As a curious child, you might remember staring at an older relative's thick stockings at the blue, gnarled veins lying under the skin like bumpy snakes. Known as varicose veins, these blood vessels, which return blood from the legs to the heart, are actually a more superficial system.
The real, working venous system for the legs lies deeper, says to Robert A. Weiss, MD, assistant professor of dermatology at the Johns Hopkins School of Medicine in Baltimore. This is good news, because it means that if the surface veins begin to clump up and bulge, they can be removed or destroyed without ruining circulation to the leg.
The National Institutes of Health estimates that 60% of all men and women suffer from some form of vein disorder. A quarter of varicose vein sufferers are men, although Weiss notes that it is almost always women who seek help for spider veins.
Spider veins, the more delicate red or blue tracings that can pop up on the skin's surface like kinky spider webs, are a minor form of varicose veins and can precede development of the more unsightly variation or cause cosmetic concerns of their own. Sun exposure can make spider veins worse by breaking down collagen under the skin.
Both varicose and spider veins result when valves designed to keep blood from running backward away from the heart and back down into the leg fail or become loose and flabby -- allowing backwash, which stretches veins and even slowly leaks into ankle and leg tissue, causing swelling.
Aside from the "purple snake" effect, varicose veins can cramp or throb at night. So much blood pools into the legs, that it can cause the legs to feel heavy and leaden. If clear fluid from the expanded vessels seeps into tissues, it can choke off circulation to the skin, causing an itchy rash or even a painful ulcer, Weiss warns.
As a rule, varicose veins are more unpleasant and ugly than dangerous.
What Causes Varicose Veins?
The exact cause of this unwanted "body art" is not known, but a genetic tendency toward weak, vein valves plays a big role, Weiss says. Hormones also play a part, accounting for the increased incidence in women. Puberty, pregnancy (pregnant women are very prone), and menopause, as well as taking estrogen, progesterone, and birth control pills, can weaken vein valves and change leg circulation.