Varicose Veins and Spider Veins

Feel-Good Therapies for Pain and Splotches

Every year, Yvonne Williams dreaded summer. As warm weather approached, the 35-year-old wedding consultant from New York City worried about hiding her unsightlyvaricose veins.

"I would never wear shorts or skirts. Absolutely never," says Williams (who asked us not to use her real name). "I always wore pants, no matter how hot it was." Even dark-colored tights didn't help: The bulging veins in her calves were still noticeable, even through navy or jet-black tights.

For ten years, Williams lived with varicose veins--knotty, protruding, blue or purple veins that run along the lower legs, usually on the calves and behind the knees. Veins become varicose, or swollen, when valves along the vein's walls fail to do their job adequately. Normally these valves prevent blood from flowing back down when it's making a return trip to the heart. But when those valves start to weaken and gravity pulls blood toward the feet, the blood-vessel walls bulge like water-filled balloons. Blood pools in the lower legs, resulting in dull pain, heaviness and slight swelling of the ankles.

When Williams started to experience swelling, pain and night cramps in her legs, she decided to do something about her veins. First, she went the medical route. Her doctor performed sclerotherapy, in which an irritating fluid is injected into the troublesome veins. In response, the veins close, then shrivel and disappear. Her troubles were over--but only temporarily. For a more permanent and satisfactory solution, she still had miles to go.

A LEGACY YOU CAN AVOID

Varicose veins are hereditary--Williams's mother had them, and she, too, had undergone sclerotherapy. Williams's doctor told her that other veins in her legs could very likely become varicose since she was born with a predisposition to weak valves.

To prevent her healthy veins from giving her trouble, Williams's doctor prescribed calf raises and other exercises. Standing on a stack of books with her heels extended over the edge, Williams alternately raised herself on her toes and lowered her heels, repeating the exercise 50 to 100 times, once a day. She also made it a habit to raise up on her toes from time to time throughout the day, when she was standing. And she started walking 1½ miles a day, rain or shine.

Together, doing calf raises and walking improved Williams's blood circulation, pushing blood back toward her heart and preventing it from pooling in her legs. "The swelling in my legs never returned, and I don't get cramps at night," says Williams. "I finally started to wear shorts and skirts."

WHY GOOD VEINS GO BAD

The veins in your legs are some of the longest in the human body, where blood has to travel quite a distance on its way back to the heart. In most people, this is no problem. The veins in your legs are equipped with a series of 10 to 20 tiny valves that act like locks in a canal, allowing blood returning to the heart to collect at various points and then move on. In some people, however, these valves become faulty, so blood that was making its way up to your heart trickles back down. Over time, sections of your veins swell as the excess blood starts to collect.

Most people who get varicose veins are women. Evidently, the female hormone estrogen is partly to blame.

With the increased production of female hormones during pregnancy, the amount of blood coursing through your veins increases by a full 20 percent, overworking the valves. So having a baby--or several--is probably one of the biggest causes of varicose veins, says Luis Navarro, M.D., founder and director of the Vein Treatment Center and senior clinical instructor of surgery at Mount Sinai School of Medicine, both in New York City.

The weight of a growing fetus increases the resistence on blood that is traveling back to the heart; thus, blood is more likely to accumulate in the legs.

Or, you may reach the big 5-0 with nary a varicose vein in sight, only to experience problems later. No one is sure why, but as you get older, your blood vessels seem to lose elasticity. And if you work as a waitress, hairstylist, retail salesperson or in other occupations that keep you on your feet for hours, gravity will force blood to pool in your legs. This, together with a genetic predisposition to weak valves, can contribute tovaricose veins, says Dr. Navarro.

TAKING ON THE PROTRUDING INTRUDERS

The key to relieving varicose veins is to take action early. "Once you have varicose veins, medical treatment is the only way to get rid of them," says Dr. Navarro. "But you can relieve symptoms and prevent them from getting worse."

Stock up on stockings. Elastic support hose not only hide varicose veins, they help some people's legs feel better by compressing the veins, says Dr. Navarro. The constant pressure of the stockings keeps blood from collecting in distended areas of thevaricose veins and helps prevent aching and swelling.

The most effective support stockings are sold at medical supply stores and are available by prescription only. The amount of pressure the garment applies to your legs is rated numerically in millimeters of mercury (mm/Hg). The higher the number, the greater the pressure. Your doctor will prescribe what's right for you.

Put your calf muscles to work. Support hose feel great, but they only work while you're wearing them. For round-the-clock relief and prevention of varicose veins, exercise is easy and effective, says Dr. Navarro. Walking, running and cycling all help push stagnant blood from the bottom of the legs back to the heart.

"When you exercise your calf muscles, they act as a pump, taking over for weak valves," Dr. Navarro explains. "So the stronger your calf muscles, and the more you move them, the better."

Many women find that exercising on a regular basis helps to ease the pain and discomfort associated with varicose veins and can help prevent the condition from worsening.

Exercise while you sit. If you find yourself unable to get up and walk around at your office or in an airplane, for example, you can do simple exercises to help keep the blood in your legs pumping, says Dr. Navarro. Try this exercise once an hour: Flex your feet, lifting your toes while keeping your heels down, as though you're pumping a piano pedal. Repeat for a minute or two.

Invert your legs with yoga. Yoga poses that position your legs above your head can temporarily reverse the pooling of blood associated with varicose veins, says Carrie Angus, M.D., medical director for the Center for Health and Healing at the Himalayan International Institute of Yoga Science and Philosophy in Honesdale, Pennsylvania.

"Lie on the floor on your back, with your legs and feet raised up against a wall, for about five minutes," suggests Dr. Angus. "With this pose, gravity helps to push the blood back to the heart." To make this pose more comfortable, Dr. Angus suggests putting a pillow under your hips. Repeat once or twice a day. (If you have a history of back trouble, you may want to check with your doctor before trying this pose.)

Have some horse chestnut. The herb aescin, the extract from the dried seeds of the horse-chestnut plant, strengthens blood vessel walls, helping to prevent veins from softening and bulging, says Joseph Pizzorno, Jr., doctor of naturopathy and founding president of Bastyr University of Naturopathic Medicine in Seattle. "Horse-chestnut seed extract also reduces inflammation associated withvaricose veins and stimulates regeneration of damaged veins," he notes. In a study of 240 people with varicose veins (194 of them women), taking 50 milligrams of aescin twice a day for 12 weeks reduced swelling in the lower legs by 25 percent.

Concentrate on fiber. Eating a high-fiber diet can take some of the pressure off varicose veins, notes Dr. Navarro. If you're constipated, you tend to push too much and too frequently when you have a bowel movement, which puts extra pressure on the valves of your legs. Chronic constipation can be one of the accelerating factors leading tovaricose veins. "To relieve constipation, try a high-roughage diet with whole grains, like oats, barley, beans, peas, lentils, baked potato with the skin, brown rice and whole wheat, and plenty of vegetables and fruits," he says. Make sure that you increase your intake of water when you addfiber to your diet. Without water, adding fiber can make your constipation worse.

Seize your C. "To keep your veins healthy, you need to be sure that you're getting enough vitamin C, which is essential to strong blood vessels," says Dr. Angus. "I recommend 1,000 to 2,000 milligrams of vi-tamin C everyday to strengthen blood vessel walls and prevent bulging when they become distended with blood." Be careful though: Excess vi-tamin C may cause diarrhea in some people. If you get diarrhea, she says, cut back to between 500 to 1,000 milligrams per day.

Try an aromatic compress. Applying a cold compress soaked with witch hazel and essential oils to your legs helps soothe varicose veins, says Valerie Cooksley, R.N., holistic nurse and aroma practitioner in the Seattle area and author of Aromatherapy: A Lifetime Guide to Healing with Essential Oils.

To prepare the solution, put one-half cup to one cup of distilled witch-hazel lotion in a bowl and refrigerate it for at least one hour. Then add six drops of cypress (Cupressus sempervirens) essential oil, one drop of lemon (Citrus limonum) essential oil and one drop of bergamot (Citrus bergamia) essential oil. These oils and the cold witch hazel have an astringent effect--they shrink small blood vessels near the surface of the skin, temporarily reducing minor swelling, explains Cooksley.

To make the compress, soak a cloth in the bowl, then apply it to the affected area on your legs for 15 minutes. Elevate your feet on a few pillows as you apply the compress: That position helps the blood leave the legs and return to the heart. "The compress is very effective. You feel immediate relief as the swelling in the area goes down," she says.

Give homeopathy a try. Pulsatilla, a homeopathic remedy taken from the windflower plant, boosts circulation of stagnant blood, says Andrea Sullivan, Ph.D, a naturopathic and homeopathic physician in Washington, D.C. Recommended dosages vary from woman to woman. To determine how much you should take of this remedy, consult a homeopath or a naturopath, suggests Dr. Sullivan.Pulsatilla may not work for everyone with varicose veins, she says.

NATURAL STRATEGIES AGAINST SPIDER VEINS

At least 40 percent of women develop spider veins--networks of tiny red, blue or purple blood vessels that appear on the upper thighs, behind the knees and on the feet.

Spider veins appear when tiny blood vessels dilate near the surface of the skin, says David Green, M.D., a dermatologist at the Varicose Vein Center in Bethesda, Maryland. Most women would prefer to avoid them, if possible, since they are very unsightly.

As with varicose veins, one cause of spider veins could be the effect that the female hormone estrogen has on blood vessels. During pregnancy, nearly two-thirds of women will develop spider veins. About six weeks after delivery, pregnancy-caused spider veins usually disappear in most women.

Heredity also plays a role, says Dr. Green. "Ask a woman who has spider veins if her mom had them, and chances are that she says 'yes.'"

Spider veins may be a unsightly, but they rarely cause the pain and swelling of varicose veins, says Dr. Green.

Foods and Herbs to Try

Doctors treat the majority of spider veins the same way they do varicose veins--with sclerotherapy. But spider veins are like gray hairs--you can pluck them out as they appear, but that won't stop new ones from cropping up, says Dr. Green.

Alternative practitioners suggest a few strategies to help reduce the appearance of spider veins.

Put blueberries on your cereal. Eating foods like blueberries and raspberries provides bioflavonoids--natural compounds that help strengthen your blood vessels, says Dr. Pizzorno. "Bioflavonoids work with vitamin C and other nutrients in the body to help make capillaries less fragile." The darker the color of the fruit, like blackberries and cherries, the morebioflavonoids they have.

Eat all your grapefruit. The white membranes of citrus fruit such as oranges and grapefruit are also a rich source of bioflavonoids, says Dr. Pizzorno.

Go for ginkgo. Taking the herb ginkgo (Ginkgo biloba), which comes from the leaf of the ginkgo tree, also helps to strengthen the tissues that make up your vein walls, says Dr. Pizzorno. "Ginkgo is also high in bioflavonoids." Dr. Pizzorno recommends taking 40 milligrams of ginkgo three times a day for spider veins. These supplements are readily available in health food stores.