is by far the most important determinant. Secondary contributing factors include female hormones (progesterone), pregnancy, obesity, prolonged standing, wearing high heels, crossing the legs, sedentary lifestyle and localized trauma.

Symptoms of Varicose Veins

Symptoms of vein disorder usually do not correlate with the size or extent of visible varicosities. They may include one or more of the following:

  • swollen feet and ankle
  • burning or throbbing in the legs
  • dry and thin skin over the affected vein
  • muscle cramp in the legs, particularly at night
  • burning, throbbing, and swelling in the lower legs
  • itching around one or more of your veins
  • a dull pain that is worse after prolonged standing and on hot days

The pain caused by varicose veins often improves after walking or elevating the legs. This is in contrast to the pain caused by arterial insufficiency, which worsens with ambulation and leg elevation. The worsening of pain on hot days is believed to be due to the fact that vasodilatation enables humans to vent the body heat and lower their body temperature. In cold weather on the other hand, vasoconstriction prevents superficial venous blood from cooling.

Prevention of Varicose Veins

If you are genetically predisposed to develop varicose veins, you may not be able to prevent their formation. However, making lifestyle changes by avoiding the factors that contribute to varicose vein formation may reduce the probability of their occurrence.

Treatment of Varicose Veins

Untreated varicose veins always get worse over time, sometimes progressing into more serious vein disorders. Compression therapy,  pycnogenol, and horse chestnut may delay the worsening of varicose veins and alleviate the pain, but cannot eliminate the veins. There are also some medications that may alleviate the pain caused by varicose veins and treat some leg vein problems.

Currently, the removal or the destruction of incompetent blood pathways is the only effective treatment for varicose veins and to get rid of the symptoms associated with them. This is achieved by either surgically removing the veins, or irreversibly damaging vein walls with heat, chemicals, or mechanical means.

It is important to understan that in most patients, the superficial venous network, including the saphenous veins, is a secondary, redundant system that is not essential for the normal circulation of the venous blood in the legs. For this reason, patients undergoing Coronary Bypass Surgery with harvested veins (most commonly the GSV) suffer no adverse circulatory effects in the legs, unless the deep veins are non-functional.

At Nu Vela Laser and Vein Center, Dr. Dishakjian, the phlebologist of the center, treats varicose veins and the sources of reflux with a combination of minimally invasive techniques, including the two FDA approved Venefit Targeted Endovenous Therapy (formerly the VNUS Closure procedure) and Endovenous Laser Treatment (EVLT) systems.

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