What Are Varicose Veins?
Varicose veins can be seen just under the surface of the skin. These veins are swollen, twisted, ropey veins that are often dark blue or red in color. They can often occur deeper under your skin where you are not able to see them.
Varicose veins usually occur in the legs. They also can appear in other parts of your body. Varicose veins are a common condition. Occur at a younger age in women than in men; who have varicose veins at the same rate as women only at an older age. They usually cause few signs or symptoms. Aside from their unpleasant appearance, other side effects of varicose veins include pain, fatigue, itching, burning, swelling, cramping, restlessness and throbbing, which will worsen over time if left untreated and can lead to serious circulatory ulcers.
Veins are blood vessels that carry blood back from your body’s tissues to your heart. The heart then pumps the blood out to your body through your arteries. Veins have one-way valves that help keep blood flowing toward your heart. If your valves are weak or damaged, blood can back up and pool in your veins. This will damage your veins causing them to swell and can lead to varicose veins.
Many factors may increase your risk for varicose veins including heredity or family history, your age and gender, pregnancy, being overweight and jobs with lack of movement. Varicose veins are treated are to relieve symptoms, prevent complications, and improve appearance.
A number of treatments are available for varicose veins that are quick and easy and don’t require a long recovery time.
Vein Problems Related to Varicose Veins
A number of vein problems are related to varicose veins, such as spider veins, telangiectasias (tel-AN-juh-ek-TA-ze-uhs), varicoceles (VAR-i-ko-seals), venous lakes, reticular veins, and hemorrhoids and other vein problems.
What Causes Varicose Veins?
The causes are unclear although there are many associated factors. Disease or trauma can damage valves in the veins can leading to varicose veins. A family history and multiple pregnancies are clearly associated with varicose veins.
Your veins return the blood to your heart, in your legs they must work against gravity to do this.
The one-way valves inside the veins open to let blood flow through and then shut to keep blood from flowing backward. If the valves are weak or damaged, blood can back up and pool in your veins. This causes the veins to swell. The backflow of blood fills the veins and stretches the walls of the vein even more. As a result, the veins get bigger, swell, and often get twisted as they fill with larger and larger amounts of fluids trying to return to the heart. These veins over time become varicose veins.
Figure A shows a normal vein with normal blood flow. Figure B shows a varicose vein with a deformed valve, abnormal blood flow, and thin, stretched walls. The middle image shows where varicose veins might appear in a leg.
Risks for Varicose Veins?
A number of factors may increase your risk for varicose veins, including family history, age, gender, pregnancy, being overweight and lack of movement.
Having family members who have varicose veins may raise your risk for the condition. About half of all people who have varicose veins have a family history of them.
Varicose veins general get worse with increasing age. The normal wear and tear of aging may cause the valves in your veins to weaken and not work as well.
Women tend to get varicose veins more often than men. Hormonal changes that occur during puberty, pregnancy, menopause, or with the use of birth control pills may raise a woman’s chances of getting varicose veins.
During pregnancy, the growing fetus puts pressure on the veins in the legs. Varicose veins that occur during pregnancy usually get better within 3 to 12 months of delivery.
Overweight or Obesity
Being overweight or obese can put extra pressure on your veins. This can lead to varicose veins.
Lack of Movement
Standing or sitting for a long time, especially with your legs bent or crossed, may raise your risk for varicose veins. This is because staying in one position for a long time may force your veins to work harder to pump blood to your heart.
What Are the Signs and Symptoms of Varicose Veins?
The signs and symptoms of varicose veins include:
- Large veins that you can see on your skin.
- Mild swelling of your ankles and feet.
- Painful, achy, or "heavy" legs.
- Throbbing or cramping in your legs.
- Itchy legs, on the lower leg and ankle. Which is often is diagnosed as dry skin.
- Discolored skin around the varicose vein, the feet and ankles
- Signs of spider veins on the legs
- Restless legs at night
Diagnosing Varicose Veins
Varicose veins are often diagnosed based on a physical exam alone. Health insurance companies will only reimburse for treatments when symptoms have reach a certain threshold. To further Evaluate your condition an ultrasound test is performed. After Dr O. receives the results she can discuss your condition and develop a treatment plan for your unique situation.
Your physical exam
To check for varicose veins in your legs, Dr. O will look at your legs both while you’re standing and again with you sitting with your legs dangling. She will ask you about your signs and symptoms, including any pain you're having. Lastly, she will discuss your answers to the quality of life questionnaire that you complied with your health history paperwork.
The Doppler ultrasound will check and measure the blood flow in your veins and look for any blood clots you may have. Ultrasound uses sound waves to create pictures of internal structures in your legs. During this test, a handheld device will be passed back and forth over your legs. The ultrasound unit will then convert the sound waves into a picture of the blood flow in your arteries and veins. A number of measures are taken that Dr O will use to quantify your vein condition.
Treatments for Varicose Veins - Conservative Measures
Treatments most often begin with conservative measures, lifestyle changes; exercise and medical compression hose are trialed for three months in many patients. The goals of treatment are to relieve your symptoms, prevent possible complications, and improve your quality of life. If conservative measures are not successful a number of other treatments will be explored.
If your symptoms are more severe, if you have significant pain, blood clots, or skin disorders as a result of your varicose veins, Dr O may recommend one or more procedures.
Treatment of Varicose Veins - Procedures
Procedures for treatment are done either to remove or to close the veins. Removing or closing the veins usually doesn’t cause problems with blood flow because the blood is redirected to veins deeper in your legs.
In sclerotherapy (SKLER-o-ther-a-pe) a liquid chemical closes off the varicose vein being treated. The chemical that is injected in the vein causes irritation and scarring inside the vein. This in turn cause it to close off, and with time the closed vein is reabsorbed by the body.
This technique is best suited for treating smaller varicose veins and spider veins. Treatments are typically done every 4 to 6 weeks.
Minimally Invasive Vein Ablation Treatment
Vein ablation is a technique that destroys varicose veins. This procedure is considered a minimally invasive technique because it is performed though a very small incision under local anesthesia with the patient awake. After the 20 to 30 minutes procedure patients walk out of the procedure room and resume their normal activities.
Dr O makes a tiny cut in your skin near the varicose vein and inserts a thin tube known as a catheter. The treatment sends bursts of energy through the catheter that is placed in the varicose vein; the resulting heat contracts the vein wall tissues along the length of the vein closing it to blood flow. The energy is supplied from either a radiofrequency generator or a laser. The procedure has a low risk of side effects and is monitored with ultrasound imaging during the procedure. Minimally Invasive Vein Ablation relieves most symptoms and often improves the appearance of your legs.
Sometimes, if your varicose veins are large and close to the surface of your skin, a procedure called ambulatory phlebectomy or sometime a microphlebectomy will be need to relieve your symptoms. In a phlebectomy Dr O will make small cuts in your skin to remove small varicose veins. You will be awake during this procedure as with all our vein procedures, but your leg will be numbed in the area around the vein being removed.
Preventing Varicose Veins?
You can't prevent varicose veins from forming. However, you can prevent the ones you have from getting worse. You also can take steps to delay other varicose veins from forming.
Avoid standing or sitting for long periods without taking a break. Raising your legs when sitting, resting, or sleeping will take pressure off your veins. Try raising your legs above the level of your heart. Physical activities that get your legs moving and improve muscle tone are helpful..
Avoid gaining weight if you are overweight start a diet and exercise program. This will improve blood flow and ease the pressure on your veins. Wear compression stockings or support hose. These create gentle pressure up the leg helping keep blood from pooling in the veins and decreases swelling in your legs and feet.
Living With Varicose Veins
Varicose veins are common. They will not improve with time so it is important to take steps to minimize their impact on your life. If your symptoms bother you or worsen consult Dr O. She will help you to feel better and develop a treatment plan to manage you condition.