AS PER clamor and request of our female readers, patients and friends, this column will carry in two-issue installments about varicose veins.

Varicose veins are visible, large surface veins felt under the skin. Generally, they are larger than one-eighth inch in width and are usually located along the inside parts of the calf or thighs.

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Varicose veins develop due to weakness of the wall of the vein and also, due to the dysfunction of the valves of the veins, Valves work by maintaining a column of blood steady on its journey back to the heart- which is going against gravity- so a weak valve allows some blood to be pulled down by gravitational forces.

Under the pressure of gravity, these veins can continue to expand and in due time, they may become longer, twisty, pouched, thickened and worse, painful.

Other vein disorders are often mistaken as varicose veins. Spider veins or telangiectasias are tiny veins that are easily seen but they are not readily palpated or felt and are usually located at the superficial skin layers. They are purple or greenish-blue veins that appear in the legs. Reticular veins are larger than spider veins but smaller than varicose veins and may cause symptoms whereas as a rule, spider veins do not cause any discomfort, much less pain.

Vein problems are among the most common chronic conditions. In fact, more people lose work time from vein disorders than from artery disease. Varicose veins affect up to 25% of women and 15% of men. By age 50, nearly 40% of women and 20% of men have significant leg vein problem.

The most important factors leading to the development of of varicose veins include family history- so if your lola or mom had it, chances are the daughters may also have it-; prolonged standing - OR nurses assisting long surgeries like brain tumor- increasing age, heavy lifting, prior blood clots in superficial or deep veins, and multiple pregnancies.

Varicose veins may be entirely symptom-free and cause no immediate health problem. Treatment in such cases is usually considered cosmetic. When symptoms are present, the most common are ankle and leg swelling, heaviness or fullness, aching, restlessness, fatigue, pain, cramps and itching. Varicose veins can also be associated with ulcers or sores of the leg. In the most severe cases, varicose veins may lead to thickening and discoloration of the skin of the legs, eczema and non-healing sores around the ankle area. Varicose veins when they are very large are at risk of forming a large blood clot, a condition known as thrombophlebitis

You cannot do anything about your heredity, age or gender. However, you can help delay the development of varicose veins or keep them from progressing. Some things you can do is to be active, moving leg muscles to keep the blood flowing. Keep your blood pressure under control. To temporarily relieve symptoms, lie down and raise your legs at least 6 inches above the level of your heart. Do this for at least 10 minutes at least 3 times a day. And don't forget, strive for a normal weight.

Next week: Diagnosis and treatment of Varicose veins.