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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).

Causation:

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 16^th chromosome, is indicated by a red line below after q24.1 ^[1]

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.

Treatment

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.

Reference:

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

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.

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

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.

Why?

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.

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:

Venefit^TM

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

Sclerotherapy

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.

San Diego Vascular Center Customer Testimonials

We gathered together a small collection of comments from San Diego Vascular Center customers from San Diego, Riverside and Orange Counties. We hope they help you feel confident about our vascular care services, ranging from spider vein treatment and varicose vein removal, IPL Laser treatments, Laser Hair Removal, to wound care and care and serious vascular disease treatment.

Varicose Vein Treatment:

“I had noticeably large varicose veins in my legs from a young age, due to heredity. I was very self-conscious, and refrained from wearing shorts or swim suits. I am so relieved after having the varicose veins removed. I can wear anything now, and feel completely confident. The treatment was a breeze, and doctors and staff treated me like gold.”

~Mona T., Aliso Viejo, Orange County, CA

“I developed varicose veins in my thirties, but held off for many years on getting them removed, because I had a fear of doctors and treatment. The veins got worse and worse and worse over the years, and eventually became painful. The doctors and even the receptionist staff at San Diego Vascular Center were so caring and gentle with me, I knew I was in good in hands. The procedure was fast and painless. If I had known that the varicose vein removal would have been so easy, I would have done it years ago.”

~Alyssa M., Riverside CA

Spider Vein Treatment

“I developed spider veins in several areas when I reached my mid-forties. They were on my legs, my ankles, and on my nose and cheeks. I thought that it would be an expensive undertaking due to how many areas I was affected by, so I didn’t pursue spider vein removal right away. Finally, my youngest son told me that my nose looked like a map, and I made an appointment (after doing some research, of course). The laser procedure on my face and ankles was non-invasive, fast and painless. They used an injection on the larger spider veins in my legs, and I watched them disappear before my eyes. I know it is a cosmetic procedure, but it is a big relief to feel confident and not embarrassed anymore. Thank you.”

~Denise R., San Clemente, Orange County, CA

Wound Care

“I brought my mother to San Diego Vascular Center for her diabetic wounds, after a referral from her primary care physician. My mom was in pain, and very nervous about treatment. I want to take a moment to write this thank you to the doctors and kind, caring staff at San Diego Vascular Center. Just looking at her foot today I can see how much better it is, and my mom is not only healthy, but very happy.”

~Ellis P., San Diego, CA

“I suffered from pressure wounds for about 18 months. Most people have no idea what this is like…not only is it a source of anxiety and extreme discomfort, but they are prone to getting infected. My body was constantly fighting infection. I would go to a doctor for treatment, but the wounds would never heal, and the infections would return. I live in Orange County, but I met Dr. Bulkin at a North County Health & Wellness fair while visiting San Diego. Dr. Bulkin impressed me with his knowledge and his manner.

After 18 months of anxiety and suffering, my wounds were healed in about 6 weeks. The San Diego Vascular Center not only cleaned and treated my wounds, but they did a holistic health assessment, and taught me more about how to care for myself and my wounds than I could ever imagine. Thank you for allowing me to move past this chapter and feel healthy and optimistic again.”

Emmaneul M., Irvine, Orange County, CA

Vascular Disease – Aortic Aneurysm

“Dr. Bulkin spoke at the nursing home where I stay. I told him that I have been having high blood pressure after a knee surgery, and I was going to speak to my doctor about how the surgery could have cause my blood pressure to skyrocket. He told me to come in immediately, because surgery would not cause high blood pressure. He saved my life. I had an abdominal aortic aneurysm, and could have died at any moment. I was a walking time bomb. With caring and reassurance, they scheduled me for surgery immediately to have the damaged aorta section replaced. If you suddenly experience high blood pressure or pain in the stomach area, it is worth getting checked immediately. I recommend the San Diego Vascular Center with my highest recommendation.

~Sergio B. , San Diego, CA