Varices

Hyperhidrosis

Specialities >> Vascular Surgery >> Varices

What are varices?

Varices are dilated or twisted veins which are develop on the surface of the skin. Depending on the stage in which they are, they may have a small, medium or large dimension.

The veins most accessed by the varicose disease are those in the inferior limbs: feet, legs and thighs. Some people present minimal ramifications (small vessels), of a reddish or bluish colouring.

These cases are usually asymptomatic and only cause aesthetical discomfort in their sufferers. These small vessels are of intradermic location.

Who has varices?

Not everybody has varices. It is calculated that 18% of the adult population have varices. In Brazil it is estimated that more than 20 million suffer from this disease. And, within these people, the greater number of victims are women because of feminine hormones, mainly progesterone which favours the dilation of veins. But, the main risk factor for one to have varices is the presence of the disease in the family: heredity.

They appear after 30 years of age and can worsen as years go by. It is less frequent before the age of 30. However, microvarices or "vascular spiders", also called vessels, may appear in people who are a lot younger.

Now see some other factors which contribute to the arising of varices or worsening the varices of those who already have it.

Sex - women are more prone than men, hormonal factors of gestation, period and menopause seem to have relation with the tendency to dilation of veins. Some researchers report hormonal reposition therapy and contraceptives increase the risk of varices.

Family History - Incidence of varices in the family increases the chances of a person having the disease.

Obesity - Excessive weight increases pressure over the veins and makes the venous return difficult.

Temperature - Exposure to heat for a prolonged time may cause dilation of the veins. It is not by chance that the incidence of varices is smaller in cold countries. Therefore, be careful with excessive exposure to sun heat, saunas, ovens, etc.

Tabagism - researches reveal that the wall of the veins also suffer aggressions from the substances which cigarettes contain.

Pregnancy - during pregnancy the quantity of blood circulating increases, therefore, the work of the veins also increases. Another fact that happens during gestation is that the womb grows in size and compresses the veins of the abdomen and pelvic region of the woman, becoming, in such a way, an obstacle for the blood to go up from the legs to the heart. Varices appearing during a first pregnancy frequently disappear after birth.

Sedentarism - leg movement is very important to pump the blood of the veins. Therefore, sitting for a long time or standing still is harmful for the work of the veins. Exercise, mainly aerobics, is important for body circulation.

Contraceptive pills and hormonal reposition - Once more we found the hormonal problem disturbing the veins of the legs. Some researchers have already blamed contraceptives for the arousal of varices in young women. The Forum of the Brazilian Society of Angiology and Vascular Surgery warns particularly that care must be taken with medicines used for therapeutic hormonal reposition.

Varices treatment:

There are different types of treatment for varices. The most important are preventive measures. When these measures of prevention are not sufficient, your doctor will be able to prescribe one or several of the treatments below:

Chemical Esclerotherapy - It is probably the technique used for the longest period. It is used frequently for microvarices (small veins/vessels) and for varices which are very small. It consists of injecting substances which induce sclerosis which expel blood to the normal veins and block the veins which are not being treated. There are many kinds of products which induce sclerosis (glucose, polydocanol, micro spume, among others.) Although these injections may need to be repeated in some veins, esclerotherapy is usually very efficient and has excellent results when performed by experienced doctors.

Surgery - Varicose surgeries are less and less aggressive. For the most part, varices can be performed nowadays through mini-incisions and hospitalisation length rarely need be beyond 24 hours. Varices removed in a surgery do not cause damage to the circulation once the other normal veins and the deep normal venous system are in charge of guaranteeing flux and return.

Esclerotherapy - esclerotherapy with laser is in the evolution process and it doesn´t yet replace chemical esclerotherapy. It can´t be applied to every type of skin and still does not have good results on more complicated veins. Developing technologies with laser will be able to widen its use. In Brazil, some doctors make a mixed treatment: laser and injections.

Endovenous laser - it consists of the introduction of a catheter by the laser inside the varices with the intention of destroying them by heat. It is a technique in trial stage.

Radiofrequency - it is the same technique mentioned previously using heat produced by catheters fitted with an RF device (radio-frequency)