For a long time, I imagined my mom’s legs were no different from those of anyone else. While her legs themselves—always pale from limited access to sunlight—were peppered with blueish-green mounds of various sizes, to me, that was normal for a woman over 40. Then once every few years, as if by magic, they’d disappear and my mom would briefly don a bathing suit and sarong before the discoloration inevitably returned and the process would repeat.
Mom’s invasive vein-stripping surgery was a fundamental part of her beauty regimen and a vicious cycle I would come to truly understand only well into my adolescence. Despite the procedure’s enormous cost ($10,000) and significant downtime (roughly four weeks), mom had for years been stripping her varicose veins on a relatively regular basis. I learned the background: both of her parents had had varicose veins (green or blue swollen blood vessels) or spider veins (a more mild version of varicose that takes on a red-purple hue), and my mom’s had first appeared post-pregnancy. Underestimating the power of genetics, I never gave it much more thought than occasionally looking at her legs with pity. Then, at the apex of my post-college graduation party phase, the veins on my own legs began to protrude.
“I see young people in my practice every week,” says Dr. Larisse K. Lee, a board-certified vascular surgeon in Sherman Oaks, California. “Heredity plays a big role in venous disease. If your parents have it, you have a higher probability [of developing] spider and varicose veins. Also, hormonal and physical changes with multiple pregnancies cause varicose and spider veins, and after delivery, they do not always go away.”
Thankfully, times have changed, claims Dr. Lee. Gone are the days of surgical vein-stripping, which required a groin incision under general anesthesia and weeks-long recovery. Common procedures now include radiofrequency and endovenous laser ablation, heat treatments that seal problem veins, shutting off blood flow via a catheter; VenaSeal, which uses an adhesive to close off damaged vessels and reroute blood flow; Varenthia, a prescription microfoam injected into the veins; and sclerotherapy, where a salt solution collapses the vein and causes the vessel to turn to invisible scar tissue.
“All these procedures replace prior vein stripping and are only minimally invasive,” explains Dr. Vinay Madan, a board-certified phlebologist in Wilton, Connecticut. “There is no downtime with these procedures. All take less than 30 minutes, and the patient may drive themselves home and return to work the same or following day. There is minimal to no discomfort during and after the procedures.”
While the technology for treating varicose and spider veins has certainly advanced, both doctors claim the knowledge surrounding vein issues remains dated—particularly among young people. Many accept, like I did, that bulging veins are a genetic anomaly that should be considered a part of everyday life, not a curable disease. Others, Dr. Madan says, are aware only of surgical solutions and assume them to be painful. Dr. Lee claims the most common misconception is that varicose veins only plague women and older people.
“While it’s true that as we get older, our vein valves weaken from elevated venous pressure, vein disease can occur at any age—I see people of all ages and genders in my practice,” she says.
“The biggest contributing factors to varicose veins include genetics and pregnancy,” adds Dr. Madan. “Statistically, if both parents have vein disease, your risk of having vein disease is over 90%. With pregnancy, the more children and pregnancies that a woman has, the higher the risk of developing vein disease. Women with three or more pregnancies have a greater than 50% chance of developing vein disease.”
The consequences of unaddressed vein diseases can be rough: hyperpigmentation, stasis dermatitis (itchy, inflamed skin) and lipodermatosclerosis (hardened skin and painful swelling) occur in the later progression stages. This is in addition to general leg swelling, restless legs, unsightly veins, and nonhealing venous ulcers.
“Poor management of vein disease will usually lead to progression of disease,” continues Dr. Madan. “The patient will progress through worsening stages of vein disease, starting with bulging varicose veins. Left unmanaged, they will likely develop some transient ankle swelling within the following decade or two.”
Of course, there are preventable, even reductive, non-procedural approaches to varicose veins. Avoiding prolonged periods of standing or sitting can reduce the risk of your vein valves weakening. Pregnancy and obesity can also put excessive pressure on your legs, which means that losing weight can be a great prevention method. Elevating your feet whenever possible is also helpful, as it recirculates blood to your heart (this is an easy solution for the computer-bound and currently working from home). Walking, or regular leg exercise, also enables veins to push the blood to your heart. Otherwise, compression is key—support pantyhose similarly redistributes blood flow, which definitely comes in handy for long periods of standing or sitting.
Of all the varicose vein symptoms, perhaps the most crippling are the psychological repercussions. Dr. Lee reveals that some of her patients are so embarrassed by their veins, they’ve avoided shorts and swimsuits for most of their lives. For as long as I can remember, I’ve seen my mother only in pants. At times, I’ve been unaware of my legs, only to later cringe in photos. Sometimes, emotional distress can be as potent as physical—and no one should be forced to live in discomfort.
“After treatment, many experience life-changing emotional and physical improvements,” says Dr. Lee. “It is rewarding to be able to improve my patients’ quality of life.”
This content was originally published here.
View the original post on the Vein Clinic of North Carolina website.
