1) Heredity plays one of the most powerful roles in their formation. After treating veins for 14 years, Dr. Galati has seen a direct correlation between the patient’s veins and their mother’s and/or father’s veins. Varicose and Spider veins almost always run in families. The old adage, “next time pick your parents well” often brings a smile or laughter to the face of a patient. Getting back on point, heredity may be the single most important player. We have patients as young as 17 years old with moderate cases of venous disease. These patients can relate another person in the family with the same problem. Sometimes it is the mother , father, and many times their grandparents. Siblings are sometimes also affected or the condition may have skipped over their brothers and sisters. The good doctor has treated women with a large varicose vein on the inside of the right leg, often these patients will say” my mother has the same vein in the same place”. The old saying “our child has your nose and my eyes” drives home the importance of the force heredity has on the formation of genetic expression of many health conditions. No where is this most evident than in male varicose veins. Although other factors can be at work, we have seen a direct link between familial inheritance.

2) The Estrogen cycle plays a large role in the expression of spider and varicose veins in women. The monthly cycle of increasing and decreasing levels of estrogen are beyond a doubt another key player for the formation of these ugly skin blemishes. Women on hormone replacement therapy (HRT) or those who take birth control pills for long durations are usually

more at risk for this condition to flourish. Again, we have seen a direct correlation between these drugs and increased risk of venous disease of varying degree. Does this mean women should stop the use of these medications? Actually, using the lowest dosage is the best approach. Consult your family physician regarding any changes in dosing. Many women are using more natural forms or HRT through holistic doctors with great success. The result has been less risk ofvenous disorders in many of these patients.

3)  Standing on your feet for long periods of time, especially in the same place, such as a cashier allows gravity to pull down towards the feet. This causes dilation of the veins and damage to the one way valves found in veins. Once damaged the blood flows downwards, expanding the vessels and causing blowouts or those red and purple blemishes we call talangectasias and venulectasias along with the bulging varicose veins. These are often associated with an aching pain and burning during the work day. So what is a person supposed to do? Quit their jobs? No, but the use of support hose can really help. If you go this route, order medical support stockings not cheap over the counter versions. These stockings can make a world of difference. If you need to order something of this nature, contacting Dr. Galati and his staff can help you with this item. At least you can slow down the progression of venous disease and reduce the pain. Then when you are ready to be treated for your condition, you will have prevented your problem from getting more expansive and difficult to treat. People that spend all day on their feet should consider using conservative measures to prevent further damage to an already pre-existing condition. It may also prevent the condition from getting a foothold. Prevention is very important.

4)  Child bearing is one of the known causes for varicosities. As the fetus grows in the mothers pelvic region, it presses against the veins that bring blood back to the heart. This blockage or impeded flow causes increased pressure in all veins bellow the pelvis. These veins swell with pressure and expand in the thighs, legs and feet. These are the varicose veins seen during and after pregnancy. Many women can accurately say “this vein was from giving birth to Peter, this one from Laura and this one from Johnny.” There are also many hormonal changes taking place during pregnancy that causes change in the legs of women. Wearing support hose during pregnancy can prevent much venous expansion. Any vein treatment should not start for 6-9 months after pregnancy; this is because most of the time many of the veins

brought on by pregnancy subside by the ninth month after giving birth. Vein treatment absolutely should never begin until breast feeding is ceased.

5)  Impact injury to the thigh and leg is another cause for this condition to arise. We noted many patients who have sustained injury to certain parts of their legs will sometimes develop varicose veins in that exact area. A good example is soccer players. Many of them get kicked over and over again behind their calves. This region is a site where large painful veins develop. The valves in the veins get damaged. The injury causes blood to flow towards the feet again causing pressure in the veins and the ballooning of new vein disease. Note over and over again you’ll hear Dr. Galati say the blood is not flowing to the heart as it should but has a tendency to flow to the feet. This is one of the underlying causes of varicose and spider veins. Probably the most significant cause in most venous disease regardless of what causes this reversal of blood flow.

6)  Obesity: this is another cascade in the myriad of causes of unwanted vein development. Fat contains one part fat and two parts water. Fat or adipose tissue, is a storage depot for water and fat used for energy. Obesity = too much, fat =overloading the body with too many fluids. The strain of weight from gravity overloads the lymph vessels and veins with too many fluids. This causes the vessels’ valves to fail, which in turn causes new veins to appear. Dr. Galati has several patients that weighed 260-375 lbs. The patients that lose much of the weight through careful dieting lost as much as 75% of all the veins that they wanted treated . We feel the obese patient should lose weight through a sensible diet program and then consider any veintreatment thereafter.

7)  High heeled shoes, too? Yes they have found a way on our list of causes. Now, how can high heeled shoes cause varicose and spider veins? Picture a bare foot making contact with the floor. First the heel strikes the ground and then the whole foot strikes the ground. (cont.)