Dr. Gabriel Lasry
Vascular Surgeon & Phlebologist — Casablanca
Varicose Vein Definition
Everything you need to know about varicose veins: what they are, how they form, why they appear, and their symptoms, stages of progression and their complications potential.
Are Varicose Veins?
Varicose veins are permanent dilations of the superficial veins, appearing mainly in the lower limbs and taking on a blue-green colour. They form when vein walls lose their elasticity and the internal valves weaken, causing blood to pool inside rather than rise towards the heart, making the veins swell and bulge beneath the skin.
The primary role of the veins is to return blood from the feet to the heart against gravity. To achieve this, they contain internal valves that open and close regularly to allow blood to flow in one direction only — upwards. When these valves weaken or malfunction, blood leaks backwards وaccumulates inside the vein, which dilates and expands and becomes visible beneath the skin as twisted blue cords.
Types of Varicose Veins
Leg Varicose Veins
The most common — appearing on the inner, posterior, or outer part of the leg and thigh
Facial & Eye Varicose Veins
Appearing around the eyes, hands, feet and chest — treatable under local anaesthesia
Pelvic Varicose Veins
Appearing in the pelvic area, causing chronic pain — especially after pregnancy
Varicocele (Varicocèle)
Dilations of the scrotal veins — may affect fertility in men
Haemorrhoids (Anal Varicose Veins)
Dilations of the anal veins — a particular form of venous varicose veins
Spider Veins
A fine network of very small vessels with a red or purple colour — primarily a cosmetic concern
Causes and Risk Factors of Varicose Veins
Varicose vein disease always results from a combination of several factors. Understanding these factors helps with prevention وidentifying those most at risk.
Genetics
The strongest factor — if one parent is affected, the risk rises to 45%; if both are affected it reaches 90%
Very high riskGender
Women are three times more likely to be affected due to hormonal influences (menstruation, pregnancy, menopause)
High riskPregnancy
The pressure of the uterus on pelvic veins and hormonal changes weaken vein walls — varicose veins worsen with each pregnancy
High riskAge
Veins progressively lose their elasticity with age — valves weaken and varicose veins typically appear after the age of forty
Moderate riskObesity وexcess weight
Excess weight increases pressure on the leg veins and weakens blood flow towards the heart — every extra kilogramin strains the veins
Moderate riskProlonged standing and sitting
Working standing up for long hours (hairdressers, surgeons, teachers) or prolonged sitting at a desk weakens pump leg muscles
Moderate riskExcessive heat
Sun, hot baths and sauna dilate the veins and weaken their walls over time
Moderate riskHormones and contraceptive pills
Hormonal medications weaken vein wall elasticity — contraceptive pills and hormone replacement therapy
Moderate riskSymptoms and Stages of Varicose Veins
Varicose veins develop progressively through escalating stages. Early detection allows treatment with the simplest techniques and least تallcostly.
Stage 1 — Early Hidden Symptoms
Symptoms begin mildly and may pass unnoticed. The veins arethe invisible.
Stage 2 — Appearance of Dilated Veins
The veins begin to appear visibly under the skin. Symptoms worsen especially in hot weather.
Stage 3 — Advanced Varicose Veins
Varicose veins are obvious and distressing, skin changes begin to appear. Medical intervention is necessary at this stage.
Stage 4 — Serious Complications
If left untreated, varicose veins may lead to serious medical complications requiring urgent intervention.
Complications of neglected varicose veins
Venous Leg Ulcer
Chronic skin wounds slow to heal due to poor vascular circulation — the most common complication varicose veins common
Thrombophlebitis
Painful inflammation of the dilated vein with blood clot formation — requires urgent treatment
Vein Haemorrhage
Rupture of the dilated vein causing bleeding under the skin or sudden external bleeding from a minor injury
Deep Vein Thrombosis
Clotting in the deep veins — a medical emergency that can be dangerous if the clot travels to the lungs
Permanent Skin Pigmentation
Dark brown patches on the skin around the ankles resulting from iron deposits from red blood cells from cells blood red
Chronic Venous Insufficiency
progressive permanent weakening in venous function making treatment more difficult and worsening skin changes