Varicose Veins

Varicose veins are enlarged veins most commonly found on the inside of the leg or on the backs of the calves. Pregnant women may also have varicose veins near the vagina or anus. Treatment for varicose veins may involve sclerotherapy, endovenous techniques, or various surgeries. Most people experience good results from treatment, although some varicose veins will recur (come back).

 

What Are Varicose Veins?

Varicose veins are enlarged veins that can be flesh-colored, dark purple, or blue. They often look like cords, and appear twisted and bulging. They are swollen and raised above the surface of the skin. Varicose veins are commonly found on the backs of the calves or on the inside of the leg. During pregnancy, varicose veins called hemorrhoids can form in the vagina or around the anus.
 
About 50 to 55 percent of American women and 40 to 45 percent of American men suffer from some form of vein problem. Varicose veins affect 1 out of 2 people age 50 and older.
 

What Causes Varicose Veins?

The cause of varicose veins is a weakening of one-way valves within the veins. When these valves weaken, blood can leak back in the vein and collect there and enlarge the vein.
 

Gravity and Varicose Veins

The force of gravity, the pressure of body weight, and the task of carrying blood from the bottom of the body up to the heart make legs the primary location for varicose and spider veins. Compared with other veins in the body, leg veins have the toughest job of carrying blood back to the heart. They endure the most pressure. This pressure can be stronger than the veins' one-way valves.
 

Risk Factors for Varicose Veins

While not causes of varicose veins, there are a number of factors that increase a person's chances for developing weakened valves. These are known as varicose vein risk factors. The more risk factors a person has, the greater their chances for developing the condition.
 
Risk factors for varicose veins include:
 
  • Increasing age
  • Genetics
  • Hormonal changes
  • Pregnancy
  • Obesity
  • Leg injury
  • Prolonged standing.
     

Symptoms of Varicose Veins

Varicose veins symptoms include swollen, aching legs that feel "heavy," numbness in the legs, and itching or a rash on the legs. If left untreated, varicose veins can become more severe, which in turn, makes the symptoms of varicose veins symptoms more severe -- they can even lead to other health problems, such as blood clots.
 

When to See a Doctor Regarding Varicose Veins

When deciding whether to see your doctor about varicose veins, consider if they have become swollen, red, or very tender or warm to the touch. If they have, see your doctor. If they have not, but there are sores or a rash on the leg or near the ankle with the varicose vein, or you think there may be circulation problems in your feet, see your doctor.
 
If none of these issues are present, continue to follow the varicose veins self-care tips discussed in Prevention of Varicose Veins.
 

Diagnosing Varicose Veins

In order to make a varicose veins diagnosis, the healthcare provider will ask a number of questions and perform a physical exam looking for signs and symptoms of varicose veins. He or she may also recommend an ultrasound to look for how the blood is flowing and possible causes of the varicose veins.
 

Treatment for Varicose Veins

Once a diagnosis of varicose veins has been made, your healthcare provider will consider a number of factors before recommending a varicose vein treatment option. For some varicose veins, treatment may involve compression stockings or other strategies that do not require surgery, such as losing weight, increasing muscle tone, and physical activity (see Prevention of Varicose Veins for more information). In other cases, treatment for varicose veins may include:
 
  • Sclerotherapy
  • Endovenous methods (such as vein ablation) that use radiofrequency or a laser
  • Surgery (see Varicose Vein Surgery).
     

Varicose Veins and Other Health Conditions

Varicose veins usually enlarge and worsen over time. Severe varicose veins can cause health problems. These include:
 
  • Severe venous insufficiency. This severe pooling of blood in the veins slows the return of blood to the heart. This condition can cause blood clots and severe infections. Blood clots can be dangerous, because they can move from leg veins and travel to the lungs. Blood clots in the lungs are life-threatening, because they can keep the heart and lungs from functioning properly.
     
  • Sores or skin ulcers can occur on skin tissue around varicose veins.
     
  • Ongoing irritation, swelling, and painful rashes on the legs.
     

Varicose Veins: Prognosis

Current treatments for varicose veins have high success rates compared to traditional surgical treatments. Over a period of years, however, more varicose veins can develop. The major reason for this is that there is no cure for weak vein valves.
 
The single most important thing a person can do to slow down the development of new varicose veins is to wear graduated compression support stockings as much as possible during the day.
 

Preventing Varicose Veins

Prevention of varicose veins begins by:
 
  • Knowing the varicose vein risk factors and the ones that apply to you (see Cause of Varicose Veins)
     
  • Making lifestyle changes to decrease your risk factors
     
  • Improving blood circulation and muscle tone.
     
Unfortunately, for a lot of people, preventing varicose veins is easier said than done; they can do all the right things, but there are still risk factors that they cannot control. With that said, if varicose veins do develop, the strategies discussed in Prevention of Varicose Veins can also help ease discomfort caused by the varicose veins you already have.
 
Written by/reviewed by: Arthur Schoenstadt, MD
Last reviewed by: Arthur Schoenstadt, MD