Are Varicose Veins Hereditary?

Many people assume that being in great physical shape will keep you from developing varicose veins, however, this is not the case. While an active, healthy lifestyle might ease the severity of varicose veins, or lessen their symptoms, physical condition alone cannot prevent the onset of varicose veins.


Hereditability Study of Varicose Veins

Kohno, Niihara,  Li X, Hamano, Nabika, Shiwaku, Isomura, Morita, Sundquist, and Zöller queried into this topic utilizing data across several generations. Participants with a biological parent afflicted with varicose veins had a significantly greater risk of developing varicose veins, in contrast to participants whose parents did not have varicose veins (standard incidence ratio 2.2; 95% CI, 1.9-2.6).



Speculations as to the root cause of varicose veins typically included work related standing or sitting for prolonged durations, or sitting with legs crossed. However, the study by Kohno and his associates indicates a hereditary component to causation. [3]

Specifically, one gene known as Fork Head gene domain, or FOXC2 (located on chromosome 16), has been identified in connection with venous valve failure in the extremities.[2]  It is important to note that varicose veins are caused by failure of the one-way venous valves, which causes blood to pool and swell the veins.

While environmental and occupational factors also link to causation of varicose veins, these hereditary findings are significant in that they show promise for predictability of varicose veins, as well as the potential for gene therapies related to varicose veins.


Genetically Speaking

The inherited FOX C2 gene mutation, located on the 16th chromosome, is indicated by a red line below after q24.1 [1]
spider vein treatment

The Fox C2 gene mutation is located on the 16th chromosome in a location whose role is to relay instructions for transfer RN’ase to distribute a micro-filamentous protein called Actin. Filamentous Actin, a.k.a. F Actin, is necessary for the structural strength and integrity of venous walls and valves.

Those individuals with the Fox C2 mutation may begin showing signs of varicose veins as early as their adolescent years, whereas those whose varicose veins resulting from external factors tend to see symptoms later in life.


Environmental Factors

Non-hereditary factors linked to the onset of varicose veins include obesity, pregnancy, smoking, prolonged standing or sitting. Symptoms include throbbing, constant pain, swelling, and weakened skin at the site of varicose veins.



Regardless of whether your varicose veins stem from hereditary or non-hereditary factors, it is a known constant that once varicose veins become visible, they will continue to degrade and worsen with time

At the San Diego Vascular Center, our team of board certified vascular surgeons specializes in providing the best minimally invasive, nonsurgical treatment options to patients who wish to have their unsightly varicose and spider vein treated. These procedures are performed in our state-of-the-art outpatient facility and include VNUS closure (Venefit™), EVLA (VenaCure®), sclerotherapy, foam sclerotherapy, and laser spider vein treatment.

The procedures are fast and virtually painless, with minimal downtime. Most patients can return to work within a day.



  1. Linkage to the Fox C2 region of chromosome 16 for varicose veins in otherwise healthy, unselected sibling pairs.
    Ng MY, Andrew T, Spector TD et al. Lymphedema Consortium. Twin research and Genetic epidemiology Unit St Thomas’ Hospital, London ,SE17EH. J Med Genet 2005 Mar: 42:235-9
  2. Familial Transmission of Hospital-Treated Varicose Veins in Adoptees: A Swedish Family Study. J Am Coll Surg.  2016; 223(3):452-60
  3. Kohno K; Niihara H; Li X; Hamano T; Nabika T; Shiwaku K; Isomura M; Morita E; Sundquist K; Zöller B



Venous UIcers and Wound Care

diabetic wound care

Venous ulcers are not only common, they are most often misdiagnosed. This situation can be exacerbated when wounds become chronic, due to difficulties in healing.

While it is a normal, everyday process to shed and replenish the outer layer of skin cells, one should consult a physician immediately if the skin becomes too thin, which often leads to venous ulceration.

While different categories of ulcers exist, the most prevalent ulcers are known as venous stasis ulcers. Venous stasis ulcers typically present themselves in the lower leg, near the ankle area. As with varicose veins, deficiencies or damage to the one-way valves in the veins can cause blood to pool or flow backward. This leads to several problems: improper blood flow inhibits the ability of the veins to carry nutrimental blood to all areas of the body. The pooling of the blood causes veins to swell, which is the typical presentation of varicose veins. The swollen superficial veins place additional pressure on the skin, increasing the probability of skin breakage, bleeding, and venous ulcers.

While diabetes is a factor for venous ulcers, other common factors should be noted, such as advanced age, surgery, and significant weight gain or long-term obesity. Senior citizens typically experience diminished vein function and thinning of the skin, and therefore the risk may be higher.

Persons with varicose veins should note that the condition of varicose veins, if left untreated, may predispose one to venous ulcers. Varicose vein treatment, as well as spider vein treatment, can be performed quickly and painlessly, with little down time or expense.

While malfunctioning veins or varicose veins can lead to skin ulcers, they are frequently precipitated cuts, scratches or bruises. These minor injuries fail to heal properly due to the compromised circulation of venous insufficiency, resulting in ulceration. These ulcerous lesions are often painful and unsightly.

It is an unfortunate tendency of many patients to assume that a venous ulcer will heal on it’s own, however, venous ulcers most often require treatment from a vascular specialist. Many patients initiate a self-treatment of applying antibiotic ointments, which actually does not assist in healing. Unprescribed antibiotic use can lead to antibiotic resistance, while the underlying ulcer persists or may even worsen over time.

Treating venous ulcers at the earliest possible sign is important, not only to prevent infection, but also due to the fact that continued ulceration of the skin leads to (sometimes irreversible) deterioration of the surrounding tissue.

A vascular surgeon, such as the board certified vascular doctors at the San Diego Vascular Center, can determine and supervise the best course of treatment. Zinc paste may be applied to facilitate healing and immune response. Several types of bandages are applied to compress the veins, which helps prevent the pooling of blood in the veins. If the skin or deeper tissues have been damaged by the ulcers, the tissue would need to be removed either by surgery or laser, to prevent tissue death (gangrene).

The underlying varicose veins may be treated by means of radiofrequency or laser ablation, which safely closes the faulty veins, allowing the body to reroute blood flow to healthier veins. This further allows the surface tissue to heal.

Venous ulcers may take weeks or months to heal on their own, during which they are at high risk of infection.
A wound is considered chronic if it does not show marked improvement within 3-5 weeks. Chronic wounds require regular visits to a vascular doctor to assess, clean, dress, and reapply compression bandages. In between visits, patients should inspect for signs of swelling, discoloration, pain, and signs of infection such as odor, pus, heat, or fluid drainage.

Diabetics should be particularly proactive with regard to wound symptoms, as heightened blood glucose levels impair circulation.


In short, it is highly recommended to have spider veins and varicose veins treated, even if they are not yet painful or ulcerated. Any signs of ulcers should be looked at immediately by a vascular doctor, and treatment regimens should be adhered to with regularity.


The San Diego Vascular Center is San Diego’s premiere practice of Board Certified Vascular Surgeons. We specializes in treating all vascular health issues, from varicose veins to wound care, for patients in San Diego County, Orange County and Riverside County. For more information or to set an appointment, please contact us.



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Varicose Veins are More Than Just a Cosmetic Concern

Varicose veins are unsightly and painful, but when treatment is avoided, they can lead to more serious problems– here’s what you should know.


Varicose veins are extremely common. over fifty percent of Americans have varicose veins, usually in the larger leg veins. Although many people consider varicose veins to be a cosmetic issue, truth be told that untreated varicose veins can lead to more serious vascular conditions.

Susceptibility to Cuts and Hemorrhaging

Varicose veins are blood vessels whose one-way valves have malfunctioned, triggering blood to pool, thus causing the leg veins to swell. The enlarged leg veins now put pressure on the skin. As an end result, patients suffering from varicose veins frequently} bleed substantially from relatively minor injuries. Unfortunately, this heightened risk remains before the bulging subsides.


Ulcerated Veins

Without treatment, varicose veins can also lead to venous ulcers, that which are opens sores or wounds caused by poor circulation. The most common indications of venous ulcers include throbbing pain, swelling, irritation, infection, a sense of heaviness in the afflicted arm, ankle or leg, and substantial discoloration of the surrounding skin. In the event that the sores are left untreated, venous ulcers can emit an distressing odor and generate infected purulence (pus), further adding to the patient’s discomfort.


Blood Clots, Deep Vein Thrombosis, and Pulmonary Embolism

By far, the most significant hazard posed by untreated varicose veins is an increased likelihood of developing a thrombus (also referred to as a blood clot). Chronic inflammation can damage the valves that control blood flow through your veins, prohibiting them from pumping blood effectively. As a result, blood continues to accumulate in the veins, obstructing blood circulation and promoting clotting. Blood clots in the deep veins of the legs are called Deep Vein Thrombosis, which, aside from being painful, can be deadly. If the blood clot were to detach and enter your bloodstream, it can lead to life-threatening conditions such as pulmonary embolism.

A pulmonary embolism results from a blood clot traveling to the lungs and blocking a pulmonary artery. If a clot is large enough to stop blood flow into the lungs, it can be deadly.


While  varicose veins can result in a number of more serious complications, we are happy to report that varicose vein treatments are painless and inexpensive. However, it’s important to seek treatment immediately in order to minimize the associated risks, and prevent varicose veins from developing into a more serious issue.

Advancements in varicose vein treatments, such as VNUS closure (Venefit™), and EVLA (VenaCure®), make the procedure quick, painless, and with little or no down time.


The San Diego Vascular Center, a leading San Diego based practice of Board Certified Vascular Surgeons, specializes in treating all vascular health issues for patients in San Diego County, as well as in nearby Orange County and Riverside County. For more information or to set an appointment, please contact us.

varicose vein treatment san diego

Easy, Everyday Tips for Maintaining Healthy Veins

How our society has evolved such that either sitting or standing all day has become the norm, I’ll never know, since both sitting are standing are terrible for circulation. Circulation issues, spider veins, and varicose veins can be worsened by the negative effects of gravity and pressure from sitting or standing. Remember, the purpose of the veins is drive blood back to the heart…this means that veins are literally fighting an uphill battle against gravity. Strain on the veins causes veins to stretch, and causes the one-way valves to malfunction, resulting in the bulging, purple appearance of varicose veins. Luckily for us, varicose vein treatment and spider vein treatment are simple, affordable, and painless, however, it’s always a better to keep healthy and avoid developing a vascular condition that requires treatment.

The function of our veins is to return blood back to the heart, after being pumped throughout our artery system. However, our veins must continually work against gravity to send blood to the heart from all areas of the body below the heart. Standing or sitting all day can make the task harder, and worsen the negative effects of gravity on blood flow.

While varicose veins and spider veins are the most common condition associated with vascular disease, in part due to the fact that they are visible to the naked eye, there are other conditions to be aware of. Deep Vein Thrombosis, or DVT, is caused by blood clots that form in the legs, and can be fatal if the blood clot dislodges and travels to block a pulmonary artery. Circulatory issues may lead to chronic wounds, a condition in which a simple wound does not get proper blood flow or nutrition to heal. Chronic wounds require wound care from a specialist, such a vascular surgeon, who may recommend lifestyle changes in addition to a wound care treatment regimen.

When veins have to work too hard, they can begin to stretch, and lose their ability to function properly. The one-way valve that helps ensure that blood flows on direction may fail, causing blood to pool. Hence, varicose veins and spider veins.

Many factors contribute to varicose veins, spider veins, and other circulation problems:

  • Constant standing or sitting, usually job-related
  • Sedentary lifestyle
  • Hereditary predisposition to varicose veins of vascular disease
  • Pregnancy

Below please find some everyday tips to keep your veins healthy.

  1. Limit Salt Intake: It pays to keep your body well-hydrated. Avoiding salt helps prevent swelling, which, in combination with sitting or standing, can put further pressure on veins. Watch for sodium levels on food labels and restaurant menus.
  2. Get Regular Exercise: Regular exercise helps improve circulation, improve vein function, strengthen the body, improve blood flow, and more. Walking, running, swimming, yoga, and gentle strength training are highly recommended at least 3 times per week. Swimming is especially beneficial for the circulatory system, as it alleviates pressure on veins, and removes the factor of gravity from the equation (while you are in the water).
  3. Wear compression garments: Compression garments, such as compression socks, can relieve swelling and help increase blood flow.
  4. Elevate your legs: Elevating the legs helps reduce the demand of the veins. Put your feet up whenever possible, and sleep with a small pillow under your feet.
  5. Re-think your sitting position: Sitting in the same position can cut off circulation in the backs of the legs. Change positions frequently, alternate between sitting and standing, and make sure to get up at least once per hour.
  6. Wear comfortable, non-restrictive shoes: High heels look great in pictures, but that’s about all they are good for. Wear shoes that allow full range of motion of the foot, ankle and calves…these areas are the furthest from the heart, and require veins to constantly work against gravity.
  7. Keep Moving: Get up and walk around at least once every hour. Perform simple calf, foot and ankle exercises and stretches every hour.
  8. Wear loose-fitting clothing: Tight clothing and support garments may limit the blood flow through your legs, waist, and pelvic area.


The San Diego Vascular Center specializes in diagnosis and treatment for all vascular health issues for patients in San Diego County, Orange County and Riverside County. For more information or to set an appointment with our staff of board-certified Vascular Doctors, please contact us.



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Five Common Myths About Varicose Vein Treatment

varicose vein removal

Five Common Myths About Varicose Vein Treatment

Since varicose veins and spider veins are so common, it’s not surprising that people have come up with unsubstantiated theories as to how they occur and how they are treated. In fact, it’s estimated that between 35% – 45% of people in the United States have varicose veins, and an even larger number have spider veins. More women than men have varicose veins, but they are not all uncommon in men.

Here are some of the most common myths concerning varicose veins:


Myth 1: Varicose Vein Treatment is Expensive

The most effective and widely-used techniques for varicose vein treatment, such as VNUS closure (Venefit™), EVLA (VenaCure®), sclerotherapy, and laser spider vein treatments, are minimally invasive and inexpensive.


Myth 2: Varicose Vein Removal Is Not Covered by Insurance

In approximately 80% of varicose vein removal cases are covered, either in whole or part, by insurance. Keep in mind that varicose veins are not only a cosmetic issue…the presence of varicose veins may be indicative of serious vascular disease. At the very least, varicose veins may worsen, causing pain. It’s worth a call to your insurance provider to see if any part of the procedure may be covered.


Myth 3: Varicose Veins Can Are Caused By Sitting With Legs Crossed, Or By Wearing High Heeled Shoes

There exists some old wives’ tales that daily habits such as sitting with your legs crossed or wearing fashionable high heels are causes of varicose veins, that is simply not true. While it is important for vascular health to get up and move around throughout your day, the act of merely sitting with your legs crossed or wearing a certain type of shoe will not result in varicose veins or spider veins. In fact, many people are genetically predisposed to varicose veins, others develop varicose veins after pregnancy, or other factors.


Myth 4: Varicose Veins Are A Cosmetic Issue; Treatment Is Optional

Untreated varicose veins may worsen, sometimes resulting discoloration of the surrounding skin, pain in the area, and chronic slow healing wounds. Most importantly, they can lead to blood clots, which may break off and block blood flow to critical organs. It’s important to get your varicose veins examined by a vascular surgeon, to make sure they are not a symptom of a more severe issue.


Myth 5: Varicose Vein Treatment Requires Invasive Surgery

Years ago, a surgical procedure known as vein stripping was the most common method of varicose vein treatment. In recent years, however, several non-invasive or minimally-invasive procedures have become the standard. Varicose vein treatments such as VNUS closure (Venefit™), EVLA (VenaCure®), sclerotherapy, and laser spider vein treatments, are minimally invasive, and affordable. They can be performed at your vascular surgeon’s office, and require little or no down time.



vein treatment

Preventing Blood Clots While Sitting or Traveling

vein treatment

Deep Vein Thrombosis (DVT), is caused when blood clots occur in the deep veins of the legs (and sometimes in the arms). DVT can be life-threatening, and people who travel are at a greater risk, due to the amount of time spent sitting. Anyone spends more than 3-4 hours travelling, regardless as to whether they travel by means airplane or ground transportation, should be aware of the risk of DVT (blood clots).
Basically, the longer your body is immobile, the higher the risk of blood clots. But travelers are especially at risk, because they sit in restrictive seating, often in the same position, for hours at a time. Without proper movement, or when one’s sitting position cuts off or inhibits circulation in the legs (especially if legs are crossed), blood clots can occur in the deep veins.
The deep veins are located in the interior of the body, such as the femoral vein, tibial veins, ulnar and fibial veins, etc. These are not visible to the eye, as may be the superficial veins that are located closer to the skin’s surface. When you get varicose veins or spider veins, these veins become more visible due to blood pooling in the area where a venous valve has become faulty. Treating spider veins and varicose veins is usually simple and painless, due to their location near the skin.

Back to blood clots in the deep veins. While these clots can sometimes dissolve or break up on their own, the real risk is that the clot gets carried away from legs back toward the lungs (for oxygenation), where it may clog or block a pulmonary artery. This prevents blood flow to the lungs, which is life-threatening. It helps to take precautions against blood clots while traveling or sitting for long periods, and to know the symptoms.

In addition to extended sitting, several risk factors may increase the likelihood of a blood clot.
Even if you travel a long distance, the risk of developing a blood clot is generally very small. Your level of risk depends on the duration of travel as well as whether you have any other risks for blood clots. Most people who develop travel-associated blood clots have one or more other risks for blood clots, such as:


Risk factors:
• Varicose veins: if varicose veins are left untreated, circulation in that area will be less than if the varicose veins had been treated
• Age: risk increases after age 45
• Obesity: excess weight places a strain on the circulatory system
• Recent surgery or injury involving deep bruising, stiches or bleeding.
• Periods of immobility or bed rest
• Hormone use, especially estrogen, for such uses as birth control or hormone replacement
• Pregnancy or recent childbirth (due to increased pressure in the veins)
• Previous blood clot or a family history of blood clots
• Smoking (inhibits circulation)
• Chemotherapy treatments

What are the symptoms of DVT?
While a deep vein blood clot may occur with no detectable symptoms, when symptoms are present, one might notice swelling, tenderness, feverish skin, feeling of fatigue in the affected limb, redness, visibly swollen veins in the affected limb.
If you have any of these symptoms, seek emergency medical care immediately.

If DVT reaches the lungs and causes a Pulmonary Embolism, the following symptoms may appear.
Symptoms of a Pulmonary Embolism may include:
1. Feeling faint or dizzy
2. Difficulty breathing
3. Accelerated (and possibly irregular) heartbeat
4. Chest pain
5. Sudden coughing with blood or blood in mucous
If you have any of these symptoms, seek emergency medical care immediately.


How to prevent DVT while traveling or sitting for long periods
Get up and move around as much as possible.
If you can’t get up, move your arms and legs. Change positions, stretch, flex and release the muscles in your arms and legs. Point and flex the toes, move the ankles in a circular motion, raise and lower the legs, make a pumping motion with your feet. Alternate raising your knees to your chest. For arms, roll your shoulders, flex and release your biceps, make wrist circles, raise and lower arms.

Thanks for reading! Stay informed, stay safe, and happy travels.

Please visit us on the web at www.sandiegovascularcenter.com for more information, or to schedule a consultation. Our team of board certified vascular doctors treat all conditions of the vascular system, from varicose vein treatment and spider vein treatment, to wound care and more serious vascular diseases.


1Gavish I, Brenner B. Air travel and the risk of thromboembolism. Internal and Emergency Medicine 2011 Apr;6(2):113-6.

varicose vein treatment

Standing all day for my job…will it cause varicose veins?

Being required to stand all day, or for long periods of time daily, can be the root cause of vein issues.

varicose vein treatment

The average person works 40+ hours per week, during which they are either sitting or standing. As we all know, many people work more than 40 hours per week. Additionally, other activities outside of work also involve standing, which further compounds the negative effects of standing. Standing for such a significant chunk of your time can lead to various health issues, including foot, back and knee problems, and vein or circulation problems.

Standing for long periods of time can be uncomfortable, which in itself is a sign from your body to change positions. Associated pain from standing may include foot, leg or back pain. However, standing for long periods also increases the likelihood of developing varicose veins, for which you wouldn’t feel any associated aches or pains. Your legs may feel fatigued, but when you first notice varicose vein, they symptoms will most likely be visible, as the reddish-purple network of veins appears on your legs, behind the knees, or ankles.

Sitting is not the best solution, as sitting for long periods also contributes to varicose veins. In addition to affecting the circulatory system and causing varicose veins, sitting is also closely associated with back and neck pain, sciatic nerve problems (often chronic), and carpal tunnel syndrome (due to improper height of hands and keyboards at standard chair and desk heights).

It’s noteworthy that not all individuals who are required to stand for long periods develop varicose veins or spider veins, and there is no way of predicting who will develop varicose veins. Those with a family history of varicose veins should pay attention, as they are most likely at a higher level of risk.

In addition to causing varicose veins and spider veins, standing for long periods daily over several years can increase atherosclerosis, due to the demands standing places on the circulatory system.


I can’t change my job, so, what’s the solution?

We’ve all heard experts recommend that we take breaks often, at least once per hour. But taking a break from standing by just sitting down will not offer much help. Try to walk as often as possible, stretch several times throughout the day, and put your feet up as often as possible.



The purpose of veins is to return blood to the heart for oxygenation. Think about how much harder the veins have to work to push the blood up to the heart from the feet and legs, while in a constant standing position. It is a constant fight against gravity, that can eventually weaken the one-way valve that facilitates the movement of blood. Once this valve is weakened, the blood pools and backflows in the area, causing the area of the vein to bulge, and also resulting in the visible purple-blue varicose veins or spider veins.

So, as much as you can do to facilitate circulation, the better. Go for a walk. Do a few yoga poses. Sit in a recliner with your feet up. Go for a swim. But do these activities throughout the day to break up the constant standing activity. It’s all about balance, right?

Already have varicose veins or spider veins? No problem. Varicose vein treatment is fast, simple, and painless. But get your varicose veins taken care of now, because allowing them to worsen can lead to greater health problems. Also, your varicose veins might not necessarily be the result of standing, you’ll want to have them checked by a vascular surgeon to make sure they are not the result of a more serious vascular disease.

Contact the San Diego Vascular Center today for your consultation and varicose vein treatment. Visit us at www.sandiegovascularcenter.com.



The Anatomy of Veins and Arteries

Before explaining the anatomy of your veins, let’s have a quick overview of your cardiopulmonary system. The cardiopulmonary system consists of a network of blood vessels, the lungs, trachea and bronchi.  The system comprises organs from both the circulatory and respiratory systems, to carry nutrients, oxygen and hormones throughout the body, as well as to removes waste. This network begins oxygenated blood is transported from the lungs to the heart via the pulmonary veins. The oxygenated blood is then transported throughout the entire body. Then, the deoxygenated blood is returned to the heart at the right atrium of the aorta, via the inferior and superior vena cava.


The Function of Arteries and Veins

While both arteries and veins are blood vessels, they are quite different. Arteries carry oxygenated blood to the organs and limbs, while veins carry the deoxygenated blood back to the heart for re-oxygenation. The only exception are the pulmonary veins, which carry oxygenated blood from the lungs to the heart.

Veins contain a smaller mass of muscle tissue than arteries, and are located in closer proximity to the skin’s surface. Arteries transport nutrient-rich blood away from the heart, while veins carry blood back toward the heart. Veins differ from arteries in that they contain valves which keep the blood moving in one direction, without risk of reflux or back -flow.


Vein and Artery Structure

Tunica adventitia – The resilient outer layer of both arteries and veins, comprised of collagen and elastin.

Tunica media – The middle layer of both arteries and veins, comprised of smooth muscle and elastin fibers

Tunica intima – The interior lining of both veins and arteries, which contain the hollow passageway for blood to flow, called the Lumen. Veins contain one-way valves, which allow blood to move back to the heart and lungs against gravity, without risk of back flow.

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How Are Varicose Veins and Spider Veins Caused?

As mentioned earlier, veins are unique to arteries in that they contain one-way valves to carry blood to back to the heart and lungs. Also, most superficial veins are closer to the surface of the skin. Sometimes, the valve inside the vein malfunctions, causing blood to pool in an area of the vein. This pooled blood becomes visible through the skin’s surface. When this occurs in smaller veins and capillaries, we refer to the condition as spider veins. When we see larger darkened and bulging veins, we refer to them as varicose veins.

While they can be unsightly, spider veins are not painful, and do not lead to serious complications. However, they can begin to worsen if untreated. Fortunately, spider vein treatment is fast, safe and completely painless. Both varicose vein treatment and spider vein treatments consist of closing the afflicted vein, by a variety of methods.

Most cases of varicose veins are painless, and also without complication. However, there is a considerable number of cases that have reached the point of discomfort, wherein patients complain of aching, painful limbs. If left untreated, serious cases of varicose veins can lead to ulcers, blood clots, or rupture/bleeding. Thankfully, varicose vein treatment is simple, painless and highly effective. The most popular varicose vein treatments are VNUS Closure (Venefit), EVLA (VenaCure), sclerotherapy, or laser treatment.


If you are considering varicose vein treatment or spider vein removal, please come in for a consultation with our team of board-certified vascular surgeons at the San Diego Vascular Center.

The San Diego Vascular center is located in San Diego, yet easily accessible from Orange County and Riverside County.


Factors Affecting Chronic Wound Healing


Many factors and causes are associated with slow healing or chronic wounds, and sometimes a combination of factors are involved in interrupting one of the phases of wound healing. Let’s look at the leading causes of chronic wounds:


Diminished ability to heal from wounds, or chronic wounds requiring wound care, as well as chronic diabetic foot ulcers, are common effects of the diabetic condition. The phenomenon of chronic diabetic wounds is based on a complex interplay of physiological mechanisms.  Deficiency of oxygen at the wound site, known as hypoxia, is caused by hyperglycemia. Excess sugar in the bloodstream causes cell walls to thicken, thereby inhibiting blood flow to the wound site. The hemoglobin insufficiency results in lack of oxygen, white blood cells and proper nutrients. Wound healing and wound care complications are sizeable factors in morbidity rates among diabetics.



When the seven-layer barrier of skin is broken, bacteria and other micro-organisms can enter below the dermis. There, they can colonize and spread rapidly. Infections can either be the result of a chronic wound, or be the cause of a chronic wound. Micro-organisms may enter a chronic wound and cause complications with healing. Similarly, the spread of infection at a fresh wound site may severely limit the ability of the wound to heal normally, resulting in a chronic wound that requires wound care.



Advanced age has been shown to be a major risk factor for slowed or inhibited wound healing. While diminished wound healing ability is predominately due to decreased hormone levels in the elderly population, reductions in t-cell production and inflammatory response are also key contributing factors.

With regard to hormone levels, we attribute higher estrogen levels in women (specifically estradiol, for its cell growth capabilities) to studies showing better wound healing statistics for elderly women, as opposed to elderly men.



Obesity, as a condition, correlates with impaired wound healing, as well as chronic wound infection, especially with regard to post-surgical wound healing. Poor perfusion (circulation) through excess tissue results in lack of necessary oxygenation and nutrition at the wound site. Additionally, increased pressure caused by excess body weight places further burden on circulation.



Without getting too technical, chemotherapy drugs are designed to prohibit the growth of cancer cells, and as a result, also prohibit necessary cell growth, collagen formation, and tissue regeneration at the wound site. Chemotherapy drugs also stifle the body’s immune response, resulting in significantly increased rates of infection and chronic infection. Chemotherapy drugs may also restrict healthy blood clotting at the incision, leading to excessive bleeding.


Cigarette Smoking:

The health consequences of frequent tobacco smoking have been documented for decades. Specific to wound healing, tobacco use restricts oxygen delivery to the wound, which, as we discussed earlier, greatly affects the body’s ability to heal. Nicotine use alters the consistency and chemical make up of the blood, with lowered levels of oxygen in the bloodstream in general, in addition to decreased circulation. Long-term smoking is linked to thickening of the arteries (atherosclerosis), which limits blood flow and subsequent oxygenation and nutrition. The process of burning tobacco creates carbon monoxide as a by-product, which, when inhaled, also suppresses proper oxygen levels in the blood.


Other Factors:

In addition to the above-mentioned causal factors of chronic wounds, poor diet, stress and frequent alcohol consumption can also affect wound healing.


Wound Care:

Chronic wounds should be treated holistically, taking all factors of a patient’s health into consideration, in addition to any diseases or medications they may be taking. Vascular surgeons treat and dress wounds, often with compression, to improve circulation and nutrition to the wound site, in a sterile environment. Proper cleansing of the wound site is also routine. Sophisticated analysis would lead a vascular surgeon to determine if curettage is required to remove damaged tissue, or if tissue is healthy enough to recover.
The San Diego Vascular Center is Ssan Diego’s foremost vascular treatment center. Whether you are looking for spider vein removal in San Diego, or need a reliable, highly-qualified staff to care for chronic wounds or vascular disease, you are in good hands with our team of board-certified doctors.





Varicose Veins and Pregnancy

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First of all, what are varicose veins?

Varicose veins are bulging, purple or bluish veins that appear close to the skin’s surface. They are most commonly found on the legs and ankles, but may also appear in the pelvic region or other areas. Varicose veins may have little or no discomfort, or they can be extremely uncomfortable. They can even lead to ulceration of the nearby skin.


Why do varicose veins are most often occur in the legs?

It’s important to remember that the function of the veins is to return blood to the heart…this means the leg veins are pumping against gravity. A one-way valve system in the veins insures the blood will move along in one direction, however, excess strain or pressure on the veins may cause damage to those one-way valves. When valves are not functioning properly, blood may pool in the areas, causing the vein to bulge and appear darker in color.


So, what do varicose veins have to do with pregnancy?

While there are various causes of varicose veins, such as heredity, standing or sitting for prolonged periods, menopause or obesity, a common cause of varicose veins is pregnancy. As the size of the uterus continually increases during pregnancy, it puts more and more stress on the interior leg veins (inferior vena cava), which directly affect the leg veins. Pregnancy also causes increased blood flow throughout the body, which can lead to enlarged veins.


How can you prevent or minimize varicose veins during pregnancy?

Keep in mind that leg veins fight against gravity to transport blood back to the heart. Therefore, anything that you can do to limit the effects of gravity will be greatly helpful. For example, keeping legs elevated as often as possible is one of the best things you can do to prevent varicose veins during pregnancy. Also, the more weight you put on, the more weight your legs have to fight against, so it is highly advisable to maintain the weight range recommended by your doctor. Daily exercise is also important to keep circulation going, including moderate exercise such as walking. Wearing compression stockings also helps support the leg veins, making their job easier.

While we’ve just listed several things you should do, it’s also important to note what you shouldn’t do. It is crucial to avoid sitting or standing for long periods at time. Make sure to rest, elevate your legs, or get up and walk around regularly to improve circulation and lessen the effects of gravity. Avoid tight-fitting clothes and shoes, that may restrict circulation.


If I develop varicose veins during pregnancy, should I be concerned?


For the most part, varicose veins are not serious, and treatment can wait until after delivery. There are a few instances in which one should see a vascular doctor, even during pregnancy. If varicose veins become painful or ulcerated, your vascular doctor can determine if they need immediate treatment.

Report any pain or swelling in the limbs to your vascular doctor, as pain and swelling may indicate Deep Vein Thrombosis (DVT), a condition wherein a blood clot may form in the deeper leg veins. These blood clots are dangerous, as they may break off and be carried to the lungs, which results in a serious condition known as Pulmonary Embolism. If you experience pain in the chest area, rapid heartbeat, or coughing up blood, call 911 immediately.

Also, there is a condition known as superficial venous thrombosis, wherein a small blood clot may occur near the skin’s surface. The area may become swollen and painful, and may cause burning or heat sensations. Please see your vascular doctor if you experience any of these symptoms.


What are my varicose vein treatment options?

Varicose veins cause by pregnancy tend to improve after giving birth, so as long as the symptoms are mild with no pain, it is advisable to wait 3-4 months before seeking varicose vein treatment, to see how much they improve on their own. You can greatly assist the healing process by remembering to exercise, elevate the legs, and wear compression hose.

Once you’ve decided that you want to have the varicose veins removed/treated, there are several options:



VenefitTM also known as VNUS closure, uses radiofrequency to shrink varicose veins, minimizing their appearance, and re-routing blood flow to healthier veins.



Sclerotherapy is used for both spider vein treatment and varicose vein treatment. Sclerotherapy is a safe, non-surgical procedure by which a solution is injected into the faulty vein, causing it to safely close.


Endovenous Laser Ablation

Endovenous Laser Ablation, or EVLA, uses laser energy to shrink and close damaged veins. The procedure is minimally invasive, whereby a small laser fiber is inserted into the vein. The procedure is quick and painless.

In summary, while there are many causes for varicose veins, pregnancy is a common cause (especially if you’ve had multiple pregnancies). The condition is rarely serious, however, you should be aware of symptoms that may indicate a more serious condition. Take steps to prevent or minimize varicose veins during pregnancy, and know that treatment options are safe, painless and highly effective. Thanks for reading!


The San Diego Vascular Center specializes in diagnosis and treatment for any and all vascular health issues for patients in San Diego County, Orange County and Riverside County. For more information or to set an appointment, please contact us.


Directions from Riverside: Take the 91 E. Follow the I-215 S and I-15 S to Gamble Ln in Escondido. Take Exit 29 from the I-15 S. Continue on Gamble Ln to W Citronado Pkwy.


Directions from Orange County: Take the 5 S and CA-78 E to Gamble Ln, Escondido. Take Exit 29 from the I-15 S. Continue on Gamble Ln to W Citronado Pkwy.