Varicose Veins

As many as 40 million Americans suffer from varicose veins, swollen veins that can be seen just under your skin’s surface. Most commonly found in the legs or pelvic area, varicose veins are abnormal, dilated blood vessels that often look blue, bulging and twisted. Sometimes varicose veins are surrounded by thin red capillaries called spider veins.

Overview and Symptoms

Veins have one-way valves to channel blood back to your heart. Varicose veins develop when a vein’s valve becomes weakened or damaged, allowing blood to pool in the vein. This enlarges the vein and it often becomes visible just below the skin.

Weakened or damaged vein valves can be caused by:

High blood pressure inside the superficial leg veins
Standing for long periods of time
Weakness in the walls of the veins

The most common symptoms of varicose veins include:

Heavy, tired, restless or achy feelings in your legs
Leg cramps that occur at night
Small visible clusters of veins in a winding pattern on your legs, or soft, tender knots of veins
Skin changes on your legs, such as color change, irritation or sores

These symptoms can become worse after standing or sitting for long periods of time. Other symptoms may include:

Veins visible through the skin, appearing enlarged, twisted and swollen (and sometimes blue)
Leg cramps
Burning or throbbing in the legs
Itching
Swollen legs
Swollen ankles and feet
Soreness behind the knee
Sores, known as venous ulcers, that develop in severe cases

Risk Factors

Family members with varicose veins
Gender: Nearly 50 percent of women ages 40 and 50, and about 75 percent of women ages 60 to 70 have varicose veins
Hormonal changes, such as with pregnancy or menopause
Pressure on the veins of the pelvis, as with pregnancy or constipation
Obesity
Working at a job that requires standing on your feet for long periods of time
Wearing knee-high socks or stockings with tight elastic
Previous leg injury
Use of birth control pills
Post-menopausal hormone replacement therapy
History of blood clots

While varicose veins can be easily seen in most cases, your doctor may also order an ultrasound of your leg veins to confirm the diagnosis.

Treatment

Sometimes, varicose veins are only a minor inconvenience. Treatment may or may not be needed. However, varicose veins can lead to more serious problems and get worse over time.

Wearing compression stockings can be an initial treatment option to try to relieve any symptoms you have. Otherwise, treatment may include minimally invasive or surgical procedures, such as:

Saphenous vein thermal ablation (Veinefit): a nonsurgical procedure using catheters to apply radiofrequency energy that shrinks and closes diseased varicose veins.
Microphlebectomy surgery: a minimally invasive procedure using tiny incisions to remove large varicose veins that are located close to the skin’s surface.
Vein stripping: a surgical procedure to tie off major varicose vein branches associated with your saphenous vein, the main superficial vein in your leg. The saphenous vein is then removed.
Adhesive sealant (VenaSeal) is a non-surgical procedure using a catheter to deliver an adhesive sealant to the site of the varicose vein. This seals the bulging vein and redirects blood flow to nearby healthy veins.