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What causes superficial venous insufficiency?

Veins are continuously pumping blood from the feet and legs to the heart against gravity. To facilitate this, veins have one-way valves that channel the deoxygenated blood back to the heart but prevent blood from flowing backwards in the reverse direction (reflux). Their dysfunction results in superficial venous insufficiency.



What are varicose veins?

Failure of these vein valves to close properly causes the blood to leak through the valves and result in pooling in the venous system. This is especially so in dependent areas where the blood tends to move down with gravity. Over time, this pooling will stretch the vein wall outwards, resulting in enlargement, bulging and tortuosity of the veins. These enlarged veins are varicose veins. Varicose veins can protrude from the skin surface resulting in a rope-like appearance. The same disease process can affect veins of any size.


What are spider veins?

When larger veins are involved, they are typically called varicose veins. When smaller veins are affected, they are typically called spider veins. Spider veins are small red, purple or blue veins located just below the surface of the skin. They can have a web-like appearance, hence, the term ‘spider’ vein. The are very common, especially in women. Around 85% of them are asymptomatic. This may be indicative of underlying venous disorder.



What are reticular veins?

Another type of vein is the reticular vein, which is also bluish but deeper than the spider veins, and often "feed" blood to the spider vein. These reticular veins need to be treated for the spider veins to be eliminated. They may be symptomatic, especially in dependent areas of the leg.


The term “varicose veins” commonly refers to the veins on the leg, although varicosities can occur elsewhere e.g. scrotum (varicocele), esophagus (varices), rectum (hemorrhoids) etc.

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