Causes of varicose veins – and how to prevent them

Causes of Varicose Veins in the Legs: Why Do They Occur, and What Treatment Works?

Varicose veins (varices) are a widespread condition affecting a large portion of the adult population. Understanding the causes of varicose veins is fundamental to providing the correct and most effective treatment for varicose veins. In this post, we look at why veins weaken and how modern methods like laser treatment for varicose veins have revolutionized the field.

Basic Physiology: Why Do You Get Varicose Veins?

Varicose veins occur in the body's venous system, whose primary function is to return oxygen-poor blood from the tissues up to the heart. Unlike arteries, which transport blood away from the heart under high pressure, veins have thinner walls and operate under lower pressure.

The biggest challenge for the veins in the legs is gravity. To counteract the downward flow, veins are equipped with venous valves - small, crescent-shaped structures that act as one-way valves.

Venous Insufficiency - The Key to Varicose Veins

The cause of varicose veins is primarily a phenomenon called venous insufficiency (venous valve failure), which creates abnormally high pressure in the venous system:

1. Valves Weaken: For unknown (often genetic) reasons, the structure of the venous valves weakens.
2. Backflow (Reflux): When the valves cannot close tightly, blood flows back down into the leg with each heartbeat.
3. Pressure and Dilation: This backflow creates an overpressure in the superficial veins. The pressure dilates the veins, causing them to bulge out and become visible under the skin as varicose veins.

The Most Common Causes of Varicose Veins (Risk Factors)

Although the precise mechanism behind the weakening of venous valves is still being researched, there are a number of well-known factors that increase the risk of developing varices (varicose veins).

1. Heredity and Genetics (Primary Varicose Veins)

This is by far the most important risk factor. Primary varicose veins occur without a known external trigger and are due to veins having a genetic predisposition to degenerate. If your parents or siblings have varicose veins, your risk is significantly higher. This genetic predisposition is the most common cause of varicose veins.

2. Gender and Age

• Gender: Women are affected approximately twice as often as men.
• Age: The risk increases significantly with age (it is extremely rare to see symptoms before the age of 20). The weakening of the vein walls is a natural part of the aging process.

3. Hormonal and Physical Pressure (Pregnancy)

Pregnancy is a frequent cause of varicose veins in women:

• Hormonal Changes: Increased levels of progesterone early in pregnancy relax the walls of blood vessels, which can lead to dilation.
• Increased Pressure: In the later stages of pregnancy, the growing uterus puts direct physical pressure on the large veins in the pelvis, preventing blood from flowing efficiently back to the heart.

Note: Approximately one-third of all pregnant women experience varicose veins, but in the vast majority of cases, these are temporary and disappear spontaneously after birth.

4. Lifestyle and Secondary Varicose Veins

• Obesity: Increased body weight puts greater pressure on the veins in the legs and pelvis, contributing to valve failure and being a contributing cause of varicose veins.
• Prolonged Standing/Standing Still:
• People with jobs requiring long periods in stationary positions constantly strain venous valves (e.g., surgeons, hairdressers, retail employees).
• Previous Blood Clots (Secondary Varicose Veins): If a previous blood clot in the leg (deep vein thrombosis) does not dissolve properly, it can permanently damage the venous valves. This increases pressure in the venous system and forms secondary varicose veins.

Treatment of Varicose Veins: From Surgery to Laser Technology

Today, treatment for varicose veins is minimally invasive, highly effective, and associated with very few discomforts. At kirurgen.dk, we specialize in the most modern methods, which have replaced older, more traumatic operations (like vein stripping).

Focus on Minimally Invasive Treatment

Modern treatment of varicose veins involves precisely closing the diseased vein so that the body itself absorbs it, and blood flow is automatically redirected to the healthy, deep veins.

1. Laser Treatment of Varicose Veins (EVLA)

Endovenous Laser Ablation (EVLA) is the preferred method for the treatment of varicose veins, especially for the large, underlying veins that cause reflux.

• Advantages of Laser Treatment:
  • Minimally invasive: Performed under local anesthesia.
  • Quick recovery: You can typically resume work the next day.
  • High success rate: Very effective at permanently closing the defective vein.
• How does it work? With laser treatment of varicose veins, a thin laser fiber is guided by ultrasound into the diseased vein. The laser's heat energy effectively closes the vein from the inside, removing the source of high pressure and thus the varicose veins.

2. Supplementary Treatments

• Foam Sclerotherapy (Ultrasound-Guided): Often used to treat smaller varicose veins or side branches not directly treated with laser. A sclerosing foam is injected to close the vein.
• Microphlebectomy: Minor surgical removal of very large, bulging varices through microscopic incisions for a better cosmetic result.

Conclusion

Understanding the complex causes of varicose veins - especially the genetically determined weakening of venous valves - is crucial. Fortunately, advances in varicose vein treatment have made it possible to treat the condition effectively and gently.

At kirurgen.dk, we offer individually tailored treatment plans, primarily focusing on laser treatment of varicose veins, to ensure you the best physiological and cosmetic solution.