Etiological factors:

There are various factors which are responsible for this condition, such as:

• Genetic cause– It can pass from one generation to another, known as hereditary factors.

• Environmental factors: An accident because it put pressure on the valve, and the valve gets weaker and damaged, which hamper the blood circulation due to impaired gravity.
• Overstretching of muscles.
• Prolonged standing in one place.
• Lifestyle-In the present time, people used to follow an unhealthy lifestyle included eating food from outside rather than the home that may lead to obesity, which becomes the major cause of varicose veins.

Biological factors:

• Changes in hormones according to different phases of life.
• Stress.
• Uses of contraceptives.
• Constipation
• Past medical history.
• Tissue impairment.

Types of varicose veins:

• Greater saphenous varicose are allied with great saphenous vein, and it is the most commonly contaminated vein. Its beginning point is inside of the ankle and expands up to the groin.
• Lesser saphenous varicose veins are a small valve disease.
• Branch type varicose veins are typically formed in the greater and lesser saphenous veins and develop in-branch vessels. It is usually found beneath the knees.
• Genital area varicose veins are external genital areas include the Mons pubis, labia majora, labia minora, Bartholin glands, and clitoris. The area containing these organs is called the vulva. Three main functions: Enabling sperm to go into the body, defending the inner genital organs from infectious organisms. 
• Reticular type varicose veins are tiny, blue, or green widen veins that emerge 1mm to 3mm in diameter in parts like legs and the face. This condition is typically smaller than varicose veins but larger than spider veins and appears flatter and less twisted.

Sign and symptoms:

• • Feeling of heaviness in legs.
  • Veins become bulge and prominent.
  • Muscle burning and cramping.
  • Worsen Pain.
  • Irritation.
  • Skin becomes cyanosed.
  • Inflammation.
  • Heaviness in legs.

     

Diagnostic finding:

• • History collection
  • Physical examination 
  • Doppler study: This test is performed to measure the blood supply under the veins and arteries with high-frequency sound waves.
  • Color duplex ultrasonography.

Management:

* General management-Patient should alter their lifestyle as:

* Do daily exercise.

* Avoid long timing standing or sitting in one position.

* Wear loose and comfortable clothes; avoid tight dresses.

* Use compression stocking to maintain the blood flow.

* Always do massage on legs to circulate blood properly.

* Medical management: There is no specific kind of medication to treat the varicose veins.

* Sclerotherapy- It is the medicinal process used to abolish varicose veins and spider veins. It involves an injection of a solution (generally of salt)directly injected into the veins. This treatment is used for small varicose veins. It allows the veins to scar, forcing blood to reroute through healthier veins.

* Surgical Management:

* Subfascial Endoscopic Perforator Surgery(SEPS) is a simple seizure approach for the ligation of irregular perforator veins under the legs’ muscle fascia. It involves making a small incision in the calf region for placement of the endoscope. Sutures are placed under the affected area to minimize the scarring, and recovery time is minimal as the well.-This procedure takes 2-3 hours, and recovery takes two weeks.

* Laser surgery: This procedure is performed to treat small varicose veins. The laser fiber catheter passed through a thin vein. During this process, the surgeon watches the vein on the duplex ultrasound screen, Laser treatment is not as much of excruciating than vein ligation and stripping, and it takes less time in recovery.

Preoperative and postoperative implications:

Preoperative instructions- 

• Wear compression stockings.
• Follow a healthy diet.
• Drink Planty of fluids.
• Avoid coffee and tea.
• Remove all accessories and lotion from the skin.

Postoperative instruction:

• Remove compression sticking in the daytime.
• Intake of medication timely.
• Take a warm bath every day.
• Start Swimming.

Myths of Varicose Vein and spider vein

• Using high heels daily give rise to varicose vein
• Varicose veins do not cause any complications
• Sitting by crossed legs develops varicose veins
• Varicose veins treatment surgeries are expensive

Risk factors :

Age: Risk of varicose increases with age. Aging causes tear and wear on the valves.

Sex: women are more prone to this condition as they suffer from hormonal changes due to puberty, pregnancy, and menopause.

Pregnancy: In pregnancy, the blood flow increase in the body.

Family History: If any person in the family suffers from this condition, there is a risk to the next generation.

Obesity: Over body mass index is also has more effect on legs.

Standing or sitting for long periods: Your blood does not flow as well if you bare in the same position for long periods.  

Complications:

* Ulcers: Painful ulcers maybe form on the affected area, particularly near the ankles.

* Blood clots: If the clots form in veins located just under the affected skin, it could lead to conditions such as:

• Thrombophlebitis: swelling of the veins in your legs and ankles.
• Deep vein thrombosis: which can cause pain and swelling in the legs and may lead to serious conditions pulmonary embolism. 

* Bleeding: sometimes, you can face bleeding issues by varicose veins near the surface of the skin, and it can occur due to any reason like a small cut there, and it may become difficult to stop bleeding. You should lie down, raise your legs, apply directly to the wound, and seek immediate medical advice if this does not stop the bleeding.

Prevention:

There’s no way to prevent varicose veins completely. But uplifting your circulation and muscle tone may lessen your possibility of developing varicose veins or getting additional ones. The precaution for varicose veins at home can help prevent varicose veins, including:

• Exercising.
• Watching your weight. 
• Eating a high fiber, low salt diet.
• Elevating your legs.