The job of the veins is to take blood back to the heart. There are two systems of veins: a deep system, contained within the muscle and not visible from the outside, and a superficial system, which is just under the skin surface. Most of the time, your legs are below the level of your heart, so how does your body get the blood in the veins to move against gravity? The answer is, the muscle of your leg acts like a pump. When you are walking or cycling or moving your leg in other activities, your leg muscle is moving. The muscle then contracts against the deep vein contained within the muscle, and forces blood out of the leg and upwards. Because the deep and superficial vein systems are connected, the superficial vein system will empty too. The direction of blood in the veins should be going from the superficial veins into the deep veins, and from the deep veins up to your heart. There are a series of valves in the veins to keep the blood moving in this direction. Valves are like one-way doors: they open to let blood flow past them, then close and don’t let the blood flow backward in the reverse direction.
Most people with varicose veins will have a problem with the valves. If the valves in the deep system are not functioning, you get leg swelling (edema). If the superficial vein valves are the problem, then you get bulging, engorged superficial veins (varicosities).
Varicose veins are common. About 30% of women and 15% of men in their 40′s have varicosities, and the incidence increases with age. Risk factors for varicose veins include increasing age, female sex, family history, leg trauma or leg surgery, history of deep venous thrombosis (DVT), obesity, and sedentary lifestyle or profession that involves prolonged standing.
In some cases, varicose veins may be a purely cosmetic issue. Often however, varicosities produce leg discomfort: aching ,throbbing, fullness or an engorged feeling in the legs. Other times, varicosities can lead to superficial vein blood clots (thrombophlebitis), bleeding episodes, and progressive skin damage (chronic venous stasis disease), which is a predisposing factor for skin infection and ulcers.