Varicose veins are twisted, enlarged veins that can appear in various parts of the body, most commonly in the legs (and sometimes the feet). While often viewed as a cosmetic concern, varicose veins indicate poor venous circulation. In severe cases, they can progress to chronic venous insufficiency, leading to significant health complications. But do you know the different types of varicose veins and how to distinguish those that are merely cosmetic from those that can cause serious symptoms?

Types of Varicose Veins and Their Symptoms

Varicose veins are primarily classified by their size, color, and depth, which also determines the severity and required treatment. Below are the main types:

• Telangiectasias (“Spider Veins”):

These are small, superficial veins less than 2 mm in diameter, located just beneath the skin. They typically appear as red or blue lines, often on the legs or face, and may form web-like patterns (hence “spider veins”). While they pose no serious vascular risks, they can affect the skin’s aesthetic appearance.

• Reticular Varicose Veins:

Slightly larger, measuring 1–3 mm in diameter, these veins appear bluish or greenish and often form a network-like pattern. While generally not associated with significant symptoms, they can cause sensations of heaviness, fatigue, or discomfort in the legs.

• Truncal Varicose Veins:

The most severe type, these veins are visibly swollen, twisted, and dilated, with a diameter of approximately 4 mm or more. Often referred to as “bulging veins,” they appear bluish-purple on the skin’s surface. Truncal varicose veins are a sign of venous insufficiency and can cause symptoms like extreme leg fatigue, swelling, itching, redness, and a burning sensation. Advanced cases may lead to eczema, painful ulcers, and an increased risk of superficial vein inflammation (phlebitis) or blood clots (thrombophlebitis).

Causes and Prevention of Varicose Veins

The venous system consists of arteries (carrying oxygen-rich blood from the heart to tissues) and veins (returning oxygen-depleted blood back to the heart and lungs). In the lower body, venous circulation works against gravity, requiring healthy vein valves to prevent backflow. When these valves malfunction, blood pools in the veins (venous reflux), causing them to enlarge and become varicose.

Several factors contribute to valve dysfunction and vein wall dilation, including:

• Hormonal influences (especially in women).

• Prolonged sitting or standing.

• Family history.

• Aging.

• Pregnancy.

• Use of contraceptives.

• Obesity.

• Smoking.

• Sedentary lifestyle.

Prevention Tips:

• Use compression stockings to support venous return.

• Exercise regularly to improve circulation.

• Maintain a healthy weight.

While prevention is not always possible, these strategies can reduce the risk of developing varicose veins.

Treatment Options

If varicose veins are already present, various treatments are available depending on their size, depth, and severity:

1. Endothermal Ablation:

This technique uses heat from lasers to cauterize and eliminate smaller varicose veins.

2. Sclerotherapy:

Best for small-caliber veins, this involves injecting a solution that scars and closes the affected veins. Multiple sessions may be needed for optimal results.

3. Phlebectomy (Surgical Removal):

For larger, more severe veins, surgical removal may be necessary.

Emerging Therapies and Natural Compounds

Recent studies highlight the role of oxidative stress in the development of chronic venous insufficiency and varicose veins. Reduced antioxidant defenses, increased reactive species production, and inflammation contribute to endothelial dysfunction, loss of vein elasticity, and venous reflux.

Natural Compounds in Focus:

• Flavonoids and Saponins: Found in Ginkgo biloba, Aesculus hippocastanum (horse chestnut), and Pinus pinaster (maritime pine).

• Derivatives like Rutin, Diosmin, and Pycnogenol: These compounds improve microcirculation, reduce endothelial fragility, and show therapeutic potential for varicose vein management.

By integrating natural remedies with traditional therapies, it is possible to optimize treatment outcomes and enhance the quality of life for individuals affected by varicose veins.