ask: How common (or rare) are varicose veins in young boys?

Kristin,

Thanks so much for your question. It's an interesting one!

To understand varicose veins, we need to understand a little about arteries and veins. Arteries carry fresh blood full of oxygen from the heart to the rest of our bodies. Veins then carry that blood BACK to the heart after the oxygen is used.

So veins in your legs are working against gravity: They have to carry that blood uphill all the way. To help in this, there are a series of small one-way valves inside the veins that open to let the blood through and then close afterward. These valves keep the blood from going backward.

If one of those valves is weak or damaged, blood can pool there, and that causes the varicose vein, the "lump" that you noticed on your son's leg.

Here's a great diagram and explanation from the National Heart, Lung and Blood Institute:

http://www.nhlbi.nih.gov/health/dci/Diseases/vv/vv_causes.html

Here's what the Mayo Clinic says about who is most at risk for varicose veins:

■Your age. Varicose veins occur most often in people ages 30 to 70, with your risk increasing as you age. Aging causes wear and tear on the valves in your veins that help regulate blood flow. Eventually, that wear causes the valves to allow blood to flow back into your veins where it collects instead of flowing up to your heart.
■Your sex. Women are more likely to develop the condition. Hormonal changes during pregnancy, premenstruation or menopause may be a factor. Female hormones tend to relax vein walls. Taking hormone replacement therapy or birth control pills may increase your risk of varicose veins.
■Genetics. If other family members had varicose veins, there's a greater chance you will too.
■Obesity. Being overweight puts added pressure on your veins.
■Standing for long periods of time. Your blood doesn't flow as well if you're in the same position for long periods.

Clearly, your son is neither in the primary age or gender group for varicose veins. Do any other family members (grandparents, aunts, uncles) have varicose veins? The best overall estimate that I saw said that varicose veins affect about 10-15% of men and 20-25% of women. (We hear more about them in women due to the varicose veins many women experience during pregnancy, and the fact that women tend to be more cosmetically sensitive to the veins' appearance.)

Also, here is the Mayo's page on treatment:

http://www.mayoclinic.com/health/varicose-veins/DS00256/DSECTION=treatme...

Did your doctor mention a particular form of surgery?

It's good your son isn't feeling pain. Pain in an area of varicose veins is something that always should be looked at by a doctor, as it might be an indication that a clot is forming.

Here's some more information about possible causes, this from medicinenet:

In other cases, weaknesses in the vein walls may cause the pooling of the blood. The walls of the blood vessels can become weaker and less competent than normal, causing the volume of blood in the veins to increase, leading to varicose veins.

Less commonly, varicose veins are caused by such things as:
-- phlebitis (inflammation of the veins),
-- blood clots or any obstruction to blood flow in the veins, or
-- congenital abnormalities of the veins.

Many people let their varicose veins go untreated, but it may be different in your case since your son is so young. Having it surgically removed would mean he wouldn't have to deal with it or the possible effects later in life.

Have you made appointments with either of the pediatric surgeons to discuss this? Do you know what procedure would be used?

Thanks for your great response, Diane! I really appreciate your time and research. Since it had been a couple of days since I asked my question, I was afraid you all had forgotten about me.

Today we consulted with a pediatric vascular surgeon and he had a bit of a different take from some of your info above. We went to see Dr. Stuart Lacey, who is an amazing surgeon. You can read and see photos from a surgery he performed last year to separate conjoined twins here: http://www.cbsnews.com/stories/2009/01/16/earlyshow/health/main4727080.s...

In any case, he definitely knows his stuff, and we had a very informative meeting with him. He believes that my son most likely will not need surgery, which is a huge relief. He does want to do some additional testing to confirm this, though. In the meantime, he's referring us to the Vascular Malformation Clinic located within Phoenix Children's Hospital. Apparently, vein malformations like my son's are very common -- so much so that there's a need for an entire clinic dedicated to this condition at PCH. And I'd never heard of this before. According to Dr. Lacey, this is simply a vascular anomaly that my son was born with. There was no cause, like an injury or anything. He just has a malformed vein in his leg. He probably won't have a problem with this anywhere else in his body. Apparently there are several different treatment options that we'll learn about once we visit the clinic and meet with one of the specialists there. Dr. Lacey said that most likely the scenario will be that we'll either not have to do anything at all to treat the vein, or we'll choose to explore the various treatment options with the clinic.

Obviously, this is such a relief. Any kind of surgery sounds scary to me! I'm really hoping that we can find some kind of treatment to make the lump go away because it is definitely noticeable and kind of weird to think that it's a vein sack filled with blood. Although Dr. Lacey said that it won't cause any kind of a threat to my son, and that he can do all the sports and activities he wants to, it still seems like it would be a nuisance, especially if it continues to grow.

Thanks again for your response. If you have any other thoughts or come across any treatment options, please let me know!

Kristin,

This is fascinating information! Thanks so much for writing me back!

It sounds like you've found the PERFECT doctor for your situation. Isn't that an amazing feeling? Especially when we're nervous about something and aren't sure about the answers. To feel like we're in the hands of a doctor (and a clinic) who knows everything there is to know about our situation is a huge weight off our shoulders.

The Mayo Clinic site has quite a bit of info on vascular malformations and their treatments. The treatments chosen generally reflect the complexity of the malformation itself. You may not know that until you have your appointment at the clinic (when is that, by the way?), but here's their info in case you do:

http://www.mayoclinic.org/vascular-center-sct/vascular-malformation-clin...

The Cincinnati Children's Hospital also has a page on this. Here's what they say about how vascular malformations are managed:

"Management of vascular malformations is dependent upon the type and location of the malformation as well as its depth. Observation and the use of supportive treatments (e.g., compression garments and drug therapy) are sometimes recommended. For lesions that are only superficial, laser therapy is commonly used. Lesions that are deep may, however, require surgical removal and other therapies such as sclerotherapy. While surgery is complex and was previously associated with the risk of blood loss, advances in technology now enable removal to be more safely performed. The management of combined vascular lesions is far more complex."

http://www.cincinnatichildrens.org/health/info/vascular/diagnose/malform...

Here's a very informative page from the Vascular Disease Foundation; there are tabs across the top that say What is it?, Symptoms, Risk Factors, Diagnosis, Treatment, Glossary, FAQs and Resources:

http://www.vdf.org/diseaseinfo/cvm/

And under Resources they have a few archived articles from their newsletter:

http://www.vdf.org/diseaseinfo/cvm/resources.php

When you learn more from Dr. Lacey and the clinic, let us know what happens next. It sounds like there are various treatment options that may be appropriate for your son. Will you update us?
Did you know there's a National Organization for Vascular Anomalies? Their website says that one in 10 children is affected by some kind of vascular anomaly, which can include port wine stain birthmarks, hemangiomas, lymphatic malformations and others in addition to vascular malformations:

http://www.novanews.org/

It looks like they're trying to start a blog and some support forums. Maybe something to watch in the future?

the vein causes the knee to swell when not wearing the stocking brace,looks like a bad,large birthmark,red. was there at birth

Hi there,
my name is Ruth and I have a 12 yo son. He is small for his age and has had different little problems with his health over the years. One thing I have noticed is that his legs are covered in veins. They are not varicose veins but they are dark, very visible and ALL OVER the lower half of his legs. His natural father died when I was expecting my son but I do remember that his father had large veins on his arms. His grand mother had some sort of problem with her legs as a younger woman and almost had them amputated but instead had extensive surgery and has had to swim or walk every day for the rest of her life to keep them working. Do you think that I should look into this?

Thanks Pat. I will talk with his grand mother and ask her to take him to her doctor as she knows all about her side of the family's medical history :0)

see my blog:
http://blog.mycvl.com/2011/01/varicose-veins-in-children.html

for a good explanation about varicose veins and children