Varicose Veins

varicose vein statisticVaricose VeinVaricose veins are enlarged, twisted, and bulging veins that can be flesh-colored, dark purple or blue. They are found most often under the skin of the calf and thigh. They develop in the system of superficial veins returning blood to the heart from the legs. Varicose veins range in severity from little or no complications to ulcerations of the skin. Varicose veins may cause some discomfort, but usually pose little threat to your health.

Causes

Varicose veins occur when there is increased pressure (venous hypertension) causing the vein to weaken. Pressure increases from gravity when we are standing or walking. It can also increase from sitting. Prolonged pressure leads to valve dysfunction, reflux, dilation of the vein, and chronc venous insufficiency. Varicose veins often begin during pregnancy as pressure from the enlarging fetus slows blood flow from leg veins and increases pressure within them. Varicose veins are more common in some families than others, indicating a genetic predisposition.

Risk Factors

  • Female gender
  • Advancing age
  • Family history
  • Prolonged standing
  • Obesity
  • Vascular malformation
  • Hormone therapy 

Warning Signs

Some common symptoms of varicose veins include:

  • Aching pain
  • Easily tired legs
  • Leg heaviness
  • Swelling in the legs
  • Darkening of the skin (in severe cases)
  • Numbness in the legs
  • Itching or irritated rash in the legs

Diagnosis & Prevention

Diagnosis of chronic venous insufficiency can be made with ultrasound. Venous disease is chronic however, measures to limit progressive enlargement of varicose veins are very effective. These include:

  • Use elastic compression stockings up to the knee.
  • Avoid prolonged sitting or standing.
  • Take frequent short walks to increase blood flow.
  • Avoid any tight garments around the thigh or calf, groin and waist.
  • Avoid wearing high-heeled shoes.
  • Elevate your legs. 
  • Don’t sit with legs crossed.
  • Pregnant women can wear elastic compression hose during the last trimester to help avoid the development of varicose veins, or to prevent their enlargement.

Treatment

  • Elastic compression stocking are a treatment as well as preventative
  • Chemical sclerotherapy – injection of sclerosing agents into the varicosity
  • Endovenous laser – minimally invasive therapy to close off the refluxing saphenous vein
  • Radiofrequency ablation – also a minimally invasive therapy to close off refluxing saphenous vein
  • Saphenous vein stripping – surgical removal of the saphenous vein
  • Stab or transilluminated phlebectomy – surgical removal of varicosities along the saphenous vein

Resources

Varicose Veins Educational Flyer

Focus on Varicose Veins

American Venous Forum