Vein Basics:

You Don't Need Surgery!

Now you can treat varicose veins with no surgery, no scars, no downtime, and minimal discomfort.
If you have been told that you need surgery for your veins, keep reading, because surgery is rapidly becoming a thing of the past. It has been supplanted by foam sclerotherapy and endovenous laser.
If you have been undergoing treatments for your veins over and over through the years and they just don't want to go away, keep reading!
The information you are going to find here is solid science, delivered to you in language that is easily understood. If you still have questions when you have finished reading this page and the pages on spider vein treatment and varicose vein treatment, please feel free to email or call for more information.

But the best way to get comprehensive information and advice that is specific to your condition is to come in for a consultation. There is no charge for consultations. You do not need a referral from your family doctor.

(If you just can't wait to find out how we achieve high success rates with varicose vein therapy, here is the short answer. At York Vein Clinic you will be cared for by a doctor who is certified in vein treatments by the American Board of Venous Medicine and the Canadian Society of Phlebology. The first thing we do is map out your varicose veins using ultrasound with the most important aspect of this being to identify the source of the problem. Then using a systematic approach, we treat your veins starting at the source. We primarily use endovenous laser and foam sclerotherapy, two amazing innovations that began rapidly rising in popularity around the world in about 2002. And we use ultrasound at every visit to give us a clear picture of what we need to treat. The ultrasound also allows us to reach veins that could previously only be treated with surgery.)


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*Results may vary.

Questions and Answers


What are veins?

Veins are blood vessels that return old blood to the heart. Arteries carry fresh blood away from the heart. Blood moves in arteries because it is pumped by the heart. The pressure generated by the heart is lost as blood moves down the arteries into smaller and smaller channels, ending in capillaries. These capillaries are so small that red blood cells can only move through them in single file. On the other side of the capillary bed, the vessels join to form larger and larger vessels called veins.

There are two systems of veins in the legs, the deep venous system and the superficial venous system.

The deep system lies within the muscles. It does most of the work of draining blood from the legs. This deep system is well-supported by the muscles of the legs and rarely causes problems.

The superficial system lies just below the skin. It receives very little support from the skin, and it is therefore, prone to problems. It is in the superficial system that spider veins and varicose veins are found.

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What makes the blood move through veins?

As explained above, the pressure generated by the heart is lost in capillary beds, so veins have very little pressure. Because there is little pressure, there has to be a way to keep the blood moving back to the heart. Therefore, veins contain a system of one-way valves. These valves allow blood to flow only toward the heart and prevent blood from flowing backwards.

In the legs, the pressure required to make blood move is generated by muscle contractions as you walk. The muscles squeeze veins of the deep system, and blood flows easily. Because of the valves, it can only flow up toward the heart. About 80% of the pumping action for leg veins is produced in the calves. The feet and thighs each add another 10%.

In the superficial system, muscle action does not squeeze veins, because the skin gives way. These veins depend on a system of connecting veins called perforators that join the superficial veins to the deep veins. Blood moving in the deep veins basically sucks blood through the perforators to drain the superficial veins.

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What are varicose veins?

Varicose veins are veins in which blood no longer moves efficiently toward the heart. Blood in these veins actually flows away from the heart and back into the legs.

The formation of varicose veins probably starts with a weakness of the vein wall. This is most commonly inherited. When the vein wall weakens, it gives way under pressure and begins to dilate. Eventually, the vein dilates so far that the valves pull apart, and they fail to hold the blood above it. Blood backs up adding to the pressure and dilatation of the vein, causing valves up and down the vein to fail. Blood actually starts to flow backwards down the vein and away from the heart. The vein bulges under the skin. This is a varicose vein.

The increased pressure in the varicose veins will also affect smaller vessels that feed into these varicose veins, and they will dilate. These smaller vessels are known as reticular veins, venulectasias, or telangiectasias (spider veins) depending on their size and location.

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How common are varicose veins?

Varicose veins are an enormous problem. At any one time, 30-40% of the population has vein problems.

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What are the risk factors for developing varicose veins?

Sex: females are about twice as likely to develop varicose veins as males (thank your hormones again!).

Pregnancy: weight gain, hormone changes, increased blood volume, and pressure on the veins from the baby in the pelvis all contribute to varicose veins in pregnancy. Varicose veins that develop in pregnancy will often disappear following the birth. If they haven't diappeared 9 months later, they probably won't ever go away. Vein problems tend to get worse with each pregnancy.

Heredity: almost all vein patients have a family history of vein problems. If you have one parent with varicose veins your risk is about 40%. If both parents have varicose veins your risk is about 90%. 

(You can blame your mother for giving you varicose veins, but she'll blame you for giving them to her when she was pregnant with you!) 

Age: varicose veins become more common with advancing age. You have inherited a weakness of your veins, and advancing age adds to the weakness, just as it does for all tissue like skin, bones, and muscles.
In women, about 30% of 30 year olds have vein problems, 40% of 40 year olds, 50% of 50 year olds, etc.

Sedentary lifestyle: if you are inactive or have a job that requires a lot of standing without being able to walk around, you are at higher risk of varicose veins. Teachers, hair dressers, and cashiers are at risk.

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Are varicose veins bad for you?

Blood in varicose veins is moving backwards down into the legs instead of up toward the heart. This old blood is full of waste products* that are recycling through the legs instead of returning to the lungs, liver, and kidneys to be removed. These waste products cause problems as described in the next question.

* Waste products, in medical terms, are unwanted by-products of metabolism. They include carbon dioxide, carbon monoxide, lactic acid, peroxides, nitrogenous substances like ammonia, and hundreds of other substances.

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Why should varicose veins be treated?

There are four reasons people choose to treat varicose veins:

1) They are unsightly.

They can cause discomfort in the legs including aching, heaviness, fatigue, cramps, itching, burning, and restlessness. They sometimes cause swollen ankles.

3) Long-standing varicose veins can lead to thickened discoloured skin (from long term deposition of blood pigment and other factors) and leg ulcers (from waste products and other factors).

People with varicose veins are more prone to blood clots in the legs. There are two kinds of blood clots:

i) Superficial venous thrombosis is an inflamed vein just under the skin. It is warm, red, and extremely tender. This type of clot is very common in people with varicose veins. These clots can travel to the lungs, but they tend to be smaller and less dangerous than deep vein clots (see next paragraph).

ii) The second type of blood clot is deep vein thrombosis. As the name implies, these clots occur in the deep vein system. Because they are located in the muscles, rather than just beneath the skin, they are not as easy to detect as superficial vein clots. Deep vein clots can break loose and travel to the lungs (pulmonary embolism). Small clots might go unnoticed. Large clots will cause chest pain and shortness of breath. Larger clots can be fatal. Some of your deep veins are very large, so clots in them can be very large. This makes them more dangerous than superficial vein clots.

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What can be done for varicose veins?

Support hose (aka graduated compression stockings) is very beneficial in relieving symptoms and slowing the progression of varicose veins.* Hose also reduces the likelihood of complications of vein disease such as leg ulcers and blood clots.*

Exercise and maintenance of a healthy body weight are also beneficial.

Bioflavonoids found in yellow and orange fruits and vegetables, especially citrus fruits, increase venous tone and improve venous elasticity. Horse chestnut, taken internally or applied as a lotion, decreases capillary permeability and helps to reduce swelling.

The modern treatment of varicose veins includes several techniques: injections, surgery, glue, and laser treatments. For details go to the Vein Treatments page.

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Don't I need these veins? If you remove them, where does the blood go?

The blood in varicose veins is already going the wrong way (away from the heart instead of back to the heart)(see the question: What are varicose veins?). You have already lost the normal function of these veins. The blood has already found another route out of your leg.

Think of your veins as a road system. If the highway is blocked, you can take secondary roads to another highway or all the way to your destination. Same goes for blood in veins. It will always find a way.  

So eliminating varicose veins does not remove a useful vein. It removes a vein that no longer works and is now potentially harmful to you.

What will happen if I just leave my varicose veins alone?

Varicose veins tend to get worse as time passes. One of the risk factors for varicose veins is age. Even if you have no other risk factors, you can't avoid this one. Basically, all our tissues wear out as we age. Veins are no exception. If you have varicose veins at the age of 40, those veins are more like 70 years old. They have weakened before their time. Now imagine what they will be like when they really are 70 years old! 
The second thing to consider is touched on in the question "Why should varicose veins be treated?" The secondary problems caused by varicose veins (eg. ulcers) get more likely over time. So, even if your veins are already as big as they are going to get, leaving them alone gives them time to cause skin damage or give you a blood clot.
The bottom line is: fix your varicose veins early! Don't wait until they are big or they are causing complications!
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