Varicose Veins

What are varicose veins?

Varicose veins are enlarged, twisted veins. They can happen anywhere in the body. But they are more common in the legs.

Varicose veins are not considered a serious health problem. But they can be uncomfortable and can lead to more serious problems. And because they may be very noticeable, they may cause people to feel uncomfortable or embarrassed.

Spider veins, a milder type of varicose veins, are smaller than varicose veins and often look like a sunburst or "spider web." They are red or blue in color and are often found on the face and legs, just under the skin.

What causes varicose veins?

Varicose veins are caused by increased blood pressure in the veins. They can occur in the veins near the surface of the skin.

The blood moves towards the heart by one-way valves in the veins. When the valves become weakened or damaged, blood can collect (pool) in the veins. This causes the veins to become enlarged. Sitting or standing for a long time can cause blood to pool in the leg veins. This increases the pressure in the veins. The veins can stretch from the increased pressure. This may weaken the walls of the veins and damage the valves.

Who is at risk for varicose veins?

You are at risk for varicose veins if you:  

  • Are overweight or obese
  • Are older in age
  • Have a family history of the condition
  • Are a woman
  • Are not physically active
  • Have had a leg injury
  • Are pregnant
  • Smoke
  • Use birth control pills (oral contraceptives) or hormone replacement

What are the symptoms of varicose veins?

The most common symptoms of varicose veins are:

  • Color changes in the skin
  • Sores on the legs (leg ulcers)
  • Rash
  • Sensations in the legs, such as a heavy feeling, burning, or aching

Over time, severe varicose veins may lead to long-term mild swelling. That can result in more serious skin and tissue problems. These include ulcers and nonhealing sores.

The symptoms of varicose veins may look like other health problems. Always talk with your healthcare provider for a diagnosis.

How are varicose veins diagnosed?

Your healthcare provider will ask about your health history and do a physical exam. You may also need a duplex ultrasound. This test is a type of ultrasound that checks blood flow and the structure of the leg veins. Duplex means 2 kinds of ultrasound are used.

How are varicose veins treated? 

Treatment will depend on your symptoms, age, and general health. It will also depend on how severe the condition is.

If you don’t have symptoms, you may not need treatment. But varicose veins may sometimes get worse without treatment. If you need treatment, it may include:

  • Leg elevation. You may be instructed to raise (elevate) your feet above your heart 3 or 4 times a day for about 15 minutes at a time. If you need to sit or stand for a longtime, bending (flexing) your legs now and then can help keep blood circulating. If you have mild to moderate varicose veins, elevating your legs can help reduce leg swelling and ease other symptoms.
  • Compression stockings. These elastic stockings squeeze the veins and prevent blood from pooling. They can be effective if they are worn every day.
  • Sclerotherapy. This is the most common treatment. A chemical is injected into the affected veins. The chemical causes scarring in the veins so that they can no longer carry blood. Blood then returns to the heart through other veins. The body absorbs the scarred veins.
  • Endovenous laser ablation or radiofrequency ablation (RFA). This is a minimally invasive procedure. A tube (catheter) puts heat right into the affected vein. This closes the vein. Once the vein is closed, less blood pools in the leg. Overall blood flow is improved.
  • Vein stripping. In more severe cases, the surgeon may tie off and remove veins by making small cuts in the skin.
  • Microphlebectomy. Special tools inserted through small cuts (incisions) are used to remove varicose veins. Microphlebectomy may be done in your healthcare provider’s office. It may be done alone or with vein stripping.

What are possible complications of varicose veins?

Varicose veins are often not serious. But complications may happen. They include:

  • Inflammation or swelling of veins (phlebitis)
  • Blood clots
  • Pulmonary embolism (when a piece of a blood clot may break off and travel to the lungs)

What can I do to prevent varicose veins?

You may help prevent varicose veins by:

  • Keeping a healthy weight
  • Exercising regularly
  • Putting your feet up while sitting
  • Not crossing your legs while sitting
  • Not wearing tight clothing

Key points about varicose veins

  • Varicose veins are enlarged, twisted veins. They are not often a serious health problem.
  • Varicose veins can happen anywhere in the body. But they are more common in the legs.
  • Varicose veins are caused by increased blood pressure in the veins.
  • Many factors may raise the risk for varicose veins, such as being overweight, smoking, and being physically inactive.
  • Raising (elevating) the legs and wearing compression stockings can help treat varicose veins. More serious cases may require surgery.
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